ARRYHTHMIA Flashcards
is a problem with the rate of rhythm of the heartbeat(Irregular heartbeat). During an arrhythmia, the heart can beat too fast, too slow, or in irregular rhythm.
Arrhythmia
Heartbeat that is too slow
Bradycardia
Heartbeat that is too fast
Tachycardia
5 elements of cardiac conduction system
Sino atrial node
Atrioventricular node
Bundle of His
Purkenji Fibers
Bundle of Branches
It is the impulse that signals the heart to contract
Sinoatrial node
P wave
Contraction of atria
QRS wave
Contraction of ventricles
T wave
Repolarization of ventricles
Phase 0 aka
Upstroke
Phase 0
Opening of Na gated channel
Phase 1 aka
Early Fast Repolarization
Phase 1
Closing of Na, Opening of K, Cl channel
Phase 2 aka
Plateu phase
Phase 2
Sustained inward movement of calcium, outward movement potassium
Phase 3 aka
Repolarization Phase
Phase 3
Sustained opening of K Channel, Closed Ca Channel
Phase 4 aka
Resting phase
Phase 4
Diastole all channel are closed
Is a rapid heart rate that is caused by electrical impulses that orginate above the hearts ventricls
Supraventricular Tachycardia
Supraventricular Tachycardia aka
Paroxymal Supraventricular Tachycardia
Most common type of arrythmia
Atrial fibrillation
Similar to atrial fibrillation, spread through atria
Atrial flutter
It is an uncommon and distinctive form of polymorphic supraventricular tachycardia
Torsades de Pointes
An extra or so called accessory pathway exist in the upper and lower chamber of the heart
WOFF PARKINSONS WHITE SYNDROME
Class 1
Na channel blockers
Class 2
Beta blockers
Class 3
Potassium channel blocker
Class 4
Calcium channel blocker
Class 1A
Dysopyramide
Quinidine
Procainamide
Class 1B
Mexiletine
Tocainide
Lidocaine
Class 1C
Moricizine
Flecainide
Propafenone
Anticholinergic moderate
Quinidine
Quinidine S/E
Cinchonism
Cinchonism
Blurred vision, Tinnitus, Headache, Psychosis
Enhances Digitalis toxicity
Quinidine
Anticholinergic short half life
Procainamide (Pronestyl)
Procainamide S/E
SLE
Drug second choice for most sustained ventricular arrthymias with MI
Procainamide (Pronestyl)
Anticholinergic Strong
Dysopyramide (Norpace)
Dysopyramide S/E
Negative inotropic effect
Decrease action potential duration
Class IB
Weakly inhibits phase O
Class IB
Used in Post arrthymia
Class IBy
Toxic metabolite of Lidocaine
Monoethyl Glycine Xylidide, Glycine Xylidide
Strongly inhibits Phase O
Class IC
Use in paroxymal atrial fibrillation
Class IC
Terminate ventricular tachycardia and prevent ventricular fibrillation after cardioversion
Lidocaine
Orally active congeger of lidocaine used in ventricular arrythmia chronic pain syndrome
Mexiletine
Undergo firstpass hepatic metabolism
Lidocaine
Lidocaine toxicity
Neurologic symptoms
Orally active weak b blocking activity supraventricular arrythymia
Propafenone
Phenothiazine derivative orally active withdrawn in US
Moricizine
Class II
Propranolol, Esmolol
B adrenoreceptor blockade
Propranolol
Propranolol duration
4-6hrs
Propranolol toxicity
Asthma, AV blockade, acute heart failure
Short acting IV only use for intraoperative
Esmolol
Class 3
Amiodarone (Cordarone)
Class 3 halflife
40-50days
Amiodarone toxicity
Hyperthyroidism
Stiffening of the lungs
Corneal deposits
Bluish discoloration of nail
Use in serious ventricular and supraventricular arrthymias
Amiodarone
Investigational
Vernakalant
Amiodarone derivative reduce mortality
Dronedarone