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cardio RC > Arrythmia > Flashcards

Arrythmia Flashcards

1
Q

when is rhuthm control prefered ?

A
  1. QOL impaired
  2. Concurrent HF
  3. hemodynamically unstable ( DC cardioversion)
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2
Q

AF tx with preexcitation ?

A

DC cardioversion
Procainamide

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3
Q

VKA + afib
- should be used for who (3)
- should be considered for who ( 1)

A
  • mech valve, rheumatic MS, mod-severe non rheumatic MS
  • <3 months post valve replacement ( surgical/percutaneous)
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4
Q

OAC for stage 4 CKD w afib

A

rivaroxaban
Apixab

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5
Q

can they receive anticoag or antiplt therapy for AF in stage 5 ckd ?

A

no . guideline says no routine anticoagulation therapy or antiplatelet therapy for AF

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6
Q

stage 4 CKD, what does CCS recommend ?

A

DOAC over VKA

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7
Q

elective PCI w/o high risk features for thrombotic CV events + AF : tx ?

A

OAC + Clopidogrel for 1-12 months post PCI
and then go directly for OAC

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8
Q

ACS w/ PCI or eletive PCI with hgih risk features for thrombotic CV events + AF

A

triple therapy : 1D -1 month
Dual therapy : oac + clopido ad 12 months post
and then directly gof ro OAC

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9
Q

ACS without PCI + AF

A

Dual therapy : OAC + clopidogrel for 1-12 months post ACS and then OAC

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10
Q

AFIB+ stable CAD w/ chads 0

A

SAPT ( or ASA + low dose rivaroxaban)

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11
Q

Per what study do they consider ASA + low dose rivaroxaban in afib + stable CAD/PAD ? to reduce what ?

A

Compass trial to reduce CV mortality !!!!

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12
Q

afib chads >0 + stbale CAD/PAD . tx ?

A

OAC only . prefer doac > VKA

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13
Q

chads 0 afib + low risk thrombotic events/elective PCI ( no acs)

A

DAPT for 6-12M (or 1-3 months if high risk bleeding)

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14
Q

chads >0 afib + low risk thrombotic events/elective PCI ( no acs)

A

dual pathway
SAPT ( P2Yinhb) + OAC for 1-12 months –> OAC alone forever

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15
Q

chads 0 afib + high risk thrombotic events/ACS w/ PCI .

A

DAPT

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16
Q

chads >0 afib + high risk thrombotic events/ACS w/ PCI .

A

triple therapy 1-30D
Dual therapy ad 12 months
OAC alone after words

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17
Q

INR target if VKA post high risk elective PCI ?

A

2-2.5

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18
Q

what’s the only OAC studied after ACS without PCI ?

A

Apixaban 5 mg po BID

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19
Q

AF anticoagulation in cancer : OAC vs VKA ?

A

DOAC

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20
Q

do you give OAC for patient with thyrotoxicosis ? if so how long

A

until euthyroid state
yes

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21
Q

which pregnant woman w/ AF should be considered for anticoagulation

A
  1. AF + structural heart disease
  2. AF + non structural heart disease + chads >1
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22
Q

which anticoag to use in pregnancy ?

A

LMWH
warfarin

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23
Q

why not doac in pregnancy

A

crossesa the placenta

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24
Q

when do you anticoagualte atrial high rate episodes

A

> 24H AHRE with chads 2+ ( equiv to risk of chads 1+)
5min-24H AHRE with chads 3 +

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25
duration anticoagulation post CV
4 weeks at first
26
new acc/aha 2023 AF guideline recommends who for rhythm control 3 points from CCS ?
- reduced EF - sx AF to improve sx - recent dx to reduce progression - combination HF + afib - QOL impairment , arrythmia induced cardiomyopathy , mutiple recurrence
27
which trial supports rhythm control in afib in CVD
east AFNET trial 2020
28
HF <40%, which rhythm control
Amiodarone
29
HF >40% , which rhythm control
Amiodarone + Sotalol
30
af + CAD , which rhythm control
Amio + sotalol + dronedarone
31
no HF, no CAD, which antiarrythmic
Amio + sotalol + dronedarone+ flecainide + propafenone
32
what case do you give dronedarone
CAD paroxymal or persistent AF ( not permanent)
33
AF with WPW ? - unstable
electrical cardioversion if unstable Stable : IV procainamide or ibutilide or electrical CV if stable ( restore SR preferred > rate control, avoid AV nodal blocking agents in pts with evidence of ventricular pre excitation)
34
class 1 indication for pacemaker n in bradyarrythmia
SCD prevention symptomatic
35
other pacemaker consideration in bradyarrhtyhmia ?not class II
- uptittrate GDMT with benefit - syncope
36
in young patients , ddx for bradyarrythmia ?
- OSA - lyme - sarcod - genetics - electrolyte - thyroid
37
for pmp w/ snus node dysfunction, what do you need ?
symptoms
38
for pm with acquired AV block, do you need sx ?
no
39
mobitsz type 1 ppm, ?
no
40
if sarcoid, neuromuscular disease, - if you need a PPM, what can you also consider and why ?
ICD - bcs risk of VT and sudden death
41
when is PPM indicated d'emblee per ESC post MI
- when AVB does not resolve within a waiting period of at least 5 days post MI
42
is a alternating BBB an indication of PPM post MI ?
yes
43
candidate for DDD?
complete heart block with intact sinus node function
44
AAI candidate ?
someone with SSS but AV node conductionb is intact
45
consequence of undersensing pacemaker
won't inhibit anything. can have issues like r on T
46
electrical storm ( vent arrhythmia) defined as what ? meds to use
> 3 episodes bb non selective, IV amiodarone
47
if stable sustained VT , tx ?
DC cardioversion vs procainamide Amidoarone vs lidocaine
48
polymorphic vt/vf with normal QT - if ischemia - no ischemia
ACS tx + amio/lido only amio ( lido for ischemia )
49
prolonged QT with polymoirphic VT/VF , treatment ? if refractory- tx >
- IV mg - overdrive pce - BB non selective - refractory : lidocaine
50
in VT, lead to look for upright QRS?
AVR
51
should we do carotid artery imaging in the absence of focal neurological findings in the context of syncope
no
52
a tilt table test in syncope done with who
if there is a diagnostic uncertainty
53
med option for recurrent and refractory VVS ?
1. Fludrocortisone / Midodrine 2. 2nd line is bb above 42Y
54
cardiac pacing for vvs criteria ?
- ++ symptomatic and above 40 - documented sx asystole > 3 sec - documented asx asystole > 6 sec - tilt table induced asystole >6 sec or HR <40 bpm for >10s
55
Should you screen for PAD - Who in that case ?
- yes - adult >50 with RF ( smoking and db)
56
antithrombotic meds for PAD
ASA + rivaroxaban 2.5 BID
57
first line htn meds for PAD target htn for PAD
acei/arb 140/90
58
full anticoagulation + antiplatlet in stable chronic PAD?
no
59
asymptomatic PAD - do we give antithrombotic ?
no
60
for PAD - area to avoid endovascular repair ?
femoral Femoral profundus
61

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