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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
Q

duration anticoagulation post CV

A

4 weeks at first

26
Q

new acc/aha 2023 AF guideline recommends who for rhythm control

3 points from CCS ?

A
  • reduced EF
  • sx AF to improve sx
  • recent dx to reduce progression
  • combination HF + afib
  • QOL impairment , arrythmia induced cardiomyopathy , mutiple recurrence
27
Q

which trial supports rhythm control in afib in CVD

A

east AFNET trial 2020

28
Q

HF <40%, which rhythm control

A

Amiodarone

29
Q

HF >40% , which rhythm control

A

Amiodarone + Sotalol

30
Q

af + CAD , which rhythm control

A

Amio + sotalol + dronedarone

31
Q

no HF, no CAD, which antiarrythmic

A

Amio + sotalol + dronedarone+ flecainide + propafenone

32
Q

what case do you give dronedarone

A

CAD
paroxymal or persistent AF ( not permanent)

33
Q

AF with WPW ?
- unstable

A

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
Q

class 1 indication for pacemaker n in bradyarrythmia

A

SCD prevention
symptomatic

35
Q

other pacemaker consideration in bradyarrhtyhmia ?not class II

A
  • uptittrate GDMT with benefit
  • syncope
36
Q

in young patients , ddx for bradyarrythmia ?

A
  • OSA
  • lyme
  • sarcod
  • genetics
  • electrolyte
  • thyroid
37
Q

for pmp w/ snus node dysfunction, what do you need ?

A

symptoms

38
Q

for pm with acquired AV block, do you need sx ?

A

no

39
Q

mobitsz type 1 ppm, ?

A

no

40
Q

if sarcoid, neuromuscular disease,
- if you need a PPM, what can you also consider and why ?

A

ICD - bcs risk of VT and sudden death

41
Q

when is PPM indicated d’emblee per ESC post MI

A
  • when AVB does not resolve within a waiting period of at least 5 days post MI
42
Q

is a alternating BBB an indication of PPM post MI ?

A

yes

43
Q

candidate for DDD?

A

complete heart block with intact sinus node function

44
Q

AAI candidate ?

A

someone with SSS but AV node conductionb is intact

45
Q

consequence of undersensing pacemaker

A

won’t inhibit anything. can have issues like r on T

46
Q

electrical storm ( vent arrhythmia) defined as what ?
meds to use

A

> 3 episodes
bb non selective, IV amiodarone

47
Q

if stable sustained VT , tx ?

A

DC cardioversion vs procainamide
Amidoarone vs lidocaine

48
Q

polymorphic vt/vf with normal QT
- if ischemia
- no ischemia

A

ACS tx + amio/lido
only amio ( lido for ischemia )

49
Q

prolonged QT with polymoirphic VT/VF , treatment ? if refractory- tx >

A
  • IV mg
  • overdrive pce
  • BB non selective
  • refractory : lidocaine
50
Q

in VT, lead to look for upright QRS?

A

AVR

51
Q

should we do carotid artery imaging in the absence of focal neurological findings in the context of syncope

A

no

52
Q

a tilt table test in syncope done with who

A

if there is a diagnostic uncertainty

53
Q

med option for recurrent and refractory VVS ?

A
  1. Fludrocortisone / Midodrine
  2. 2nd line is bb above 42Y
54
Q

cardiac pacing for vvs criteria ?

A
  • ++ 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
Q

Should you screen for PAD
- Who in that case ?

A
  • yes
  • adult >50 with RF ( smoking and db)
56
Q

antithrombotic meds for PAD

A

ASA + rivaroxaban 2.5 BID

57
Q

first line htn meds for PAD
target htn for PAD

A

acei/arb
140/90

58
Q

full anticoagulation + antiplatlet in stable chronic PAD?

A

no

59
Q

asymptomatic PAD - do we give antithrombotic ?

A

no

60
Q

for PAD - area to avoid endovascular repair ?

A

femoral
Femoral profundus

61
Q
A

cardio RC (4 decks)

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