Arrythmias

Question 1

Steps in EKG assessment

Answer 1

Mantra
Stable or unstable 
Too fast or too slow 
Wide or narrow 
Regular or irregular 
P waves

Question 2

Common tachycardias

Answer 2

Sinus tachy
A fib or a flutter
SVT- AVNRT and AVRT
Ventricular tachy

Question 3

Narrow complexes (<0.12/0.08 in children) examples

Answer 3

SVT- AVNRT and AVRT
Afib
MAT

block the AV node

Question 4

Wide complexes mean

Answer 4

Vtach
ischemia
electrolyte abnormalities
drug toxicity

Question 5

Irregular means

Answer 5

SVT (likely afib)
block the av node
not vtach

Question 6

P wave after qrs “retrograde” is

Answer 6

SVT

Question 7

No p wave is

Answer 7

a fib

Question 8

Narrow regular

Answer 8

Sinus tachy
Atrial tachy
SVT- AVRT and AVNRT
A flutter

Question 9

Narrow irregular

Answer 9

A fib
MAT (multifocal atrial tachycardia)
A flutter w block

Question 10

Wide regular

Answer 10

V tach

SVT w aberrancy

Question 11

Wide irregular

Answer 11

V tach

Irregular SVT w aberrancy

Question 12

AVNRT vs AVRT HR

Answer 12

AVNRT- HR 180-200

AVRT- >200

Question 13

AVRT-

Orthodromic WPW vs Antidromic WPW

Answer 13

O- down av node, retrograde up accessory bypass track

A- down accessory tract and up av node (wide and looks like vt)

Question 14

AVNRT

Answer 14

circus within av node

Question 15

HR of 150 2:1 is

Answer 15

a flutter- macro reentry - rate 150

Question 16

Vagal maneuver will slow

Answer 16

sinus or avnrt

Question 17

Adenosine will unmask

Answer 17

flutter wave

Question 18

AVNRT usually happens in

Answer 18

young healthy women
not associated with heart disease
alcohol, caffeine, stimulants

Question 19

AVRT- WPW treatment

Answer 19

Procainamide- do not block the av node

Or electricity

Question 20

Fast, narrow and unstable treatment

Answer 20

50-100 j

Question 21

Fast, narrow and stable treatment

Answer 21

Block the av node

Convert- adenosine
Control rate- av node blockers (CCB, BB or Amiodraone)

Question 22

Afib and flutter treatment

Answer 22

Rate control (CCB- Diltiazem, Amiodarone) OR 
Rhythm conversion + anticoagulation 

ER- conduction (rate) control > conversion- especially if Afib >48hrs and not anti-coagulated

Question 23

What is sustained vt?

Answer 23

More than 30 seconds

Question 24

V tach treatment

Answer 24

Amiodarone then cardio version

Unstable= shock w 200j

Question 25

V fib treatment

Answer 25

Chest compressions early then shock until rhythm established

Meds

• epi
• vasopressin
• Amiodarone
• mag

Question 26

PVCs characteristics

Answer 26

No p wave
Wide QRS- premature
ST and T wave segment are in opposite direction of QRS *
Found in health and ischemia

Question 27

Bradycardias examples

Answer 27

Sinus Brady
SA blocks
AV blocks- 2nd degree mobitz 2, 3rd degree
Sick sinus syndrome

Question 28

1st degree and 2nd degree type 1 av node relationship

QRS?

Answer 28

Above av node
Narrow QRS
Not significant

Question 29

Which two rhythms should you be cautious about ever stopping unless you know there is no av block ?

Answer 29

Idioventricular

Atrioventricular

Question 30

2nd degree block type 2 (Mobitz) QRS

Answer 30

May be wide
Or dropped
(Same PR intervals)

Question 31

Narrow Bradys are

Answer 31

More stable
Atropine sensitive
Block av node

Question 32

Wide Bradys

Answer 32

Block below av node
Slower
Degrade to asystole
Not atropine sensitive

Question 33

Mobitz 2 and CHB treatment

Date

Answer 33

Transcutaneous pacing (TCP)
Atropine- up to 3 g
Dopamine- chronotrop
Epi