Arrythmias Flashcards

1
Q

Arrhythmias are described in terms of

A

rate and site of origin

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2
Q

Rate

A

Bradycardias

Tachycardias

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3
Q

Site of origin

A

Supraventricular

Ventricular

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4
Q

alterations in impulse formation involve

A

Changes in automaticity

Triggered activity

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5
Q

abnormalities in impulse conduction arise from

A

Re-entry
Conduction block
Accessory tracts

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6
Q

Partial conduction block

A

Slowed conduction

Tissue conducts all impulses, but more slowly than usual

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7
Q

First degree block

A

longer PR interval

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8
Q

Intermittent block

A

Tissue conducts some impulses but not others

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9
Q

2 types of 2nd degree heart block

A

Mobitz Type 1

Mobitz Type 2

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10
Q

Mobitz Type 1

A

PR interval gradually increases from cycle to cycle until AV node fails completely and a ventricular beat is missed

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11
Q

Mobitz Type 2

A

PR interval is constant but every nth ventricular depolarisation is missing
Missing R waves

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12
Q

Complete heart block

A

No impulses conducted through affected area

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13
Q

Accessory pathway

A

Electrical pathway parallel to AV node

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14
Q

Bundle of Kent

A

Impulse through bundle of Kent is quicker than through AV node
Ventricles receive impulses from both normal and accessory pathways

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15
Q

Ventricular arrhythmias occur

A

Origin is ventricle

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16
Q

Supraventricular arrhythmias occur

A

Origin is above ventricle

(SA node, atria, AV node,

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17
Q

Ectopic beats

A

Beats originating in places other than SA node

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18
Q

A normal action potential may trigger abnormal oscillations in membrane potential called

A

afterdepolarisations

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19
Q

Repeated afterdepolaristaions can cause

A

an arrhythmia

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20
Q

Early afterdepolarisation

A

Occur when heart rate is slow

Can lead to Torsades de Pointes

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21
Q

Delayed afterdepolarisation

A

Occur when heart rate is fast

Triggered by drugs increasing Ca++ influx

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22
Q

1st degree heart block story

A

Wife (P) waits at home

Husband (QRS) comes home late every night but at the same time

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23
Q

2nd degree heart block Type 1 story

A

Wife (P) waits at home

Husband (QRS) comes home later and later every night until one day he doesn’t come home at all

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24
Q

2nd degree heart block Type 2 story

A

Wife (P) waits at home

Husband (QRS) sometimes comes home, sometimes doesn’t

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25
Q

Complete heart block story

A

Wife (P) no longer waits at home
She and husband (QRS) are on separate schedules and have no relationship
Requires ‘counselling’ from a permanent pacer

26
Q

Rhythm control classes

A

I and III

27
Q

Rate control classes

A

II and IV

28
Q

Class I

A

Reduce Na channel current

29
Q

Class II

A

B-adrenergic antagoinsts

30
Q

Class III

A

Action potential prolongation

31
Q

Class IV

A

Ca channel antagonists

32
Q

Supraventricular Tachycardias

A

Atrial Fibrillation
Atrial Flutter
Ectopic atrial tachycardia

33
Q

Supraventricular Bradycardia

A

Sinus bradycardia

Sinus pauses

34
Q

Ventricular arrhythmias

A

Ventricular ectopics
Ventricular tachycardia
Ventricular fibrillation
Asystole

35
Q

AVN node arrhythmias

A

AVN re-entry tachycardia
AV reciprocating tachycardia
AV block

36
Q

Re-entry

A

Requires more than one conduction pathway with different speed of conduction

37
Q

Symptoms of Arrhythmias

A
Palpitations
SOB
Dizziness
Syncope
Presyncope
Sudden cardiac death
Angina
38
Q

Investigations of arrhythmias

A

ECG
CXR
Echo
Stress ECG, 24 hour ECG

39
Q

Sinus Bradycardia

A

< 60 bpm
Athlete
Drugs (B blocker)

40
Q

Treatment for sinus bradycardia

A

Atropine

Pacing

41
Q

Sinus tachycardia

A

> 100 bpm
Anxiety, fever, hypotension
Illegal drugs

42
Q

Treatment of sinus tachycardia

A

Treat underlying cause

B blockers

43
Q

Atrial ectopic beats

A

Asymptomatic or palpitations
No treatment
Avoid stimulants

44
Q

SVT management

A
Acute = IV adenosine, IV veramapril
Chronic = B blockers, anti-arrhythmics
45
Q

Causes of AVN conduction disease (heart block)

A
Age
MI
Myocarditis
Drugs
Genetic
46
Q

Treatment for 1st degree heart block

A

none

47
Q

Types of pacemaker

A

Single chamber or dual chamber (replaces RA and RV)

48
Q

Ventricular fibrillation

A

chaotic ventricular electrical activity causing heart to loose ability to function as a pump

49
Q

Treatment of V fib

A

Defibrillation

Cardiopulmonary resuscitation

50
Q

Atrial Fibrillation

A

Chaotic and disorganised atrial activity
Irregular heartbeat
Can be paroxysmal, persistant or chronic

51
Q

AF termination

A

Anti-arrhythmic drugs
DCCV
Spontaneous reversion to sinus rhythm

52
Q

Paroxysmal AF

A

Less that 48 hours

53
Q

Persistant

A

More than 48 hours

Reacts to drugs

54
Q

Chronic

A

Inability of pharmacological methods to restore

55
Q

A fib symptoms

A
Palpitations
Presyncope
Syncope
Chest pain 
Dyspnea
Sweatiness
Fatigue
56
Q

ECG of AF

A

Irregularly irregular

Absence of P waves

57
Q

Management of AF

A

Rhythm control
Rate control
Anti-coagulation

58
Q

Rate control drugs

A

Digoxin
B blockers
Veramapril

59
Q

Rhythm control drugs

A

DCCV

60
Q

Atrial flutter

A

Rapid and regular form of atrial tachycardia
Paroxysmal
Seconds to years

61
Q

Atrial flutter ECG

A

Saw tooth

62
Q

Atrial flutter treatment

A

Pharmacological
Cardioversion
Warfarin