Arrythmias

Question 1

What is an innappropriate bradyarrhythmia?

Answer 1

<60 bpm

Question 2

What is an innappropriate tachyarrhythmia?

Answer 2

> 100 bpm

Question 3

What is 3rd degree heart block?

Answer 3

Blocked connection between atria and ventricles

Question 4

What effect does 3rd degree heart block have on the cardiac rhythm

Answer 4

HR is slow, degree of slowing depends on location of block

Question 5

What are some of the causes of 3rd degree heart block?

Answer 5

Idiopathic bundle branch fibrosis, atherosclerotic coronary heart disease(ischaemia leading to damage), dilated cardiomyopathy

Question 6

What are the symptoms of 3rd degree heart block

Answer 6

Temporary syncope as heart stops, breathlessness, fatigue, chest pain (esp with effort)

Question 7

What would an ECG of a patient with 3rd degree heart block show?

Answer 7

Atrioventricular dissociation

Atria and ventricles beat independently of each other, QRS complex becomes dissociated from P wave

Question 8

What is AF

Answer 8

Chaotic atrial rhythm with rapid, irregularly irregular ventricular rhythm

Question 9

What are the risk factors for AF?

Answer 9

Atrial dilatation, HF, hypertension, excessive alcohol intake, old age, thyrotoxicosis

Question 10

What are the symptoms of AF?

Answer 10

Palpitations, breatlessness, dizziness, syncope

Question 11

What tests would be done to see if a patient has AF

Answer 11

ECG - would show atrioventricular dissociation
TFT
U&E’s

Question 12

What would an ECG of a patient with AF look like

Answer 12

Lack of P waves + irregularly irregular QRS complex

F wave present (fibirilatory wave) present instead)

Question 13

What is the anti-arrhythmic drug classification system called?

Answer 13

Vaugham Williams and Singh

Question 14

What is the Vaughan Williams and Singh drug classification system + examples

Answer 14

Class 1: Na channel blockers - suppress conduction - flecainide
Class 2: Beta blockers - reduce excitability - bisoprolol
Class 3: Drugs which prolong the refractory period - amiodarone
Class 4: Ca channel blockers - inhibit AVN conduction - verapamil

Question 15

What are Vaughan Williams and Singh class 1 drugs + example

Answer 15

Na channel blockers to supress conduction

Flacainide

Question 16

What are Vaughan Williams and Singh class 2 drugs + example

Answer 16

Beta blockers - reduce excitability

Bisoprolol

Question 17

What are Vaughan Williams and Singh class 3 drugs + example

Answer 17

Drugs which prolong the refractory period

Amiodarone

Question 18

What are Vaughan Williams and Singh class 4 drugs + example

Answer 18

Ca channel blockers to inhibit AVN conduction

Verapamil

Question 19

What is ventricular tachycardia

Answer 19

A run of rapid (120-200) successive ventricular beats caused by an ecopic site in one of the ventricles

Question 20

What causes ventricular tachycardia

Answer 20

Cardiac scarring after MI or dilated cardiomyopathy

Question 21

What will an ECG look like in a patient with ventricular tachycardia?

Answer 21

Either monomorphic VT or polymorphic VT (torsades de pointes)
AV dissociation

Question 22

What shape is polymorphic ventricular tachycardia on an ECG

Answer 22

Torsades de pointes

Question 23

Where is an implanted defibrillator placed?

Answer 23

Connected to electrodes in right ventricle and superior vena cava