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Y1 Cardiovascular > Arrythmias > Flashcards

Arrythmias Flashcards

1
Q

what are the two types of arrhythmias and what difference is there between them?

A

supraventricular (origin above the ventricle)

ventricular (origin in the ventricle)

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2
Q

name two types of supraventricular arrhythmias

A

SVT

bradycardia

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3
Q

what arrhythmias are SVT’s?

A

atrial fibrillation
atrial flutter
ectopic atrial tachycardia

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4
Q

name four ventricular arrhythmias

A

premature ventricular complexes (PVC)
ventricular tachycardia
ventricular fibrillation
asystole

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5
Q

what is another name for premature ventricular complexes?

A

ventricular ectopics

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6
Q

name three AV node arrhythmias

A

AVN re-entry tachycardia (AVNRT)

AV re-entrant tachycardia (AVRT)

AV block

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7
Q

what are the different types of AV block?

A

1st-3rd degree

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8
Q

what is an ectopic beat?

A

a beat/rhythm that originates outwith the SA node

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9
Q

what two things can cause an ectopic beat?

A

altered automaticity e.g. in ischaemia

triggered activity e.g. caused by digoxin

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10
Q

how does re-entry work to cause an arrhythmia?

A

has more than one conduction pathway, each with different speeds of conduction

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11
Q

name three things that can cause re-entry in the heart

A

accessory pathway tachycardia (WPW)

previous MI

congenital heart disease

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12
Q

what triggers re-entry?

A

an ectopic beat

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13
Q

when does an ectopic rhythm take over the intrinsic, sinus rhythm?

A

when it becomes faster than sinus rhythm

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14
Q

what is triggered activity

A

when a small depolarisation higher than threshold occurs in phase 3 of the AP causes a sustained train of depolarisations

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15
Q

what mechanism underlies digoxin toxicity, torsades de pointes and hypokalaemia?

A

triggered activity

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16
Q

name investigations done for arrythmias

A

ECG (+ exercise ECG + 24 hour recording)
CXR
ECHO
electrophysiological study

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17
Q

what does an ECG look for in arrythmia?

A

assesses the rhythm

looks for previous MI and pre-excitation

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18
Q

what condition does pre-excitation occur in?

A

wolff parkinson white

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19
Q

what is an electrophysiological study for arrythmias?

A

an arrhythmia is induced to study its mechanism and trace it

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20
Q

what effect does inspiration have on heart rate and how?

A

increases heart rate as it reduces vagal tone

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21
Q

what is bradycardia?

A

heart rate under 60bpm

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22
Q

who might have physiological bradycardia?

A

athletes

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23
Q

what drug is used to treat sinus bradycardia?

A

atropine

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24
Q

what is used to treat sinus bradycardia if there is a haemodynamic compromise?

A

pacemaker

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25
Q

what is tachycardia?

A

heart rate over 100bpm

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26
Q

how is sinus tachycardia treated?

A

treat underlying cause

give beta blockers

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27
Q

how are atrial ectopic beats treated?

A

beta blockers may help

avoid stimulants i.e. coffee and cigarettes

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28
Q

what causes AVNRT?

A

a re-entry circuit within the AVN

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29
Q

what makes up acute management of SVT?

A

increase vagal tone

IV adenosine and IV verapamil

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30
Q

what can be done to increase vagal tone?

A

valsalva manoeuvre

carotid massage

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31
Q

what is involved in the management of chronic SVT?

A

avoid stimulants
radiofrequency ablation
beta blockers
antiarrhythmic drugs

32
Q

name two drugs that can cause heart block

A

beta blockers

calcium channel blockers

33
Q

what happens in first degree heart block?

A

the conduction following each P wave takes longer

34
Q

what is different in the ECG of someone with first degree heart block?

A

longer PR interval than normal

35
Q

what happens in second degree heart block?

A

intermittent block at the AVN causing dropped beats

36
Q

what are the two types of second degree heart block?

A

mobitz I

mobitz II

37
Q

what happens in mobitz I heart block?

A

progressive lengthening of the PR interval, eventually causing a dropped beat

38
Q

what happens in mobitz II heart block?

A

some action potentials fail to get through the AVN

39
Q

how is mobitz II treated?

A

permanent ventricular pacing

40
Q

what happens in type 3 heart block?

A

no action potentials from the SA node get through the AV node

41
Q

how is type 3 heart block treated?

A

ventricular pacing

42
Q

what are the two types of pacemakers and which is used for AVN disease ?

A 
single chamber 
dual chamber (used for AVN disease)
43
Q

how does a single chamber pacemaker work?

A

paces the RA/R V only

44
Q

how does a dual chamber pacemaker work?

A

paces the RA + RV

maintains AV synchrony

45
Q

how are ventricular ectopics treated?

A

beta blockers

ablation of focus

46
Q

what are the two types of VT?

A

monomorphic

polymorphic

47
Q

name two inherited arrhythmia syndromes that can cause VT?

A

long QT

brugada

48
Q

what is ventricular fibrillation?

A

chaotic ventricular electrical activity which causes the heart to lose the ability to pump

49
Q

how is VF treated?

A

defibrillation

CPR

50
Q

what is the long term treatment for VF?

A

implantable cardioverter defibrillators (ICD)

VT catheter ablation

51
Q

what is atrial fibrillation?

A

chaotic and disorganised atrial activity

52
Q

what are the three types of AF?

A

paroxysmal
persistent
permanent

53
Q

what is paroxysmal AF?

A

lasts less than 48 hours

often recurrent

54
Q

what is persistent AF?

A

an episode lasting more than 48 hours, that can be cardioverted to NSR

55
Q

what is permanent AF?

A

AF where no methods can restore NSR

56
Q

what is the most common sustained arrhythmia?

57
Q

what three ways can AF be terminated?

A

pharmacological cardioversion

DCCV

spontaneous reversion to NSR

58
Q

how does AF result in reduced cardiac output?

A

diastole shortened

atrial kick lost

59
Q

what might AF cause, especially if cardiac output is reduced?

A

congestive heart failure

60
Q

ventricular rates above which value suggest an AV conduction disease?

61
Q

what is another name for lone AF?

A

idiopathic AF

62
Q

what is lone AF?

A

AF in the absence of heart disease and ventricular dysfunction

63
Q

what is there a risk of in AF in elderly patients?

64
Q

what rate is commonly seen upon ECG of AF?

A

over 300bpm

65
Q

describe the rhythm of AF

A

irregularly irregular

66
Q

what can be seen on ECG of AF?

A

no P waves

67
Q

what are the two possible goals of AF treatment?

A

rate control

rhythm control

68
Q

what is atrial flutter?

A

a rapid and regular form of atrial tachycardia

69
Q

name a class I antiarrhythmic drug

A

lignocaine

70
Q

name a class II antiarrhythmic drug

A

propranolol

71
Q

name a class III antiarrhythmic drug

A

amiodarone

72
Q

name a class IV antiarrhythmic drug

73
Q

how does a class I antiarrhythmic work?

A

reduces sodium channel current

74
Q

how does a class II antiarrhythmic work?

A

beta adrenergic antagonist

75
Q

how does a class III antiarrhythmic work?

A

prolongs action potential

76
Q

how does a class IV antiarrhythmic work?

A

calcium channel antagonists

77
Q

what sustains atrial flutter?

A

a macro re-entrant circuit in the RA

Y1 Cardiovascular (22 decks)

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