Atrial Arrhythmias Book info

Question 1

3 basic mechanisms that are responsible for ectopic beats

Answer 1

Altered automaticity

Triggered activity

Reentry

Question 2

An excessively rapid heart rate may lead to ______ and may compromise cardiac output

Answer 2

myocardial ischemia

Question 3

PACs may be seen in people with:

Answer 3

emotional stress (caused by an increase in sympathetic tone)

Ingestion of certain substances such as alcohol, caffeine, or tobacco

Hypoxia

Electrolyte imbalances

myocardial ischemia

Ect.

Question 4

Infrequent PACs require NO treatment

Frequent PACs are treated by:

Answer 4

correcting the underlying cause:

reducing stress

reducing or eliminating the consumption of alcohol, tobacco, or caffeine

Administering oxygen

Correcting electrolyte imbalances

Treating congestive heart failure

discontinuing certain drugs

If needed frequent PACs may be treated with beta blockers, CCB, or anti-anxiety meds

Runs of PACS may require amiodarone to prevent more serious atrial arrhythmias from developing

Question 5

Where do all atrial arrhythmias start?

Answer 5

ectopic sites in the atria

Question 6

Premature atrial beats are common and can occur in individuals with a normal heart or in those with heart disease

Question 7

Atrial tachycardia may occur in people with healthy herts as well as those with diseased hearts.

It is the most common arrhythmia in _____

It has been associated with ingestion of substances such as:

Answer 7

children

caffeine, alcohol, or tobacco; anxiety; fatigue; electrolyte imbalances; lung disease; ect.

Question 8

During an episode of atrial tachycardia, many individuals can feel the palpitations , and this is a source of anxiety.

Question 9

Treatment of atrial tachycardia is directed toward:

Answer 9

controlling the ventricular rate and converting the rhythm

Question 10

Atrial Tachycardia

_______ is the treatment of choice in patients whose condition is unstable.

Signs and Symptoms of these patients include?

If the patient is stable, _____ may terminate the rhythm and slow the rate.

Answer 10

Cardioversion

Systolic BP less than 90
cool, clammy skin
reduced consciousness or cognitive function
reduced urine output
complaints of chest pain or dyspnea
exhibits signs of HF

Sedation

Question 11

If sedation is unsuccessful at terminating PAT, _____ work by slowing the heart rate through increasing parasympathetic tone

Answer 11

Vagal maneuvers:
squatting
breath-holding
carotid sinus pressure
stimulation of the gag reflex
immersion of the face in cold water

Question 12

If vagal maneuvers fail, administer:

Answer 12

adenosine IV x3

Question 13

If Vagal maneuvers or adenosine do not work, _____ and _____ drugs work by slowing the ventricular response

Answer 13

beta-blocker

calcium channel blockers (Amlodipine, -pine, Diltizamn)

Question 14

Atrial fluter typically originates in the ______ and is rarely seen in people with normal hearts.

This rhythm may be seen in patients with heart failure; decreased blood flow to the heart related to ischemia; cardiomyopathy; abnormalities of the heart valves, especially the mitral and tricuspid valves; septal defects of the heart; and following heart surgery. COPD. Stimulants.

Answer 14

right atrium

Question 15

Atrial flutter priority treatments include:

Answer 15

Controlling ventricular rate - beta blockers, CCB (diltiazem

Assessing anticoagulation needs- has it been greater than 48 hours, if so, the presence of blood clots should be assessed and treated with anticoagulants (heparin, coumadin)

Restoring Sinus rhythm- cardioversion or antiarrhythmic (amiodarone)

Question 16

Because the recurrence of atrial flutter is high with cardioversion, _____ is becoming the treatment of choice

Answer 16

radiofrequency catheter ablation

Question 17

Atrial fibrillation is a rapid, highly irregular heart rhythm caused by chaotic electrical impulses that arise from _______ sites in the atria, depolarizing at a rate greater than 400 beats per minute.

Answer 17

multiple ectopic

Question 18

Atrial fibrillation is the most common rhythm seen next to sinus rhythm.

It can occur in those with heart disease or in healthy individuals.

It may occur in episodes or be chronic in nature.

In healthy individuals, the rhythm is usually temporary and associated with _____ or ____

Other conditions include:

Answer 18

emotional stress or alcohol consumption

valvular disease, pulmonary disease, congestive heart failure
coronary artery disease, hypertension, heart surgery

Question 19

with artial flutter, the atria not contract strong enough to empty all the blood

With A. Fib, the atria quiver and do not contract at all

Both result in a loss of ___

Answer 19

atrial kick

Question 20

Treatment of A. Fib. includes

Answer 20

Controlling the heart rate

Providing anticoagulation as a prophylaxis for thrmoboembolism

Returning the atria to sinus rhythm

Question 21

Treatment protocols for A. fib are the same as those for atrial flutter:

Answer 21

Rate control should be achieved first using CCB (diltizem, or a beta-blocker.

If the rhythm is less than 48 hours old, cardioversion or an antiarrhthmic.

Greater than 48 hours, use anticoagulants

Question 22

Unstable atrial flutter and A fib should be cardioverted immediately, regardless of the duration of the arrhythmia.