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RCES RETEST- FINAL > AVNRT / AVRT > Flashcards

AVNRT / AVRT Flashcards

1
Q

What type of mechanism AVNRT?

A

Micro- Reentry

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2
Q

What are the two pathways of AVNRT?

A

Alpha & Beta

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3
Q

What is the Alpha pathway also known as?

A

Slow Pathway

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4
Q

Where is the slow pathway located?

A

Close to the CS os

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5
Q

Does the slow pathway have a long or short refractory period?

A

Short Refractory

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6
Q

What is the Beta pathway also known as?

A

Fast pathway

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7
Q

Where is the fast pathway located?

A

By the tricuspid annulus superior to the Triangle of Koch

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8
Q

Does the fast pathway have a long or short refractory period?

A

Long Refractory

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9
Q

What is the typical pathway for AVNRT?

A

Slow- fast

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10
Q

Explain the conduction of typical AVNRT.

A

Conduction antegrate down the slow pathway then retrograde up the fast pathway

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11
Q

What is the atypical pathway for AVNRT?

A

Fast- Slow

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12
Q

Explain the conduction of atypical AVNRT.

A

Conduction antegrate down the fast pathway then retrograde up the slow pathway

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13
Q

What does a short refractory period mean?

A

It means that it takes a shorter time until it is able to conduct again

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14
Q

What does a long refractory period mean?

A

It means it takes a longer time until it is able to conduct again

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15
Q

What does antegrate conduction mean?

A

Conduction from the atria to the ventricles

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16
Q

What does retrograde conduction mean?

A

Conduction from the ventricles to the atria

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17
Q

What are the treatment options for AVNRT?

A

RF ablation, Vagal Manuvers, Medication, or cardioversion

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18
Q

How do you induce AVNRT?

A

PES Pacing

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19
Q

How do you terminate AVNRT?

A

Adenosine

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20
Q

What is the end goal of a RF ablation for AVNRT?

A

Destroy the slow/ alpha pathway

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21
Q

How do you know if you RF ablation is successful in AVNRT?

A

A slow junctional rhythmn

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22
Q

*****What do you do if you see a fast junction rhythm after an ablation and what causes this?

A

Stop ablation and this is caused because you are too close to the AV node

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23
Q

What type of mechanism is AVRT?

A

Macro- reentry

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24
Q

What does AVRT use to get from the ventricles back to the atria?

A

The bundle of Kent

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25
Q

What is the most common form of AVRT?

A

Wolff- parkinson- white (WPW)

26
Q

Is WPW an antidromic or orthodromic AVRT and why?

A

AVRT is an orthodromic AVRT because it had a narrow QRS

27
Q

What are the indications of WPW?

A

A short PR interval and delta waves on the ECG.

28
Q

Does orthodromic AVRT have a wide QRS or a Narrow QRS?

A

Narrow

29
Q

Does orthodromic AVRT conduct antegrade or retrograde?

A

Antegrade

30
Q

Does antidromic AVRT have a wide QRS or a Narrow QRS?

A

Wide

31
Q

Does antidromic AVRT conduct integrate or retrograde?

A

Retrograde

32
Q

What is the most common medication given to patients with WPW?

A

Amiodarone

33
Q

Can a manifest pathway conduct antegrate, retrograde, or both?

A

Both

34
Q

Can a concealed pathway conduct antegrate, retrograde, or both?

A

Retrograde only

35
Q

Will you see delta waves on AVRT that has a manifest pathway, a concealed pathway, or both?

A

Manifest pathway only

36
Q

What structures are involved in the AVRT circuit?

A

Atria, Ventricles, AV node, and AP

37
Q

On an ECG how do you tell if the AP in AVRT is right or left sided?

A

A + delta wave on V1 means left sided, a - delta wave on V1 means right sided

38
Q

(-) delta on V1 left or right sided?

A

right sided

39
Q

(+) delta on V1 left or right sided?

A

Left sided

40
Q

Left or right sided AP; “V” spike on HRA will proceed the “V” spike on HIS

A

Right sided

41
Q

Left or right sided AP; “V” spike on the CS will proceed the “V: spike on HIS

A

Left sided

42
Q

Left or right sided AP; VA interval increases with RBBB

A

Right sided

43
Q

Left or right sided AP; VA interval increases with LBBB

A

Left sided

44
Q

What is the goal on an ablation for AVRT?

A

Eliminate the delta wave

45
Q

How do you terminate AVRT?

A

Adenosine

46
Q

What catheters are used in an EP study for AVRT?

A

HRA, HIS, CS, RVA

47
Q

Where do you ablate for AVNRT?

A

Below the AV node

48
Q

What do you want to ensure you never do and why?

A

Ablate the HIS, this will cause a complete heart block and the patient will need a PPI

49
Q

What are contraindications for preforming a carotid massage on a patient?

A

Stroke or TIA in the past 3 months, MI in the past 3 months, or coronary artery disease

50
Q

What is the cardioverson energy used for AVNRT?

A

50-100J

51
Q

How do you tell slow- fast AVNRT on an ECG?

A

P waves are hidden in the QRS

52
Q

How do you tell fast- slow AVNRT on an ECG?

A

P waves are retrograde after the QRS

53
Q

How do you tell if an EGM is displaying AVNRT?

A

There will be an AH jump, the V and A will line up, there will be a wide QRS

54
Q

How do you tell the best place to ablate AVNRT based on an EGM?

A

There will be a fractionated signal on the ablation catheter

55
Q

For AVRT if a patient asymptomatic would you proceed with an ablation?

A

No, only if the patient is not symptomatic

56
Q

For WPW what is the first line of treatment if the patient is stable?

A

A cardioverson

57
Q

What meds should you avoid in a patient with WPW?

A

dixogin, verapamil, diltiazem, and beta blockers

58
Q

How do you induce AVRT?

A

PES Pacing

59
Q

What population is AVRT most common in?

A

Younger men

60
Q

On an EGM how do you know if you are in/ on the AP?

A

There will be a fusion

61
Q

How do you know if you are testing for AP ERP on an EGM?

A

There will be an “A” spike but no “V” spike

62
Q

what is parahisian pacing used for?

A

Helps differentiate septal AVRT from AVNRT

RCES RETEST- FINAL (21 decks)

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