Bradyarrhythmias

Question 1

2 Sources of Bradys

Answer 1

Disorders of Impulse Formation (sinus brady, sinus sickness, SA exit block)
Disorders of AV Conduction (1-3 deg AV block)

Question 2

2 Pathologic Disorders of Impulse Formation

Answer 2

Fibrosis of sinus node

Drug Induced - BBs, Ca channel blockers, digoxin

Question 3

Sinus Rhythm P Wave (2)

Answer 3

P before QRS

+ in I, II, and vF

Question 4

Wandering Atrial Pacemaker

Answer 4

P wave goes inverse occasionally, maybe from other pacer taking over

Question 5

Sinus Exit Block

Answer 5

No P wave, so get AV junction rhythm or something

Question 6

Sick Sinus Syndrome

Answer 6

Group of arrhythmias which have sinus nodal dysfunction manifesting in periods of sinus bradycardias or pauses

Question 7

Afib QRS

Answer 7

Irregularly regular

Question 8

AV Nodal Block vs. His Purkinje Block Categories

Answer 8

First deg and second deg, Type 1 vs. Second deg, Type 2, High deg AV block, and 3rd deg AV block

Question 9

Decremental Conduction

Answer 9

AV node responds to increased impulses by prolonging conduction/blocking impulses under autonomic control. If by exercise, symp will cause AV conduction to increase. If artificially/(pathologically) set really high, AV will delay conduction for 1st or 2nd deg block

Question 10

First Deg AV Block

Answer 10

Increased PR interval. Each P still followed by QRS

Question 11

Wenckebach

Answer 11

2nd deg Type 1. PR interval longer successively until block

Question 12

2nd Deg AV Block Type 2

Answer 12

Block w/out PR prolongation, usually block in His-Purk so much more dangerous and probably needs pacemaker

Question 13

2:1 AV Block

Answer 13

Second deg, can’t tell Type 1 or 2 bc can’t see if PR prolongs before block

Question 14

Third Deg AV Block

Answer 14

No relationship b/w P and QRS. Block can be anywhere

Question 15

2 Medical Treatments for Bradys

Answer 15

Withhold AV nodal blocking agent (BBs, Ca channel, digoxin)

Beta agonists

Question 16

2 Pacemaker Types

Answer 16

Single Chamber (VVI) - chronic afib
Dual Chamber (DDD, DDI) - AV block. Tachy/brady syndrome

Question 17

Unipolar vs. Dipolar Pacing

Answer 17

Unipolar has cathode at the end and uses your own tissue/itself as anode vs. has cathode and anode at tip

Question 18

VVI Pacemaker Response to Intrinsic QRS

Answer 18

Inhibited if sensing properly