Bradycardia

Question 1

Define Bradycardia

Answer 1

Failure of impulse initiation or conduction leading to slower HR <60

Question 2

What is the most common pathological bradycardia

Answer 2

SA node dysfuction and AV block

Question 3

What coronary arteries supply the SA node?

Answer 3

RCA and Lcx

Question 4

What are extrinsic vs intrinsic causes of SA node dysfunction

Answer 4

Extrinsic are often reversible: hypothyroidism, drugs, hypothermia, hypoxia, ETT suction, cardiac infections, amyloidosis

Intrinsic: Degenerative fibrotic changes in the SA node, typically caused by acute or chronic CAD

Question 5

What is Sick Sinus Syndrome (SSS)

Answer 5

Increase in fibrous tissue of the SA node
People at risk include: DM, CAD, HTN, vascular disease, cardiomyopathy

Question 6

What are A. Fib risk factors

Answer 6

Age, HTN, DM, heart disease, and ventricular pacing

Question 7

What are tachycardia bradycardia risk factors

Answer 7

> 65, CVA, vascular disease, LV dysfunction, arterial enlargement

Question 8

What are s/s of bradycardia

Answer 8

Palpitations, angina, heart failure, hypotension, syncope, fatigue, weakness

Question 9

SSS symptoms

Answer 9

Syncope and HF

Question 10

What in chronotropic incompetence

Answer 10

Inability for HR to increase in response to stressors

Question 11

What is the difference between sinus pauses and sinus arrest/exit block?

Answer 11

Sinus pause: The inability for the SA node to implement an impulse
Sinus exit block: the SA node implements an impulse but it can not conduct past the surrounding tissue. Maintains the same RR interval

Question 12

How to diagnose bradycardia of the SA node??

Answer 12

Clinical
EKG
Holster monitor or implantable EKG

Question 13

SA bradycardia treatment plan

Answer 13

Relieve symptoms
Treat extrinsic causes
Permanent pacer