Cardiac Arrhythmia Dr Opaleye

Question 1

What is cardiac electrophysiology?

Answer 1

A subspecialty of cardiology that focuses on the study and management of heart rhythm disorders.

Question 2

What are cardiac arrhythmias?

Answer 2

Abnormal heart rhythms that can be too fast, too slow, or irregular.

Question 3

What are the five phases of the cardiac action potential?

Answer 3

Phase 0: Rapid upstroke, Phase 1: Early repolarization, Phase 2: Plateau, Phase 3: Late repolarization, Phase 4: Resting potential.

Question 4

What is the primary function of the sinoatrial (SA) node?

Answer 4

It acts as the heart’s natural pacemaker by generating rhythmic impulses.

Question 5

What are the three primary mechanisms of tachyarrhythmias?

Answer 5

Enhanced automaticity, triggered activity, and re-entry.

Question 6

What is re-entry in cardiac arrhythmias?

Answer 6

A condition where an electrical impulse continuously circulates within a loop, causing sustained arrhythmia.

Question 7

What is the most common cause of atrial fibrillation?

Answer 7

Ectopic foci from the pulmonary veins.

Question 8

What is the hallmark ECG finding in atrial fibrillation?

Answer 8

Irregularly irregular rhythm with absent P waves.

Question 9

What is the first-line therapy for stable atrial fibrillation with rapid ventricular response?

Answer 9

Rate control with beta-blockers or calcium channel blockers.

Question 10

What is the ECG finding in Torsades de Pointes?

Answer 10

A polymorphic ventricular tachycardia with a characteristic twisting of the QRS complexes.

Question 11

What are the Vaughan Williams classes of antiarrhythmic drugs?

Answer 11

Class I: Na+ channel blockers, Class II: Beta-blockers, Class III: K+ channel blockers, Class IV: Ca2+ channel blockers.

Question 12

Which antiarrhythmic drug has properties of all Vaughan Williams classes?

Answer 12

Amiodarone.

Question 13

What is the most common cause of ventricular fibrillation?

Answer 13

Ischemic heart disease.

Question 14

What is the primary treatment for ventricular fibrillation?

Answer 14

Immediate defibrillation and CPR.

Question 15

What is the treatment for unstable supraventricular tachycardia (SVT)?

Answer 15

Immediate synchronized cardioversion.

Question 16

What is the recommended drug for acute termination of narrow-complex SVT?

Answer 16

Adenosine.

Question 17

What electrolyte imbalance is most commonly associated with Torsades de Pointes?

Answer 17

Hypokalemia and hypomagnesemia.

Question 18

What is the first-line treatment for symptomatic bradycardia?

Answer 18

IV atropine.

Question 19

What is the role of catheter ablation in arrhythmia treatment?

Answer 19

Used to eliminate arrhythmogenic foci, especially in atrial fibrillation and AVNRT.

Question 20

What is the purpose of an implantable cardioverter-defibrillator (ICD)?

Answer 20

To detect and treat life-threatening ventricular arrhythmias.

Question 21

What is the mainstay of long-term anticoagulation in atrial fibrillation?

Answer 21

Direct oral anticoagulants (DOACs) or warfarin.

Question 22

What is the CHADS₂-VASc score used for?

Answer 22

Assessing stroke risk in atrial fibrillation patients.

Question 23

What is the primary goal in treating atrial fibrillation?

Answer 23

Stroke prevention and rate or rhythm control.

Question 24

What is the first-line treatment for acute ventricular tachycardia in stable patients?

Answer 24

IV amiodarone or procainamide.

Question 25

What is the preferred treatment for symptomatic Wolff-Parkinson-White (WPW) syndrome?

Answer 25

Catheter ablation of the accessory pathway.

Question 26

What is the hallmark ECG finding of WPW syndrome?

Answer 26

Short PR interval, delta wave, and widened QRS complex.

Question 27

What is sick sinus syndrome?

Answer 27

Dysfunction of the SA node causing alternating bradycardia and tachycardia.

Question 28

What is the key difference between atrial flutter and atrial fibrillation?

Answer 28

Atrial flutter has a regular sawtooth pattern; atrial fibrillation is irregular.

Question 29

What condition presents with syncope and a 'family history of sudden death'?

Answer 29

Long QT syndrome or Brugada syndrome.

Question 30

What is the best test to confirm Brugada syndrome?

Answer 30

ECG showing ST elevation in V1-V3, often unmasked with a sodium channel blocker.

Question 31

What arrhythmia is commonly associated with hyperthyroidism?

Answer 31

Atrial fibrillation.

Question 32

What lifestyle modifications help prevent atrial fibrillation recurrence?

Answer 32

Weight loss, reducing alcohol intake, and managing hypertension.

Question 33

What is the first-line treatment for catecholaminergic polymorphic ventricular tachycardia?

Answer 33

Beta-blockers without intrinsic sympathomimetic activity.

Question 34

What is the gold-standard diagnostic test for arrhythmias?

Answer 34

Electrophysiologic (EP) study.

Question 35

What arrhythmia is commonly associated with COPD?

Answer 35

Multifocal atrial tachycardia.

Question 36

What is the classic ECG finding in junctional rhythms?

Answer 36

Absent or inverted P waves with a narrow QRS complex.

Question 37

What is the treatment for symptomatic bradycardia?

Answer 37

Atropine, pacing, or addressing the underlying cause.

Question 38

Which antiarrhythmic drug should be avoided in structural heart disease?

Answer 38

Flecainide.