Cardiac Arrhythmias Flashcards
arrhythmia
- variation in normal heartbeat
- rhythm
- rate
- conduction pattern
cause of arrhythmia
disorders of cellular automaticity and conductivity
what are some types of disorders that cause arrhythmia
- CV
- pulmonary
- autonomic
- systemic
arrhythmia is secondary to
- electrolyte imbalances
- foods
- drugs
classifications of cardiac arrhythmias
- supraventricular
- ventricular
examples of supraventricular arrhythmias
- sinus nodal disturbances
- disturbances of atrial rhythm
- heart block
examples of ventricular arrhythmias
- premature ventricular complexes
- ventricular tachycardia
- ventricular fibrillation
atrial fibrillation
rapid, disorganized, weak atrial contractions bombard the AV node
what does atrial fibrillation result in?
irregular, rapid ventricular contractions
a-fib pre-disposed pts to what?
blood clot
what happens if clot travels to RIGHT ventricle on pts with a-fib?
pulmonary embolism
what happens if clot travels to LEFT ventricle on pts with a-fib?
stroke
heart block
impulse slowed or blocked in AV node
what does heart block result in?
ventricles may generate a contraction (slower)
ventricular tachycardia
rapid, regular ventricular contractions
what does ventricular tachycardia result in?
inadequate ventricular filling/pumping to body
ventricular fibrillation
rapid, chaotic impulses
what does ventricular fibrillation result in?
fatal if not restored to normal sinus rhythm within minutes
symptoms of arrythmia
- palpitations
- dizziness
- syncope
- and those related to heart failure
arrythmia can precipitate what?
- heart failure
- MI
- stroke
treatment of arrhythmias depend on what?
- depends on symptoms
- type of arrhythmia
- and pt
treatment for bradycardia
implantable pacemakers
treatment for tachycardia
drugs to normalize rate
treatment for arrhythmias to correct irregularity
- antiarrhythmic drugs
- implantable cardioverter-defibrillators
- ablation
a-fib pts are at an increased risk for what?
stroke secondary to thromboembolism
mechanism of coumadin (warfarin)?
inhibit vitamin K-dependent coagulation factor synthesis
how is the coagulation tested for pts on coumadin?
INR
mechanism of pradaxa (dabigatran)?
antithrombin
mechanism for eliquis (rivaroxaban)?
direct factor Xa inhibitor
mechanism for savaysa (edoxaban)?
direct factor Xa inhibitor
a-fib is considered what type of risk?
MAJOR
*significant arrhythmias
which CV disease should you defer elective care for?
- high-grade AV blocks
- symptomatic ventricular rhythms
abnormal ECG and rhythm other than sinus is considered what type of risk?
minor
mods to dental treatment for pts with arrhythmia
- profound LA, limit epi
- stress reduction/decrease anxiety
- familiarity with implantable devices
- drug interactions
- post-procedure analgesia
what are you concerned about if you have to do surgery on a pt with a-fib?
bleeding if anticoagualted with warfarin
*pt will bleed on you if INR too high
when do you want an INR drawn?
at least 48 hours before appt
should you txt a pt if their INR is >3?
no treatment, talk to physician
should you txt a pt if their INR is <3?
yes
what is normal INR?
1-2