Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SPR2015_Week2 > Clincial Treatment of Arrhythmia > Flashcards

Clincial Treatment of Arrhythmia Flashcards

1
Q

The last portion of the PR interval is represented by conduction time through ____

A

bundle branches and Purkinje

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Two types of arrhythmias
- too slow called?

  • too fast called?
A

too slow = bradyarrhythmia

too fast = tachyarrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of SA node bradyarrhythmia (4)

A

1) sinus bradycardia
2) sinus arrest/pause
3) tachy-brady syndrome
4) chronotropic incompetence (can’t make appropriate HR with exercise)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define Sinus bradycarida

A

SA node <60 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define sinus arrest

A

pause in rate of SA node firing

failure of sinus node discharge –> absence of atrial depol and ventricular asystole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

with sinus arrest, there is ____ betwen pause and cycle length

A

NO RELATIONSHIP BETWEEN PAUSE AND CYCLE LENGTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

brady-tachy syndrome

A

intermittent episode of slow and fast rates from SA node or atria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how does brady-tachy manifest

A

atrial tachycarida, flutter, fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what occurs after stopping tachycardia?

A

long pauses from SA node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

define chronotropic incompetence

A

cannot incr heart rate with exercise

oscillation of HR with activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of AV node bradyarrhythmia

A

1st degree AV block

Mobitz 1 2nd degree AV block (Wenkebach)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define 1st degree AV block

A

AV conduction delayed

prolonged PR interval (>200 ms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define 2nd degree AV block

A

atrial depol sometimes don’t reach ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define 2nd degree AV block - Mobitz 1 (Wenckebach)

A

progressive prolonging of PR interval until ventricular beat dropped (no QRS)

QRS usually normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Types of conduction problems below AV node (infranodal= His PUrkinje)

A

Mobitz II 2nd degree AV block

Complete heart block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define Mobitz II 2nd degree AV block

A

intermittent dropped ventricular beats preceded by constant PR interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how to separate Mobitz 1 vs. 2

A

Mobitz 1 = difference btwn PR interval > 0.02 sec

Mobitz 2 = difference between PR interval < 0.02 sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define 3rd degree block = complete heart block

A

no conduction from atria to ventricles

no relationship btwn P and QRS waves (variable PR interval)

initiate new QRS below AV node
40-60 = His bundle initiate
<40 = Purkinje fiber initiate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

when should you be concerned about bradyarrhythmia

A

1) when patient symptomatic

2) when rhythm is infranodal (below AV node) –> can become 3rd degree block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Steps of treating brayarrhythmia chronic

A

1) find and treat reversible causes - ischemia/infarct/hypothyroidism/neuro/Lyme
2) stop offending meds (antiarryhtmic, clondiine, lithium..)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Steps of treating bradyarrhythmia

acute treatment for unstable

A

beta agonist (dopamine/isoproteronol)

transcutaneous pacing (esp if infranodal)

temporary transvenous pacing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Steps of treating bradyarrhythmia

long term

A

pacemaker

23
Q

Two types of tachyarrhythmia

A

above ventricle = supraventricular tachycardia

at ventricle = v-tach, v-fib

24
Q

Types of irregular SVT

A

1) atrial fibrillation = no discrete P
2) multifocal atrial tachycardia = 3+ P
3) atrial flutter = variable conduction + flutter waves

25
Q

what is a regular SVT?

A

1:1 P:QRS

26
Q

How to treat SVT

A

1) if unstable (hypotension/HF) = shock/cardiovert
2) if stable and irregular SVT, rate control, antiarrhythmic, or cardiovert
3) if stable and regular SVT, ADENOSINE (block AV node transiently to see P waves) to diagnose

27
Q

5 C’s of Afib

A

1) cause: Reverse
2) control rate
3) antiCoagulation
4) control rhythm
5) cure: ablation

28
Q

Causes of Afib

A

1) HTN
2) Ischemic heart disease
3) mitral valve disease
4) alcohol
5) cardiomyopathies
6) hyperthyroidism
7) lone AF = 14%

29
Q

Immediate treatment options for AFib

A

1) cardiovert = for unstable patients

2) control rates

30
Q

How to control rhythm in AFib via cardioversion

A

1) Electrical = DC shock 70-90% day procedure with sedation

2) pharm = less successful, no sedation
Class 3
Class 1C

31
Q

Maitenance of rhythm control in Afib

A

Class 1C (contraindicated in CAD and structural heart disease)

Class 3

ALWAYS Anticoagulation due to thromboembolism risk

32
Q

Rate control in AFib

A

1) beta blocker (good with exercise)
2) digoxin (not good with exercise)
3) verapamil
4) diltiazem
5) amiodarone (esp with decomp heart failure)

33
Q

side effect of rate control meds

A

heart block

34
Q

rhythm control via cardiac ablation

A

target triggers = mainly left atrium

35
Q

atrial flutter treatment

A

similar to Afib

catheter ablation better than meds; can be curative

36
Q

which has lower risk of ablation, atrial flutter or afib

A

atrial flutter

37
Q

how to perform atrial flutter ablation

A

target isthmus in right atrium btwn tricuspid valve and IVC

to block circuit causing atrial flutter

38
Q

Other SVT

A

1) AV node reentry tachycardia
(circuit in AV node)

2) accessory pathway mediated tachy
3) focal atrial tachycardia

39
Q

define accessory pathway mediated tachcyardia

A

abnormal connection btwn atrium and ventricle

40
Q

define focal atrial tachycardia

A

abnromal focus of atrial tissue with incr automaticity “hotspot”

41
Q

how to treat “other SVT’s”

A

1) nonpharm = vagal

2) meds only for symptoms
- beta blocker, Ca2+ ch blocker for AV node

  • class 1 to decr ectopic foci
    3) cardiac ablation
42
Q

define: ventricular tachyarrhythmia

A

wide complex tachy

43
Q

if patient has coronary artery disease, 90% of the time the wide complex tachycardia is ____

A

ventricular tachycardia

44
Q

acute treatment for stable v-tach

A

meds = amiodarone, lidocaine, procainamide

treat underlying cause

45
Q

acute treatment for UNSTABLE v-tach

A

SHOCK!!!!!!

treat underlying cause

meds

46
Q

long term treatment for v-tach WITH NO STRUCTURAL HEART DISEASE

A

1) usu idiopathic = focal benign trigger
2) use meds/ablation

RARELY DEFIBRILLATOR USED

47
Q

long term treatment for v-tach WITH STRUCTURAL HEART DISEASE

A

1) treat underlying cause

2) USE DEFIBRILLATOR because sudden death

48
Q

where do v-tachyarrhythmias arise?

A

outflow tracts of RV or LV

49
Q

what meds to use for v-tachyarrhythmias?

A

1) beta blocker
2) ca2+ channel blocker
3) class 1C
4) class 3

50
Q

when is defibrillator needed for v-tachycarrhythmias?

A

1) if pt has sudden cardiac arrest due to VT or VF w/o reversible cause

2) risk of MI
- ischemic heart disease, EF<35%

ischemic disease, EF 35-40% + inducible VT

HCM, cardiac sarcoid, congenital heart disease, ARVC

51
Q

Difference betwn defibrillator implant and pacemaker

A

leads of defib = coils

52
Q

Sudden Cardiac Death cause

A

due to ventricular fibrillation

53
Q

treatment for sudden cardiac death

A

bystander basic life support

early defib with an external defibrillator

54
Q

if greater than 2 risk factors then blood thinner for afib is ____

A

warfarin

SPR2015_Week2 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions