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RCES self assessment > EGM assessment of arrhythmias > Flashcards

EGM assessment of arrhythmias Flashcards

1
Q

What is Chronic AFL associated with?

A

Underlying heart disease

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2
Q

What is the acute management of AFL?

A

Cardioversion

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3
Q

What are the two types of cardioversions?

A
  • Electrical (<50J)
  • Chemical (IV ibutilide, amiodarone, sotalol, or Class IV)
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4
Q

What is the treatment of choice for AFL?

A

ablation of the cavotricuspid isthmus (CTI)

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5
Q

What would we do for a patient when a CTI ablation has failed?

A

AVN ablation with pacemaker

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6
Q

What other than rate control do we need to be concerned about with AFL?

A

Stroke prevention therapy with asparin or warfarin

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7
Q

During BBB, most frequently RBBB, how can flutter beats be conducted?

A

Aberrantly

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8
Q

What are the two segments of RA endocardium?

A

anterolateral trabeculated posterior smooth-walled

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9
Q

Where is the crista terminalis located?

A

descends the lateral wall from the anterior septal aspect of the SVC to the inferior lateral aspect of the IVC

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10
Q

Where is the inferior tricuspid annulus located?

A

a short distance (1 to 4 cm) anterior to the eustachian ridge

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11
Q

Where is the CS ostium located?

A

medial to the orfice of the IVC at the base of the RA posterior septum

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12
Q

What is the activation sequence of counterclockwise AFL present?

A
  1. UP the RA septal wall
  2. ACROSS the roof of RA
  3. DOWN the lateral wall of RA
  4. ACROSS the tricuspid isthmus
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13
Q

What can chronic AFL degenerate into?

A

A. Fib

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14
Q

What does fib-flutter resemble on an EGM?

A

variable CL

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15
Q

How can AFL/Afib be induced?

A

single atrial extra/incremental A. stimulus during RRP

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16
Q

How can you differentiate between intra-atrial tach and AFL?

A

the rate and termination

  • AFL = 220 - 350 ms.
    • terminated: rapid pacing
  • intra-atrial = 120 - 220 ms.
    • termination: single premature impulse
17
Q

What is the activation sequence of clockwise AFL?

A
  1. DOWN the RA septal wall
  2. ACROSS the tricuspid isthmus
  3. UP the RA lateral wall
  4. ACROSS the roof of the RA
18
Q

Other than typical and atypical flutter, name three other types of AFL?

A
  1. Double-wave re-entry
  2. lower loop re-entry
  3. intra-isthmus re-entry
19
Q

What type of AFL is considered Atypical?

A

clockwise

20
Q

What type of AFL is considered typical?

A

counterclockwise

21
Q

Which type of AFL can be induced with pacing in the CS?

A

CCW

22
Q
A

typical or counterclockwise AFL

23
Q
A

Atypical or clockwise AFL

24
Q

Name the 3 types of scenarios for entrainment pacing for AFL.

A
  1. PPI-TCL = <30ms AND no change in atrial activation (concealed entrainment)
  2. PPI-TCL = <30ms AND change in atrial activation (manifest entrainment)
  3. PPI - TCL = >30ms AND change in atrial activation (manifest entrainment)
25
Q

What is manifest entrainment?

A

PPI-TCL = <30ms

Pacing site is within the flutter circuit, but not in the isthmus

26
Q

Name the 3 types of AVNRT

A
  1. slow-fast
  2. slow-slow
  3. fast-slow
27
Q

What are the characteristics of a jump beat?

A

>50 ms in the AH interval

28
Q

How does AVNRT present of an EGM?

A

Stacked V waves when in the tachycardia

29
Q

What is the pattern of activation for AVNRT?

A

H-VA

30
Q

When burst pacing in the ventricle, what is the VA interval for AVNRT?

A

<85ms

31
Q

When burst pacing in the ventricle, what is the VA interval for AVRT?

A

<85 ms

32
Q

When burst pacing in the ventricle you see the response: A-A-V, what is the arrhythmia?

A

AT

33
Q

What’s the difference between WPW pattern and syndrome?

A

WPW syndrome is associated with symptoms

34
Q

What is a major difference between manifest BTs and concealed BTs?

A

concealed BTs are only capable of retrograde conduction

35
Q

When V1 is positive with a delta wave, where would we look for an accesory pathway?

A

left sided

RCES self assessment (11 decks)

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