Electrophysiology Flashcards
Loop monitors are indicated in syncope when a … was negative.
24h Holter monitor testing
Carotid sinus hypersensitivity causing syncope is treated with
AV dual chamber PPM
A long RR interval followed by a short RR initiates …
torsades de pointes
… is associated with a peculiar ECG pattern consisting of a pseudo-RBBB and persistent ST segment elevation in V1 to V3 and a related disorder, the sudden unexpected nocturnal death syndrome (SUNDS).
Brugada syndrome
If Valsalva maneuver stops the arrhythmia, … and … should be considered.
SV tachycardia / AV node tachycardia
… are a better alternative to Holter monitoring, with better yield and when they fail to diagnoses arrhythmias, an implantable event recorder should be placed.
Transtelephone monitors
Patients older than 50 or with heart dz should have an ECG done before starting Rx with lithium because it can cause… .
sick sinus syndrome
The drugs of first choice in orthostatic hypotension are…
fludrocortisone (Florinef) and midodrine (ProAmatine).
In the patient with a WCT and subtle, non-rate-related fluctuations or variations in QRS and ST-T wave configuration suggest …
VT and may reflect variations in the VT reentrant circuit within the myocardium.
Early repolarization, in an athlete … require additional evaluation (European Society of Cardiology - Eur Heart J 2009;Dec 22).
does not
Post catheter based ASD closure, the most common longer term complication is …
device erosion (0.1%, typically with oversized devices).
… is reasonable for treatment of recurrent ventricular tachycardia in patients post-MI with normal or near normal ventricular function who are receiving chronic optimal medical therapy and who have reasonable expectation of survival with a good function
ICD implantation (Arrhythmias and the Prevention of Sudden Cardiac Death: ACC-AHA-ESC 2006 Guidelines)
An… (morphopathologic change) can be inferred from the presence of deep S in anterior leads and high R in the lateral leads.
enlarged LV diameter
A very low lead impedance (<250ohms) may indicate…
failure of lead insulation.
Lidocaine, a negative inotropic agent, can induce… in patients with total AVB.
asystole
Left posterior hemiblock is typically associated with a QRS axis of about…
+120°.
The antianginal therapy of choice in patients with supraventricular tachycardia is… (2 classes).
beta-blockers and nondihydropyridines (verapamil and diltiazem)
… is the only arrhythmic drug that has a beneficial effect on mortality and reduces the number of arrhythmic deaths in patients with low EF (CASCADE trial).
Amiodarone
After successful resuscitation of a cardiac arrest victim, this intervention is indicated if the patient remains comatose…
hypothermia at 32-34C.
Spontaneous VT without structural heart disease not amendable to drug therapy is class I indication for…
ICD therapy. (ACC/AHA/NASPE guidelines)
Patients with congenital long QT syndrome should have… available to take when having excessive sweating and diarrhea.
K+ supplement
Syncope of undetermined origin with EPS inducible VT/VF and ineffective drug therapy is class I indication for…
ICD therapy. (ACC/AHA/NASPE guidelines)
An unwitnessed in-hospital arrest with the initial rhythm not VT/VF and CPR for more than 10 minutes has a survival of… %.
0
The standard recommended dose for epinephrine is…
1mg IV q 3-5 minutes.
The standard recommended dose for atropine in ACLS is…
1mg IV q 3-5 minutes with maximum total 3mg.
The results of the ALIVE study show that… should be the drug of choice for shock resistant VF.
IV amiodarone
The immediate therapy in AF caused by pre-excitation with HR>250 or hemodynamic compromise is…
cardioversion.
In…, the anatomic substrate or abnormality is the presence of dual AV node pathways (slow and fast) each with slightly differing conduction and refractory periods.
AVNRT (AV node)
Patients with congenital long QT syndrome should not engage in…
competitive sport activities.
A dramatic improvement in the outcome of patients after CPR was obtained with… (CPR technique).
interposed abdominal compression
The usual dose of amiodarone is a… and infusion 1mg/min for 6 hours then 0.5mg/min to a maximum daily dose of 2 grams.
300mg rapid IV infusion with repeat 150mg doses PRN
… is the most effective drug for cholinergic-mediated bradycardia, hypotension and vagal reactions.
Atropine sulfate
A cardiac arrest due to VT/VF not related to a reversible cause is class I indication for…
ICD therapy. (ACC/AHA/NASPE guidelines)
Spontaneous sustained VT in association with structural heart disease is class I indication for…
ICD therapy. (ACC/AHA/NASPE guidelines)
In atypical AVNRT, the P wave is generally … in lead I
upright or isoelectric
Erythromycin has been shown to cause this EKG change…
prolong the QT interval
Mutations in the SCN2A gene (the gene that encodes the alpha subunit of the cardiac sodium channel gene, leading to Na channel inactivation) lead to two diseases associated with sudden death: one form of congenital long QT syndrome and the… syndrome.
Brugada
Because of the high success rate with catheter ablation in patients with AVN reentrant tachycardia, a… becomes the most common indication.
drug-free lifestyle
Symptomatic patients with WPW should undergo…
accessory pathway ablation.
A carotid hypersensitivity test is defined as cardioinhibitory when there is a pause greater then… seconds.
3
Antiarrhythmic agents with predominant… (Na channel blockers) are effective at converting and suppressing SVT and ventricular ectopy.
class I action
… is useful in atrial, AV junctional and ventricular tachyarrhythmias.
Quinidine
Class I action antiarrhythmic agents are associated with increased mortality in patients with…
structural heart disease.
… (drug) is particularly useful in AF with rapid conduction over an accessory pathway.
Procainamide
The correct way to check for carotid hypersensitivity is with the patient in upright position and pressing on the carotid bifurcation for… seconds.
5
Ibutilide is only available IV for the acute termination of…
AF/FL.
… (drug) is universally effective in reentrant arrhythmias that use the AVN as a portion of the circuit.
Adenosine
… is the most common form of paroxysmal SVT.
AVN reentrant tachycardia
The best indication for catheter ablation in patients with… is for the relief of symptoms in patients refractory or intolerant to vagal maneuvers and AVN blocking agents.
AVNRT
The cause of type I AV flutter is a… (direction) current around the tricuspid annulus seen from below the valve plane.
counterclockwise
After checking the ECG for LBBB and before checking for ST segment deviation, check for the …
RBBB
Systematic reviews have found that… reduces the risk of sudden death and marginally reduces mortality in people at high risk of arrhythmic death after myocardial infarction (based on low EF, frequent PVCs, or NSVT, but no history of sustained symptomati
amiodarone
One RCT has found good evidence that an… reduces mortality in people with heart failure who have experienced a near fatal ventricular arrhythmia.
implantable cardiac defibrillator
… is useless in the pre-excitation syndrome due to repolarization abnormalities.
Routine ECG stress test
Patients with QRSD>200ms on RV pacing for bradycardia and severely depressed EF and symptomatic CHF should be considered for…
CRT (cardiac resynchronization therapy).
If the diagnosis of pre-excitation syndrome is in doubt, recording an ECG during the administration of… exposes the accessory pathway conduction.
adenosine IV
The best candidates for… in AF are patients with frequent AF episodes and drug-refractory AF.
ablation
Patients in VT not responding to an antiarrhythmic drug should receive…
electrical cardioversion instead of other drug.
… is sustained AF, either resistant or not appropriate for, cardioversion.
Permanent AF
Typical… has a RBBB aspect with pseudo-r’ waves.
AVNRT
… is episodic AF caused by heavy alcohol consumption.
Holliday heart syndrome
In acute lead perforation, the lead should be…
withdrawn and repositioned.
… is the easiest IV drug to use for termination of a tolerated sustained VT.
Procainamide