Electrophysiology

Question 1

Typical flutter

Answer 1

Counterclockwise. Down in 2,3 and avf.

Question 2

Cardio version for Afib/flutter

Answer 2

Ok within 48 hours. Otherwise need to wait 3 weeks or negative tee. Need to stay on afterwards.

Question 3

What is optimal rate control

Answer 3

Less than 100 or less than 120 with exercises

No need to intervene in pauses unless symptoms.

Question 4

Af Chf trial

Answer 4

No difference in rate versus rhythm control in any outcomes with pharmacologic therapy.

Question 5

Andromeda

Answer 5

More deaths in HF patients on dronederone

Question 6

Av junctional ablation in HF patient

Answer 6

Do crrt

Question 7

Guidelines for stable vt

Answer 7

Procainamide or amiodarone.

Nexterone no hypotension

Question 8

Most common cause of polymorphic vt

Answer 8

Bradycardia and ischemic

Question 9

Secondary prevention trials

Answer 9

Avid, cids and cash

Rrr of 30%

Question 10

Differences between madit 2 and scd heft

Answer 10

Madit prior mi ef < 30

Both showed a rrr of around 30%

Question 11

Cabg patch

Answer 11

No benefit post cabg

Guideline: no icd for primary prevention within 90 days of revascularization

Question 12

Indications for icd primary prevention

Answer 12

Madit ef < 30, prior mi
Nyha class 2,3 ef <35 3 months minimum after dx

Question 13

Trials to establish CRT

Answer 13

Companion: optimal med therapy vs CRT pacing, CRT d.
Resynch decreased heart failure
care HF: just pacing still improved outcomes. Including sudden death.

Question 14

How does scar impact CRT

Answer 14

Less scar the better. Non ischemics better than ischemics

Question 15

Indications for CRT

Answer 15

Qrs >130
Ischemic class I or non ischemic class II

Question 16

How to optimize CRT

Answer 16

1. Fix anything you can

2. Are they lv pacing?

Question 17

Lv pacing on EKG

Answer 17

R/s > 1 n v1

R/s in 1 < 1

Question 18

When not to do icd

Answer 18

Cabg or pic within 3 months
Acute mi within 40 days
Candidate for revascularization.

Question 19

Madit CRT
Enrollment
Primary outcome

Answer 19

Class I HF
Ef 130
Either death or HF events

Question 20

Avid cash and cids
What wre they
Which ones in HF patients
Rrr?

Answer 20

Avid was in low Ef
AICD versus antiarrhythmics
Arr around 7%

Question 21

Madit 1
Groups
Arr

Answer 21

Hx of Icshemic with Ef <35
Asymptomartic Nsvt with inducible vt
Arr 19%

Question 22

Scd heft
Inclusion
Results:

Answer 22

Ischemic or non ischemic
Ef < 35%
Class 2-3
Arr 7 Nnt 14

Question 23

Companion

Answer 23

CRT d vs CRT p vs control in EF 120

Both improved outcomes. No mortality benefit

Question 24

Which icd CRT trial improved mortality

Answer 24

Care hf

Question 25

What stage b patients should get icd? What stage b patients should get CRT?

Answer 25

NYHA class I Ef< 30
NYHA class 2 or ischemic class 1 lvef < 30 and qrs >130

Question 26

Ace and aspirin

Answer 26

Should use