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Cardiac Electrophysiology I > Fogoros Homework > Flashcards

Fogoros Homework Flashcards

1
Q

What does Mobitz II AV block indicate?

A

distal AV block

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2
Q

What does Phase 2 of the AP correlate to on the surface EKG?

A

ST segment

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3
Q

Where is the site of Wenckebach AV block usually located?

A

localized to the AV node

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4
Q

What does HV interval measure?

A

conduction through the His - Purkinje system

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5
Q

Name evaluations done in an EP study

A
  1. Assess function of the SA node, Av node and purkinje system
  2. Mapping the locaiton of arrhythmogenic foci
  3. Evaluation efficacy of antyiarrhythmic drugs or devices
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6
Q

How do you calculate Cycle Length to Heart rate?

A

60 000 divided by cycle length

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7
Q

Where can AV block originate from?

A
  1. within the AV node
  2. distal to the AV node in the His Bundle
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8
Q

What is the inward moving depolarization ion in the Cardiac Muscle?

A

Sodium

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9
Q

Which interval is prolonged if the block is within the AV node?

A

AH interval

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10
Q

In the extrastimulus technique, what is S2?

A

After the drive train S1 a single premature beat is initiated called S2

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11
Q

What is the equation for Corrected Sinus Node Recovery Time?

A

cSNRT = SNRT - BCL

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12
Q

What is the couplign interval?

A

the time between the lst normal impulse and premature impulse
S1 - S2

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13
Q

What are 2 uses for an electrode catheter?

A
  1. recoding
  2. pacing
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14
Q

How is the refractory period of cardiac tissue defined in the EP lab?

A

terms of the tissue’s response to premature paced impulses

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15
Q

Define overdrive suppression of the SA node

A

When an automatic foci (SA node) can be overdriven by a more rapidly firing pacemaker

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16
Q

What measurement is used to asses the automaticity of the SA node?

A

SNRT
Sinus Node Recovery Time

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17
Q

What does the coupling interval (S1 - S2) that produces block in the AV node represent?

A

AVNERP

AH lengthens until S2 is blocked

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18
Q

What does Phase 0 of the AP correlate to on a surface EKG?

A

QRS

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19
Q

Name the two pacing methods used to evaluate the AV conduction system

A
  1. Extrastimulus pacing
  2. Incremental pacing
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20
Q

What phase of the AP is generally recorded on the electrogram?

A

Phase 0

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21
Q

What is the outward moving repolarizing ion in a cardiac muscle cell?

A

Potassium

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22
Q

What are the three basic components of the PR interval?

A
  1. PA interval / intraatrial conduction
  2. AH interval
  3. HV interval
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23
Q

What ion mediates the rapid upstroke of the AP?

A

Sodium

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24
Q

Which interval is prolonged if the block is below the AV node?

A

HV interval

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25
Q

In most EP labs, what measurement of the SNRT is considered abnormal ?

A

> 1500 ms

26
Q

Which type of AV block is a normal phenomenon with rapid atrial pacing?

A

Wenchebach

27
Q

What is the most common mechanism for tachyarrhythmias?

A

Reentry

28
Q

Define extrastimulus pacing.

A

PES - introducing one or more premature impulses at preprogrammed intervals

29
Q

Which intracardiac electrogram is most valuable in assessing ht evarious types of AV nodal block?

A

His Bundle Electrogram

30
Q

What are the three mechanisms for tachyarrhythmias ?

A
  1. Automaticity
  2. Triggered
  3. Re entry
31
Q

What is the EP equivalent of heart rate?

A

cycle length

32
Q

What ion accounts for the plateau phase of the AP?

A

Calcium

33
Q

What part of the action Potential curve determines the speed of conduction?

A

Phase 0

34
Q

What does the AH interval measure?

A

Conduction time through the AV node

35
Q

Define incremental pacing.

A

introducing a train of paced impulses at a fixed cycle length

36
Q

What type of block is potentially lethal?

A

AV block occuring distally to the AV node

37
Q

True or False:
Each membrane channel is selective for its particular ion.

A

True

38
Q

What causes phase 0 depolarization in a cardiac muscle cell?

A

rapid influx of Sodium into the cell

39
Q

At what mV do the m gates open allowing Na+ ions to rush into the cell? What do we call this level?

A

-60 mV
Threshold membrane potential

40
Q

What is the basic unit of time in EP?

A

Milliseconds (ms)

41
Q

What is the primary benefit for slowing of the impulse through the AV node?

A

Allows for complete atrial emptying before the electrical impulse reaches the ventricles

42
Q

What is the resting potential of a cardiac muscle cell?

A

-80 to -90 mV

43
Q

What electrode distance provides very focused view of tissue?

A

2mm

44
Q

What should the EGM be recording?

A

Depolarization

45
Q

What does high bandpass filter do?

A

Allows for higher frequencies to be displayed by rejecting filters below

46
Q

What is the typical high bandpass filter cutoff?

A

30 Hz

47
Q

What does a low bandpass filter do?

A

everything below 30 Hz is cut out

48
Q

What is often the low bandpass filter cutoff frequency?

A

500Hz

49
Q

What is the typical range for high-low bandpass filtering?

A

30 - 500Hz

50
Q

What is the nomenclature that refers to an 8 beat pacing train?

A

S1

51
Q

What does S4 represent ?

A

Indicates the third premature response

52
Q

Describe unipolar

A
  1. one electrode within the heart recording
  2. more information
  3. not as specific
53
Q

Describe bipolar recording

A
  1. voltage difference between 2 electrodes within the heart
  2. more specific
54
Q

What happens when a wave of depolarization goes toward a positive electrode?

A

positive deflection

55
Q

What does the maximum negative slope in a unipolar recording coincide with?

A

the arrival of the depolarization wavefront directly beneath the electrode

56
Q

What other electrogram finding helps the ablation to be more precise?

A

point of earliest activation on a unipolar matching with bipolar

57
Q

How are low-frequency oscillations removed?

A

by high pass filtering that attenuates the frequencies that are slower than the specified cut off

58
Q

What does low pass filtering reduce?

A

attenuate frequencies that are slower than the specified corner frequency (200 - 500Hz)

59
Q

What can a notch filter eliminate?

A

reduce electrical noise introduced by the frequency of common AC current (50 or 60 Hz)

60
Q

How do most antiarrhythmic drugs work?

A

by affecting the shape of the action potential

61
Q

Which class of drugs affects the rapid sodium channel?

A

Class 1

62
Q

What percentage of the population has Torsades de Pointes?

A

3-4%

Cardiac Electrophysiology I (15 decks)

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