Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

BNF INTRODUCTIONS > INTRODUCTION TO ARRHYTHMIAS > Flashcards

INTRODUCTION TO ARRHYTHMIAS Flashcards

1
Q

Electrocardiography is esential in managing arrhythmias T/F

A

True

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

Management of an arrhythmia requires precise diagnosis of the type of arrhythmia T/F

A

True

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

If a patient had ectopic beats abdominal normal heart, what is the general management

A

Treatment is rarely required and reassurance will suffice
Beta blockers are safer than suppressant drugs

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

Treatment aims for atrial fibrillation

A

Reduce symptoms
Prevent complications especially stroke

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

Two approaches to managing atrial fibrillation

A

Rhythm control (restore and maintain sinus rhythm)
Rate control (controlling ventricular rate)

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

Ablation strategies are considered in atrial fibrillation when……

A

Drug treatment has failed

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

In A. Fib, referral is made within how many weeks when cardioversion and drug treatment fails

A

Within 4 weeks

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

All patients with life- threatening haemodynamic instability caused by new onset atrial fibrillation should undergo…….

A

Emergency cardioversion without delaying to achieve anticoagulation

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

In A. Fib patients without life- threatening haemodynamic instability, what approach is preferred when onset is less than 48 hours and when onset is nore than 48 hours

A

<48 hours - rate or rhythm control
>48 hours or uncertain - rate control

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

Drugs used when urgent rate control is needed in A. Fib acute presentation

A

IV Beta blockers

Rate limiting -CCB( eg. Verapamil if LVEF is 40 or more)

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

Methods of cardioversion

A

Pharmacological
Electrical

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

Is cardioversion a rhythm or rate control strategy

A

Rhythm control strategy

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

Drugs for pharmacological cardioversion

A

Flecainide
Amiodarone

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

Among amiodarone and flecainide, which cannot be used in structural or ischemic heart disease patients

A

Flecainide is not used but Amiodarone is used

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

When is electrical cardioversion preferred to chemical

A

When atrial fibrillation has been present for more than 48 hours

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

How long should a patient be anticoagulated before electrical cardioversion

A

At least 3 weeks

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

How long is anticoagulation done after cardioversion

A

Right after cardioversion and continued for at least 4 weeks

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

If anticoagulation for 3 weeks before electrical cardioversion isn’t possible, what should be done

A

Rule out a left thrombus
Give a parenteral anticoagulation (heparin) immediately before cardioversion

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

Prior to cardioversion, patients should not be on rate control therapy. T/F

A

False

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

What is the regimen for amiodarone as a rate control therapy before and after cardioversion

A

Amiodarone HCl 4 weeks before and continued for 12 months after electrical cardioversion to maintain sinus rhythm

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

When is rate control not preferred as a first line treatment strategy in atrial fibrillation

A
  1. New-onset atrial fibrillation
  2. Atrial flutter suitable for ablation strategy
  3. Atrial fibrillation with reversible cause
  4. Heart failure caused by atrial fibrillation
  5. Rhythm control more suitable based on clinical judgement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Sotalol is used to control ventricular rate in atrial fibrillation

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Drugs for controlling ventricular rate in atrial fibrillation

A

Beta blockers
Non-DHP- CCB
Digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Factors that’ll affect choice of rate control drug in atrial fibrillation

A

Symptoms
Heart rate
Comorbidities
Patient preference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
When is Digoxin monotherapy considered for ijitial rate control
Patients with non-paroxysmal atrial fibrillation who are predominantly sedentary or when other rate limiting drugs are unsuitable
26
Combination therapy for atrial fibrillation and when it is indicated
Combination of any 2 of digoxin, beta blocker and Non-DHP CCB Used when monotherapy is ineffective
27
What is the next option when combination rate control drugs is not effective in A fib
Rhythm control
28
Preferred rate control combination therapy in heat failure (LVEF < 40%) patientd with A fib
Beta blocker and Digoxin
29
Rhythm control regimen post cardioversion
Beta blocker except sotalol as first line Alternative drugs Amiodarone Flecainide Propafenone Sotalol
30
Anti arrhythmic drugs avoided in structural heart disease or ischemic heart disease
Flecainide Propafenone
31
Amiodarone can be used in heart failure or left ventricular impairment T/F
True
32
Dronedarone is considered as a second line rhythm control drug in……
Persistent or paroxysmal atrial fibrillation
33
Pill-in-the-pocket approach can be used in patients with…….
Infrequent episodes of symptomatic paroxysmal atrial fibrillation
34
What is the pill-in-the-pocket approach
Patient takes an oral antiarrhythmic drug to self-treat an episode of atrial fibrillation
35
Factors the determine when to stop anticoagulation in atrial fibrillation
Patient preference Stroke and bleeding risk Arrhythmia
36
Score for assessing stroke risk in A fib
CHA2DS2VASc score
37
Score for assessing bleeding risk in atrial fibrillation before anticoagulation
ORBIT risk tool
38
CHA2- DS2- VASc risk tool parameters
C - Congestive heart failure - 1 H - Hypertension - 1 A- Age of 75 or more - 1 D- Diabetes - 1 S- Stroke/TIA/Thromboembolism - 2 V- Vascular disease - 1 A- Age - 65- 75 - 1 S - Sex (female)- 1
39
CHA2- DS2- VASc risk tool interpretation
Give anticoagulation if score is 2 or more Consider anticoagulation in men if score is 1
40
When is Parenteral anticoagulation with heparin given in atrial fibrillation
New-onset atrial fibrillation who are receiving subtherapeutic or no anticoagulation therapy, until assessment is made and appropriate anticoagulation is started
41
When is oral anticoagulation given in confirmed atrial fibrillation
1. Stable sinus rhythm has not been successfully restored within 48 hours of onset 2. Risk of stroke outweighs risk of bleeding 3. Have had, or are at high risk of, recurrence of atrial fibrillation such as those with structural heart disease, a prolonged history of atrial fibrillation (more than 12 months), or a history of failed attempts at cardioversion
42
When is oral anticoagulation given in confirmed atrial fibrillation
1. Stable sinus rhythm has not been successfully restored within 48 hours of onset 2. Risk of stroke outweighs risk of bleeding 3. Have had, or are at high risk of, recurrence of atrial fibrillation such as those with structural heart disease, a prolonged history of atrial fibrillation (more than 12 months), or a history of failed attempts at cardioversion
43
Recommended oral anticoagulation in non-valvular atrial fibrillation
Direct acting oral anticoagulants Apixaban Edoxaban Rivaroxaban Dabigatran
44
If DAOC are contraindicated in a patient with atrial fibrillation, what anticoagulant can be given
Warfarin
45
Aspirin can be used as monotherapy for stroke prevention in patients with atrial fibrillation
False
46
Role of left atrial appendage ovclusion in atrial fibrillation
For stroke prevention if anticoagulant treatment is contra-indicated or not tolerated
47
Role of left atrial appendage ovclusion in atrial fibrillation
For stroke prevention if anticoagulant treatment is contra-indicated or not tolerated
48
Treatment approaches for atrial flutter
Controlling the ventricular rate Attempting to restore and maintain sinus rhythm
49
Rate control drugs used in atrial flutter
Beta blockers Non-DHP CCBs Digoxin
50
Rate control drugs used in atrial flutter
Beta blockers Non-DHP CCBs Digoxin
51
Preferred drugs for rapid rate control in atrial fibrillation
IV Beta blockers IV Verapamil
52
Conversion to sinus rhythm in atrial flutter can be achieved with
Electrical cardioversion Pharmacological Cardioversion Catheter ablation
53
How long should anticoagulation be done for in patients with atrial flutter for more than 48 hours or unknow duration before cardioversion and if patient cannot wait what should be done
3 weeks If not possible, parenteral anticoagulation should be given and a left atrial thrombus ruled out before cardioversion
54
How long should anticoagulation be done for in patients with atrial flutter for more than 48 hours or unknow duration before cardioversion and if patient cannot wait what should be done
3 weeks If not possible, parenteral anticoagulation should be given and a left atrial thrombus ruled out before cardioversion
55
How long should oral anticoagulation be done after cardioversion in atrial flutter
For at least 4 weeks
56
How long should oral anticoagulation be done after cardioversion in atrial flutter
For at least 4 weeks
57
Preferred method of cardioversion in atrial flutter when rapid cardioversion is necessary
Direct current cardioversion
58
Preferred method of cardioversion in recurrent atrial flutter
Catheter ablation
59
Rhythm control drugs in atrial flutter
Flecainide Propafenone Amiodarone when other drugs are contraindicated or ineffective
60
Is thromboprohylaxis necessary in atrial flutter
Yes
61
Is thromboprohylaxis necessary in atrial flutter
Yes
62
Criteria for anticoagulation in atrial flutter is same as in atrial fibrillation. T/F
True
63
Why do antiarrhythmics have a limited role in atrial flutter
Not always effective
64
Initial management of paroxysmal supraventrivular tavhycardia
Spontaneous termination Reflex vagal stimulation
65
Initial management of paroxysmal supraventrivular tavhycardia
Spontaneous termination Reflex vagal stimulation
66
Reflex vagal stimulation techniques
Valsava maneuver Immersing the face in ice cold water Carotid sinus massage
67
Reflex vagal stimulation techniques
Valsava maneuver Immersing the face in ice cold water Carotid sinus massage
68
Drugs for PSVT when reflex vagal stimulation fails or severe symptoms are present
IV adenosine
69
Drugs for PSVT when reflex vagal stimulation fails or severe symptoms are present
IV adenosine
70
Drug to be given in PSVT when IV adenosine is contraindicated or ineffective
IV Verapamil
71
Direct cardioversion in PSVT is needed when…..
Patient is Hemodynamically unstable Reflex vagal stimulation fails Drugs such as IV adenosine and verapamil are ineffective in restoring sinus rhythm
72
Direct cardioversion in PSVT is needed when…..
Patient is Hemodynamically unstable Reflex vagal stimulation fails Drugs such as IV adenosine and verapamil are ineffective in restoring sinus rhythm
73
Treatment for recurrent episodes of PSVT
Catheter ablation Prevention with drugs
74
Drugs for prevention of PSVT
Diltiazem Verapamil Beta blockers including sotalol Flecainide Propafenone
75
Drugs for bradycardia after myocardial infarction
Iv atropine
76
Drug for bradycardia after MI if atropine is ineffective or patient is at risk of asystole
Epinephrine by IV infusion
77
Treatment for pulseless ventricular tachycardia or ventricular tachycardia
Resuscitation
78
Patients with unstable sustained ventricular tachycardia,who continue to deteriorate with signs of hypotension or reduced cardiac output, should receive ............. to restore sinus rhythm
direct current cardioversion
79
What should be done if direct current cardioversion fails in unstable sustained ventricular tachycardia
Give IV Amiodsrone and repeat direct current cardioversion
80
What should be done if direct current cardioversion fails in unstable sustained ventricular tachycardia
Give IV Amiodsrone and repeat direct current cardioversion
81
Treatment for hemodynamically stable ventricular tachycardia
Intravenousa antiarrhythmics Amiodarone hydrochloride - preferred Flecainide acetate Propafenone hydrochloride lidocaine hydrochloride - less effective
82
Treatment for hemodynamically stable sustained ventricular tachycardia if IV antiarrhythmics are ineffective
Direct current cardioversion Pacing
83
Treatment for hemodynamically stable sustained ventricular tachycardia if IV antiarrhythmics are ineffective
Direct current cardioversion Pacing Catheter ablation if urgent cessation of arrhythmia is not needed
84
Maintenance treatment for ventricular tachycardia
Implantable cardioverter defibrillator plus beta blocker or sotalol or amiodarone Or Implantable cardioverter defibrillator plus amiodarone plus beta blocker or Beta blocker with or without amiodarone if Implantable cardioverter defibrillator is not appropriate
85
Torsades de pointes
Form of ventricular tachycardia associated with a long QT syndrome
86
Causes of Torsades de pointes
Drugs Hypokalemia Severe bradycardia Genetics
87
Treatment of torsades de pointes
IV Magnesium sulphate Beta blocker(not sotalol) Atrial or ventricular pacing
88
Why are antiarrhythmics not advisable in Torsades de pointes
They prolong QT interval and worsen the condition

BNF INTRODUCTIONS (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions