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Cardio > Introduction to Cardiac Arrhythmias > Flashcards

Introduction to Cardiac Arrhythmias Flashcards

1
Q

Name the 2 types of Electrical disfunction

A

Altered automaticity

Triggered activity

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2
Q

What happens in altered automaticity?

A

latent pacemaker subverts SA node function as normal pacemaker of the heart

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3
Q

When does Altered automaticity occur?

A

when SA node firing is pathologically low or impaired

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4
Q

Name the 2 types of triggered activity

A

EAD - early afterdepolarisation

DAD- delayed afterdepolarisation

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5
Q

Name 2 defects in Impulse conduction

A

re-entry

conduction block

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6
Q

Name the 2 types of conduction Block

A

Partial

Complete

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7
Q

What shows a partial block on ECG of 1st AV degree?

A

slower conduction=lower PR interval

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8
Q

Name the 2 types of 2nd degree AV block

A

Mobitz 1

Mobitz 2

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9
Q

Describe the PR interval in morbitz 1?

A

PR interval gradually increases from cycle to cycle until AV node fails completely and a ventricular beat is missed

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10
Q

Describe the PR interval in morbitz 2?

A

PR interval is constant but every nth. ventricular depolarization is missing

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11
Q

What is a 3rd degree AV block? A complete block aka?

A

atria and ventricles beat independent of one another

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12
Q

Name some accessory pathways

A

bundle of kent

WPW syndrome

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13
Q

What is an accessory pathway?

A

some individuals possess electrical pathways that bypass the AV node

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14
Q

What are anti-arrhythmic drugs put into for classification?

A

Vaughan Williams Classification

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15
Q

Name the 3 classes that target Na+ channels?

A

Class IA
IB
IC

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16
Q

Name a class IA drug and describe rate

A

disopyramide

intermediate

17
Q

Name a class IB drug and describe rate

A

lignocaine

rapid

18
Q

Name a class IC drug and describe rate

A

Flecainide

slow rate

19
Q

Name the class of drugs that are B-receptor antagonists? Name a drug and effect/

A

Class II
Metoprolol
decrease the rate of depolarisation in SA and AV

20
Q

Name the class of drugs that target voltage activated K+ channels? Name a drug and effect?

A

Class III
Amiodarone
prolong AP duration

21
Q

Name the class of drugs that target voltage activated Ca+ channels? Name a drug and effect?

A

Class IV
Verapamil
Slows conduction in SA and AV nodes

22
Q

What classes are rhythm control drugs?

A

I+III

23
Q

What classes are rate control drugs?

A

II + IV

24
Q

Name the 3 drugs used in Supraventricular Arrhythmias?

A

Adenosine
Digoxin
Verapamil

25
Q

When is adenosine used and what does it do?

A

– hyperpolarises the AV node briefly, suppressing impulse conduction. Treats PSVT atrial firing rate 140-250 bpm
Use this in acute phase

26
Q

When is Digoxin used and does it have a low therapeutic index?

A

stimulates vagal activity
stimulates vagal activity (slows conduction and prolongs refractory period in AV node and bundle of His). Used to treat AF (narrow therapeutic index )

27
Q

Name some effects of the narrow therapeutic index of digoxin?

A

nausea, yellow vision, bradycardia, ventricular arrhythmias

28
Q

What does Verapamil do and when is it used?

A

– type IV agent – blocks L type Ca+ channel. Slows conduction and prolongs refractory period in AV node and bundle of His. Treats atrial flutter and AF. (Mostly replaced by adenosine acutely) This is a cardio selective blocker.

29
Q

Name the drug used to treat ventricular arrhythmias? what it does and when its used?

A

Lignocaine – type IB agent – rapid block of voltage activated Na+ channels. Primarily affects Na+ channels in areas of the myocardium that discharge action potentials at high rate (e.g. an ischaemic zone). Used to treat Ventricular arrhythmias following MI

30
Q

Name some drugs used in atrial and ventricular arrhythmias?

A 
Disopyramide + procainamide 
Flecainide
Propranolol and atenolol 
amiodarone and sotolol
Amiodarone
31
Q

What type of agents are disopyramide and procainamide and what they do?

A

type Ia agents – moderate block of Na+ channels

32
Q

What type of agent are flecainide and what they do?

A

type Ic agent – slow block of Na+ channels. Prophylaxis of paroxysmal AF

33
Q

What type of agents are propanolol and atenolol and what they do?

A

type II agents – control SVT suppressing impulse conduction through AV node. Suppress excessive sympathetic drive that may trigger VT

34
Q

What type of agents are Amiodarone and sotolol and what they do?

A

type III – slow repolarisation of the action potential by blocking K+ channel so increases action potential duration and refractory period

35
Q

What type of agents are Amiodarone and what they do?

A

effective against SVT and VT (it has class IA, II and IV actions and blocks B adrenoceptors). Reduces mortality following MI and Congestive heart failure. Not recommended for long term can cause Pulmonary fibrosis, thyroid disorders, photosensitivity, peripheral neuropathy

Cardio (28 decks)

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