Lecture 36

Question 1

Rentry arrhythmias account for between 50-80% of all arrhythmias, and they respond well to _______ conversion. They tend to have an ____ on/of set.

Answer 1

Electrical

Abrupt

Question 2

Enhanced automaticity arrhythmias are typically induced via _______, they tend to have a _____ on/off set, and they do NOT respond well to _____ conversion (should make sense since most are toxicity induced).

Answer 2

Catecholamines

Gradual

Electric

Question 3

Triggered arrhythmias arise from an interruption of repolarization after depolarization, typically caused by ____ or catecholamines. Should make sense that, like enhanced automaticity, they do NOT respond well to ______. For example, Torsades should be treated with IV ______.

Answer 3

Ischemia

Electricity

Magnesium

Question 4

Rate management for patients with EF < 40% should be mostly ___ _____ but NOT _____ _____ _____ (bc the latter has some negative inotrope qualities.)

Answer 4

Beta Blockers

Calcium Channel Blockers

Question 5

Once rate is controlled, patients should be considered for _______ therapy, especially those with mechanical or prosthetic valves or those with stroke risk score of ____ or more.

Answer 5

Anticoagulation therapy

2

Question 6

For patients with no other cardiac issues, IV _____ is the first choice for chemical cardioversion. For those with heart failure or CAD, IV _____ should be used.

Answer 6

Ibutilide

Amiodarone

Question 7

Cardio-tricuspid Isthmus _____ is the treatment of choice for patients with Atrial _____.

Answer 7

Ablation

Flutter

Question 8

Electrophysiology management for patients with A-fib is different depending on the state of their heart.

Normal heart –> Class ____ or ablation.

Left Ventricular Hypertrophy –> Class ___ or ablation.

Heart Failure –> Amiodarone or Dofetilide or ablation.

Patients that do not respond to therapy –> Ablation of the ____ node and insert pacemaker.

Answer 8

Class 1C

Class 3

Ablation of the AV node + pacemaker

Question 9

Pill in the Pocket therapy uses a single dose of Propafanone at ____mg and a single dose of Flecanide at _____mg. Remember that these are Rhythm control drugs, so which drugs should be given first to control rate?

Answer 9

600mg

300mg

Usually Beta blockers (Class 2)

Question 10

AV Nodal Reentrant Tachycardia (AVNRT) is the most common PSVT and requires only the AV node to participate. This is bc the AV node in these cases has 2 separate _______ pathways (a slow and a fast). Treatment is ablation of the _____ pathway.

Answer 10

Conduction pathways

Slow

Question 11

Atrioventricular Reentry Tachycardia (AVRT) occurs when there is a _____ track that carries the signal around the AV node with a simultaneous signal coming through the AV node into the ventricles. The signal from the ventricles can travel up the _____ track and back down through the AV node to form an Orthodromic circuit. Keep in mind if the signal travels down the ____ track and back up to the AV node, this will give you a _____ (wider or more narrow?) QRS, while conduction down the AV node and UP the _____ track will give you a ______ (wider or more narrow?) QRS.

Answer 11

Bypass

Bypass

Bypass

Wider

More Narrow

Question 12

If the EKG of a patient in A-fib shows a _____ wave (pre-excitation), it’s important NOT to give them an AV nodal blockade, bc this will force the signal to take the _____ track, which may be lethal. Instead, they should be given ______.

Answer 12

Delta-wave

Bypass

Procainamide

Question 13

Stable SVT should be treated with _____, while unstable should be treated with cardioversion or defibrillation.

Answer 13

Procainamide