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Diagnostics > Tachyarrhythmias > Flashcards

Tachyarrhythmias Flashcards

1
Q

PAC characteristics

A
  • Early atrial depolarization
  • Bigeminal or trigeminal
  • P wave morphology may be different
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2
Q

SVT characteristics

A
  • Narrow QRS complex at 140-240 bpm
  • Abrupt onset/offset
  • P wave buried in QRS
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3
Q

What causes SVT?

A

An accessory pathway

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4
Q

What terminates SVT?

A

Adenosine

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5
Q

AV re-entry tachycardia: Normal conduction/sinus steps

A
  1. Conduction occurs normally through atrium

2. Accessory pathway conducts to ventricles & AV node

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6
Q

AV re-entry tachycardia: Tachycardia activation steps

A
  1. Premature beat arrives while accessory is still refractory
  2. Slowly activates AV node
  3. By the time the signal reaches the ventricle, accessory pathway has recovered & is able to transmit signal to atria
  4. Atria reactivates ventricle via AV node
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7
Q

Concealed pathway

A

SVT via an accessory pathway, but has normal EKG

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8
Q

WPW characteristics

A
  • SVT via accessory pathway & has delta wave on resting/sinus EKG
  • Pre-excitation of ventricle in the location of accessory pathway, while conducting through AV node
  • Narrow PR interval
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9
Q

WPW definition

A

Must have SVT, sx, & delta wave on EKG

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10
Q

AVNRT: Dual AV nodal physiology

A
  • Slow pathway (fast recovery)

- Fast pathway (slow recovery)

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11
Q

AVNRT: Initiation of tachycardia

A
  1. Normal impulse conducted
  2. PAC occurs (conducted via slow pathway bc fast pathway is refractory)
  3. PAC reaches end of slow pathway –> fast pathway is recovered –> transmits signal to atria
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12
Q

Atrial tachycardia characteristics

A
  • Originates within atria, but outside sinus node
  • Bc rate is faster than sinus rate, it takes over as main pacemaker
  • Rate of 140-220, rarely sustained for long periods
  • P wave often buried within T wave
  • Not terminated by adenosine
  • May require meds if symptomatic
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13
Q

Multifocal atrial tachycardia

A
  • Multiple ectopic foci in atria firing –> multiple p wave morphology
  • HR: 100-150
  • Transitional arrhythmia from AT to AF
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14
Q

What is the most common cause of COPD?

A

MAT

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15
Q

AF characteristics

A
  • Ventricular rates are usually fast, over 100

- No discernable p waves

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16
Q

What is the most common chronic arrhythmia?

A

AF

17
Q

How do you tx AF?

A
  • Rate control
  • Stroke prevention
  • DCCV
  • Anti-arrhythmics
18
Q

AF carries a risk of what?

A

CVA (evaluate w/ CHADS score)

19
Q

Atrial flutter characteristics

A
  • “Saw tooth” in inferior leads (II,III, & aVF)
  • Short re-entrant circuit within RA (conducting at 300bpm)
  • Usually regular ventricular response (150bpm)
20
Q

Atypical atrial flutter

A

re-entrant circuit in the atria from any other location in the atria

21
Q

Atrial flutter carries a risk of what?

A

CVA (anticoagulation = prevention)

22
Q

How do you tx atrial flutter?

A
  • Anticoagulation
  • Ablation
  • Anti-arrhythmics
23
Q

PVC characteristics

A
  • Wide QRS w/out preceding P wave

- Bigeminal or trigeminal

24
Q

What can PVCs cause?

A

Palpitations

25
Q

How do you treat PVCs?

A
  • Beta blocker
  • Calcium channel blocker
  • Ablation if sx/cardiomyopathy
26
Q

VT characteristics

A
  • 3 or more consecutive PVCs (160-200bpm)
  • Nonsustained: more than 3 beats but less than 30 seconds before terminating spontaneously
  • Sustained: over 30 seconds &/or requiring DCCV
27
Q

How do you tx VT?

A

Based on hemodynamic stability

  • Stable: IE beta blockers, anti-arrhythmics
  • Unstable: cardiovert emergently
28
Q

Monomorphic VT

A

Due to re-entrant circuit within ventricle (caused by MI scar)

29
Q

Polymorphic VT

A
  • Omnious, indicating more electrically unstable/irritable ventricle
  • See Review 8a
30
Q

Wide complex tachycardia

A
  • VT or aberrantly conducted SVT

- Dx via cardiology/EP

31
Q

How do you tx wide complex tachycardia?

A

Tx as VT until proven otherwise

- If unstable, tx w/ DCCV

32
Q

Torsades de Pointes characteristics

A
  • Polymorphic VT (long QT interval)
  • Twisting of QRS complex along isoelectric baseline
  • Also occurs in complete heart block
33
Q

How do you tx Torsades de Pointes ?

A
  • Emergent defibrillation
  • Leads to sudden cardiac death
  • Magnesium after defibrillation
34
Q

VF characteristics

A
  • No discernable ventricular activity (200-300bpm)

- Pulseless

35
Q

How do you tx VF?

A
  • Causes death unless quickly resuscitated (next step = asystole)
  • Requires defibrillation ASAP
36
Q

Indications for ICD

A
  • EF less than 35%

- Previous cardiac arrest in absence of reversible cause

Diagnostics (11 decks)

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