Tachyarrhythmias - Quiz 2 - SPEND MORE TIME ON THIS Flashcards
treatment of acute AVRT
- vagal maneuvers
- adenosine
treatment of atrial flutter
- anticoagulation for stroke prevention
- AV nodal blockers for rate control
- catheter ablation
diagnosis from EKG
AV nodal reentry tachycardia
- P wave immediately after (or within QRS)
what do you ablate for treatment of atrial flutter
- cavo-tricuspid isthmus
diagnosis of EKG
AF with pre-excitation
diagnosis from EKG
- AVRT (SVT)
- P wave immediately after QRS
reasons why the conduction would not be travelling through the normal conduction system?
- bundle branch block (aberrancy)
- pre-excitation (accessory pathway)
- originates in the ventricle
treatment of chronic VF
- need implantable defibrillator if no reversible cause
treatment of AF with pre-excitation
- DC cardioversion
- then ablation of accessory pathway
SVT due to
- AV nodal re-entry tachycardia
- AV re-entry tachycardia
- unifocal atrial tachycardia (rarest)
AV nodal reentry tachycardia during sinus beats
- conduction occurs via fast pathway
- conduction via slow pathway is blocked
tachyarrhythmias defined as
- heart rate > 100 BPM
diagnosis from EKG
- atrial flutter (variable conduction)
look at V1 and see the 2:1 and then 4:1 flutter
AF with pre-excitation due to
- AF conducts to ventricle through accessory pathway at very rapid rates
diagnosis from EKG
- sinus tachycarida with RBBB
- HR > 100
- sinus P wave (upright in I, II, aVF)
- T wave inverted in V1 and V2
example of polymorphic ventricular tachycardia
- torsade
conditions with regular narrow (QRS <120) tachycardia
- sinus tachycardia
- atrial flutter
- SVT
- junctional tachycardia
WITH REGULAR AND NARROW YOU WANNA SAY “YASS” BUT INSTEAD YOU SAY “JASS”
atrial flutter- pattern on the EKG
- sawtooth pattern
treatment of chronic AVRT
- catheter ablation of accessory pathway
diagnosis from EKG
atrial flutter (4:1 conduction)
diagnosis from EKG
- sinus tachycardia
- HR > 100
- sinus P wave (upright in I, II, and aVF)
diagnosis from EKG
Atrial fibrillation
- irregular QRS activity
- no consistent atrial activity
rate of atrial fibrillation
- variable rate
- depends on refractoriness of AV node
torsade is seen in
- patients with underlying long QT
- predisposing to EADs
AV nodal reentry tachycardia is due to
- dual AV nodal conduction
AV nodal reentry tachycardia during tachycardia
- premature atrial contraction blocks in fast pathway
- conducts through slow
- retrograde conduction through fast
- reentry
where would you see this?
- AV nodal reentry tachycardia
- extra P wave right after QRS
role of adenosine
- transiently block AV node
- causes cell hyperpolarization via A1 receptor
rhythm control for symptomatic AF
- DC cardioversion
- antiarrhythmic drug therapy to suppress abnormal automaticity and disrupt reentry
- catheter ablation
treatment of chronic ventricular tachycarida
- implantable defibrillator
- antiarrhythmic drug therapy
- catheter ablation
AF maintained by
- functional reentry
diagnosis from EKG
- long QT
diagnosis of EKG
ventricular fibrillation
- wide, irregular tachycardia
atrial flutter - atrial cycle length of approximinately
- 300 bpm (200 ms)
typical atrial flutter due to
- re-entrant arrhythmia of the right atrium involving cavo-tricuspid isthmus
IN ENGLISH
the loop is just going around and around the tricuspid valve
conditions with an irregular narrow (QRS <120) tachycardia
- atrial fibrillation
- atrial flutter with variable block
- multifocal atrial tachycardia
IRREGULAR AND NARROW SAYS “MAA”
DR. MAA WAS A BIT IRREGULAR AND SO STRAIGHT EDGE SO WE’LL CALL HER NARROW HERE
wide QRS indicates problem where?
- conduction NOT travelling through normal conduction system
AF initiated by
- automaticity or tiggered activity at pulmonary venous muscle sleeves or nonpulmonary venous sites
treatment of acute torsade
- defibrillation
- magnesium
- rapid pacing
treatment of chronic torsade
- implantable defibrillator unless reversible cause
diagnosis from EKG
- atrial flutter (2:1) conduction
treatment of chronic AVNRT
- AV nodal blocker
- catheter ablation of slow pathway
treatment for atrial fibrillation
- anticoagulation for stroke prevention
- AV nodal blockers as necessary
conditions with irregular wide (QRS > 120) tachycardia
- ventricular fibrillation
- polymorphic VT
- atrial fibrillation with aberrancy
- atrial fibrillation with pre-excitation
IRREGULAR AND WIDE LIKE A VAPE CLOUD. WE GET IT BRO YOU VAAP
what is the preferred method of blocking AV nodal transmission if vagal maneuvers are ineffective?
- adenosine as a rapid IV push
ventricular tachycarida in patients with structural heart disease
- due to reentry around scar
treatment of acute VF
- CPR
- defibrillation
- treat underlying cause
treatment of sinus tachycardia
- treat underlying cause
the most common tachyarrhythmia
- atrial fibrillation
diagnosis from EKG
- ventricular tachycardia
- look for P wave not connected to QRS
Due to rhythm originating in the ventricle
diagnosis based on EKG
torsade de points
diagnosis from EKG
AVRT (SVT)
treatment for someone in acute AVNRT
- vagal maneuvers
- adenosine
conditions with regular wide (QRS > 120) tachycardia
- ventricular tachycardia
- SVT with aberrancy
- SVT with pre-excitation
- hyperkalemia
VSSH
REGULAR AND WIDE LIKE A VOLUPTOUS HiSS
THINK OF A REGULAR FAT SNAKE
ventricular tachycardia in patients without structural heart disease
- due to delayed afterdepolarizations (triggered arrhythmia)
diagnosis of EKG
- WPW sinus rhythm
- look for delta wave
treatment of acute ventricular tachycardia
- ACLS
- CPR, defibrillation
atrial flutter - ventricular rate
- at a multiple of 300 bpm
THIS IS A BIG CLUE FOR ATRIAL FLUTTER
