treat arrhythmias Flashcards
What is used to terminate most episodes of PSVT
IV adenosine or IV or oral verapamil used mostly
… but esmolol, metoprolol, dilitiazem, and digoxin are possibilities
What are the treatments for mechanical interruption of acute Paroxysmal supraventricular arrhythmias?
valsalva maneuver coughing breath holding stretching putting thehead between the kenees applying cold water to the face unilateral carotid sinus massage
Prevention of supraventricular arrhythmias
diltiazem and/or verapamil or a B-blocker
treatment of atrial flutter
Ibutilide
or electral cardioversion
What is the treatment of choice for a chronic a-flutter
amiodarone or dofetilide
-radiofreq ablation recommended for refractory or recurrent conditions
what is defined as three or more consecutive ventricular premature beats
V-tach
What is V-tach a frequent complication of
acute MI and dilated cardiomyopathy
V tach in which the QRS complex twists around the baseline.
Torsades de pointes
In what pt does Torsades de pointes occur
spontaneously or when the patient has hypokalemia or hypomagnesemia, or following administration of drugs that prolongs the QT
Describe Long QT Syndrome
may be congenital or acquired and causes recurrent syncope, a QT interval usually 0.5 to 0.7 seconds long, ventricular arrhythmias, and sudden death
Genetic disorder, more common in Asians and in men, that causes syncope, ventricular fib, and sudden death
Brugada’s syndrome
No effective pumping action exists, without intervention, death ensues
V-Fib
Which ventricular arrhythmia is associated with sudden death, most often in the mornings?
Ventricular Fibrillation
what is the treatment of Ventricular premature beats
beta blockers in symptomatic patient; class I and III agents can be used with caution only in symptomatic patient
In V tach with severe hypotension or loss of consciousness?
synchronized cardioversion may be necessary; ventricular overdrive pacing may help
what is the preferred pharmacologic agent for acute V tach
lidocaine, procainamide, and amiodarone
empiric magnesium may help
When do you use an implantable debrillator to treat Ventricular arrhythmias?
- chronic recurrent sustained V tach without a reversible cause
- congenital long QT syndrome
- Brugada’s syndrome
What is the treatment for Torsades de Pointes
BB, magnesium, and temporary atrial or ventricular pacing
When is Sick Sinus Syndrome Reversible?
caused by digitalis, quinidine, B-Blockers, or aerosols
a wastebasket of arrhythmias caused by SA Node dysfunction associated with unresponsive supraventricular (atrial and Junctional) automaticity foci, which are also dysfunctional and cant employ their normal escape mechanism to assume pacing responsibility
SSS
patients with SSS may develop intermittent episodes of SVT (sometimes even Aflutter or Afib) mingled with the Sinus Bradycardia what is this?
Bradycardia- Tachycardia Syndrome
describe the clinical features of SSS and AV Block
SSS = syncope, dizziness, confusion, heart failure, or angina
AV block = weakness, fatique, light headed ness, and syncope
What is the treatment for SSS?
What is the treatment for AV Block?
SSS = permanent pacemaking if the pt is symptomatic
AV block = cardiac pacing
