Trigger - Dysrhythmias part 1 Flashcards
d/t reflex changes in vagal influence on normal pacemaker
sinus arrhythmias
disappears when holding breath
sinus arrhythmias
chronotropic incompetence results in what
sick sinus syndrome
what could cause:
Increased O2 consumption
Decreased Coronary blood flow
Decreased CO due to shortened ventricular filling time
Exacerbation of existing HD
structural heart disease with tachycardia
what is the SECOND LINE treatment in symptomatic/inappropriate sinus tach
non-DHP CCBs or ivabradine
1st line is BB
abnormal conduction within the AV Node
mobitz type 1 HB
abnormal conduction within the bundle of His
mobitz type 2 HB
PR interval > 0.2s with all atrial impulses conducted
1st degree AV block
presents with weakness
Mobitz type 2 HB
treated via avoidance of PR prolonging drugs
1st degree AV Block
treatment includes adressing underlying cause and Avoiding AV node slowing drugs
mobitz type 1 2nd degree AV block
which AV block is treated with pacemaker implantation
- 2nd degree type 2
- 3rd degree
characterized by varied P - wave morphology
PAC
1st line tx is BB
2nd line is flecanide or propafenone
PAC
remember PVC uses class III additionally second line
tx includes:
1st line BB
2nd line is class IC or III
PVC
if there is significant burden you can do a cath ablation
characterized by a wide QRS with a compensatory pause
PVCs
can be suppressed via exercise
PVCs
commonly caused by reentrant tachycardia
PSVT
Narrow QRS complex with regular rhythm and rate of 140+ bpm
PSVT
can be treated by doing things such as cold water on face, valsalva, coughing, stretching, putting head between legs, holding breath.
PSVT
in a stable patient the first line therapy for this dysrhythmia is:
Adenosine
CCB or BB
PSVT
procainamide as 1st line for which dysrhythmia
antidromic PSVT (WCT to WPW)
when is cardioversion 1st line
Hemodynamically unstable PSVT or VT
also indicated if adenosine, BB, CCB are CI or ieffective
if adenosine, BB, CCB are CI or ineffective in their treatment what is used?
cardioversion
this is for PSVT
what is the preventative measures for PSVT that is recurrent and symptomatic.
- catheter ablation
- 1st line med is BB and CCB
- add class IC or class III if still sx
treat with clas IC or class III AND BB or CCB
pts with AVRT (WPW) and PSVT becuase they are prone to afib and aflutter
if a patient with PSVT has WPW syndrome and has been given adenosine but is still in PSVT, what do you give them?
what if they DO NOT have WPW
Procainamide for WPW
amiodarone for no WPW.
if the pt has WPW syndrome they are considered a antidromic SVT, which indicates procainamide
