Trigger - Dysrhythmias part 1

Question 1

d/t reflex changes in vagal influence on normal pacemaker

Answer 1

sinus arrhythmias

Question 2

disappears when holding breath

Answer 2

sinus arrhythmias

Question 3

chronotropic incompetence results in what

Answer 3

sick sinus syndrome

Question 4

what could cause:
Increased O2 consumption
Decreased Coronary blood flow
Decreased CO due to shortened ventricular filling time
Exacerbation of existing HD

Answer 4

structural heart disease with tachycardia

Question 5

what is the SECOND LINE treatment in symptomatic/inappropriate sinus tach

Answer 5

non-DHP CCBs or ivabradine

1st line is BB

Question 6

abnormal conduction within the AV Node

Answer 6

mobitz type 1 HB

Question 7

abnormal conduction within the bundle of His

Answer 7

mobitz type 2 HB

Question 8

PR interval > 0.2s with all atrial impulses conducted

Answer 8

1st degree AV block

Question 9

presents with weakness

Answer 9

Mobitz type 2 HB

Question 10

treated via avoidance of PR prolonging drugs

Answer 10

1st degree AV Block

Question 11

treatment includes adressing underlying cause and Avoiding AV node slowing drugs

Answer 11

mobitz type 1 2nd degree AV block

Question 12

which AV block is treated with pacemaker implantation

Answer 12

1. 2nd degree type 2
2. 3rd degree

Question 13

characterized by varied P - wave morphology

Answer 13

PAC

Question 14

1st line tx is BB
2nd line is flecanide or propafenone

Answer 14

PAC

remember PVC uses class III additionally second line

Question 15

tx includes:
1st line BB
2nd line is class IC or III

Answer 15

PVC

if there is significant burden you can do a cath ablation

Question 16

characterized by a wide QRS with a compensatory pause

Answer 16

PVCs

Question 17

can be suppressed via exercise

Answer 17

PVCs

Question 18

commonly caused by reentrant tachycardia

Answer 18

PSVT

Question 19

Narrow QRS complex with regular rhythm and rate of 140+ bpm

Answer 19

PSVT

Question 20

can be treated by doing things such as cold water on face, valsalva, coughing, stretching, putting head between legs, holding breath.

Answer 20

PSVT

Question 21

in a stable patient the first line therapy for this dysrhythmia is:
Adenosine
CCB or BB

Answer 21

PSVT

Question 22

procainamide as 1st line for which dysrhythmia

Answer 22

antidromic PSVT (WCT to WPW)

Question 23

when is cardioversion 1st line

Answer 23

Hemodynamically unstable PSVT or VT

also indicated if adenosine, BB, CCB are CI or ieffective

Question 24

if adenosine, BB, CCB are CI or ineffective in their treatment what is used?

Answer 24

cardioversion

this is for PSVT

Question 25

what is the preventative measures for PSVT that is recurrent and symptomatic.

Answer 25

• catheter ablation
• 1st line med is BB and CCB
• add class IC or class III if still sx

Question 26

treat with clas IC or class III AND BB or CCB

Answer 26

pts with AVRT (WPW) and PSVT becuase they are prone to afib and aflutter

Question 27

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

Answer 27

Procainamide for WPW

amiodarone for no WPW.

if the pt has WPW syndrome they are considered a antidromic SVT, which indicates procainamide