Ventricular Arthymias

Question 1

What are the types of ventricular arrhythmias

Answer 1

SVT, Wolfparkinson White Syndrome, V Fib, V tach, and Torsade Te Pointe

Question 2

How do you differentiate SVT from Sinus Tachycardia?

Answer 2

SVT onset abrupt and cessates quickly

Question 3

SVT pathophysiology

Answer 3

rentrant pathway that originates at the AV node, accessory pathway

Question 4

What is the most common SVT?

Answer 4

AVNRT (rentrant)
Atrioventircular nodal rentrant tachycardia. Here the refractory period o the AV node is bypassed which initiates a circuit of electrical stimulation.

Question 5

How can you tell SVT on ECG?

Answer 5

narrow QRS, HR 150 beats per min

Question 6

How do you manage SVT>

Answer 6

Depends on if the patient is stable: vagal (carotid sinus massage increasing the cranial nerve 10 input vagus nerve, adenosine, ccbs, B blockers)

Unstable:
Cardioversion
Ablation

Question 7

When does the AVNR typically present?

Answer 7

is most typical in younger patients with no cardiac history

Question 8

What is wolf parkinson white syndrome?

Answer 8

In WPW, an alternative pathway called the bundle of Kent is also facilitating electrical transmission. Wide QRS, slurred upstroke of QRS (delta wave)

Question 9

What is the presentation of Wolf Parkinson White syndrome?

Answer 9

asymptomatic

Question 10

What are the types of WPWS?

Answer 10

sinus, orthodromic AVRT, and antidromic avrt
orthodromic AVRT: anterograde AV node, retrograde through bundle of Kent.
Antidromic AVRT: anterograde through bundle of Kent, retrograde through AV node

Question 11

What is the treatment for WPKS?

Answer 11

Antidromic AVRT- procainamide
Orthodromic AVRT- adenosine, CCB

Unstable: cardioversion, ablation

Question 12

What are the complications of treating WPWS?

Answer 12

AV nodal blocking agents and vagal maneuevers- V tach or V fib

Question 13

What are the two types of V tach?

Answer 13

Polymorphic vs Monomorphic
Polymorphic: Torsades- QT prolongation quindine

Question 14

Does amiodrone cause long QT?

Answer 14

no

Question 15

What is polymorphic ventricular tachycardia

Answer 15

irreuglar irregular rhythm.

Question 16

What is the treatment for Torsades?

Answer 16

Magneisum, avoid the QT prolonging drugs

Question 17

What are the QT prolonging drugs?

Answer 17

Class I and III, Macrolides (Fluroquinolones, Haloperidol, TCA- methadone, Onadansetron, Azoles)
A- Antiarrhtymics
B- Antibiotics
C- Antipsychotics
D- Antidepressants
E- Antiemetics, Electrolytes
F- Antifungals

Question 18

What is monomorphic ventricular tachycardia

Answer 18

abberant ventricular foci caused by ischemic structural heart disease, acute MI, elecrolyte disturbances (hypokalaemia, hypomagnesmia)

Question 19

What is ventricular fibrillation

Answer 19

uncoordinated ventricular depolarization

Question 20

What is the most common cause of sudden cardiac death?

Answer 20

ventricular fibrillation

Question 21

Ventricular arrhythmias are most common- when?

Answer 21

24-48 hours after the MI

Question 22

What do you want to avoid in WFW syndrome?

Answer 22

Calcium Channel Blockers
Beta Blockers
Digoxin
Adenosine
Vagal Maneuevers

Question 23

What do you want to avoid in Torsades?

Answer 23

Any drugs that prolong long QT syndrome.