Ventricular Tachycardia

Question 1

how can premature ventricular complexes (PVCs) show up on ECG?

Answer 1

• single
• pairs (couplets)
• alternating w/ sinus beats

Question 2

in healthy adults, PVCs are?

Answer 2

benign

Question 3

ventricular tachyarrhythmias consist of

Answer 3

• VT
• VF
• torsades de pointes

Question 4

ventricular tachyarrhythmias are characterized by

Answer 4

• QRS > 120 ms

- AV dissociation

Question 5

typical ventricular rate in VT

Answer 5

140-250 bpm

Question 6

typical ventricular rate in VF

Answer 6

> 300 bpm

Question 7

typical ventricular rate in TdP

Answer 7

200-300 bpm

Question 8

further classification of VT

Answer 8

sustained vs nonsustained

Question 9

nonsustained VT duration

Answer 9

< 30 seconds

Question 10

characterization of morphology of VT

Answer 10

monomorphic vs polymorphic

Question 11

monomorphic VT

Answer 11

QRS complex in same leads do NOT vary in contour

Question 12

polymorphic VT

Answer 12

QRS complex in same leads DO vary in contour

Question 13

why is differentiating VT from SVT w/ aberrancy important?

Answer 13

tx differs A LOT

Question 14

what is more common in a pt w/ structural heart disease, VT or SVT w/ aberrancy?

Answer 14

VT

Question 15

WIDE QRS TACHYCARDIA SHOULD BE CONSIDERED what UNTIL PROVEN OTHERWISE?

Answer 15

VT

Question 16

what makes the dx of VT almost certain?

Answer 16

• structural heart disease

- previous MI

Question 17

what is TdP?

Answer 17

specific form of polymorphic VT a/w LONG QT syndrome

Question 18

how long does TdP usually last?

Answer 18

typically short-lived and terminate spontaneously

Question 19

multiple successive episodes of TdP can cause

Answer 19

• syncope

- VF

Question 20

when should PVCs be tx in otherwise healthy pts?

Answer 20

disabling sxs

Question 21

tx for PVCs in otherwise healthy pts

Answer 21

BBs

Question 22

when should pts w/ nonsustained PVCs be tx’d?

Answer 22

only if positive sxs

Question 23

tx for pts w/ nonsustained PVCs

Answer 23

BBs

Question 24

tx for VT in UNSTABLE pt

Answer 24

• immediate electrical cardioversion

Question 25

tx for pulseless VT

Answer 25

same as VF

Question 26

tx for VT in hemodynamically STABLE pt w/ impaired LV function

Answer 26

- lidocaine or amiodarone IV (preferred) | - procainamide or sotalol (2nd line)

Question 27

what reduces sudden cardiac death in pts w/ VF or sustained VT a/w hemodynamic compromise?

Answer 27

ICD

Question 28

DON'T BE TRICKED - does suppression of PVCs in pts w/ structural heart dz affect outcomes?

Answer 28

NO