VT STIM and Triangle Of KOCH Flashcards
What is the cut off for sustained VT and NSVT
30 seconds
Does NSVT require VT stim study?
No
Give me 5 types of VT
Monomorphic Polymorphic Fascicular Idiopathic Torsades de points
Give me 3 differential diagnosis of wide complex tachy
VT
SVT with abberancy
SVT with pre-excitation
If the tachy is septal or from the LV - which BBB morphology should I see
RBBB
If the tachy is from the RV, with BBB should I see
LBBB
If negative in the INF leads, where is the tachy located
APEX
If positive in the INF leads, where is the tachy located
Base / Outflow tracts
If i have BB re-entry and it appears RBBB - which way is it going
Antegrade
Retrograde BB re-entry will look like what on the ECG
LBBB
5 Features of RVOT VT
LBBB INF Axis Adenosine terminates Benign Automatic - therefore cant induce
What drug terminates RVOT VT
Adenosine
During LV VT, is LV function normal
Yes - normal function is preserved
Three hallmarks of LV VT
RBBB
Normal LV function
Left Axis Deviation
What two things must patients have to qualify for a VT stim study
NSVT + Frequent VE’s
What two other factors are there as indications for VT stim study
Low EF
Symptomatic VEs
If I increase the yield, what happens to specificity
It reduces
Name two ways to increase yield
Increase Agressiveness
Introduce second stim
Give 5 complications of VT stim
Pneumothorax Haemothorax Stroke Pulmonary embolism Tamponade Requiring cardioversion
Example the protocol
Drive train 8 beats @ 600ms
s2 = 10ms decrement to VT or VRP
s2 20ms up from VRP, s3 added and decremented
Add more stims, do again at faster drive train
Where is the TOC located
Superficial Paraseptal endocardium of RA
What 3 things make up the TOC
Coronary Sinus Ostium
Tendon of Todaro
Septal leaflet of TV
Where does the CS Ostium sit in relation to the TOC
Posteriorly
Where does the compact AV node sit in relation to the TOC
Superiorly, right on the top of triangle
What two things cause the size to differ
Age and Gender
What does the tendon of Todaro do
Connects valve of inferior vena cava ostium to central fibrous body
