VT STIM and Triangle Of KOCH

Question 1

What is the cut off for sustained VT and NSVT

Answer 1

30 seconds

Question 2

Does NSVT require VT stim study?

Answer 2

No

Question 3

Give me 5 types of VT

Answer 3

Monomorphic
Polymorphic
Fascicular
Idiopathic
Torsades de points

Question 4

Give me 3 differential diagnosis of wide complex tachy

Answer 4

VT
SVT with abberancy
SVT with pre-excitation

Question 5

If the tachy is septal or from the LV - which BBB morphology should I see

Answer 5

RBBB

Question 6

If the tachy is from the RV, with BBB should I see

Answer 6

LBBB

Question 7

If negative in the INF leads, where is the tachy located

Answer 7

APEX

Question 8

If positive in the INF leads, where is the tachy located

Answer 8

Base / Outflow tracts

Question 9

If i have BB re-entry and it appears RBBB - which way is it going

Answer 9

Antegrade

Question 10

Retrograde BB re-entry will look like what on the ECG

Answer 10

LBBB

Question 11

5 Features of RVOT VT

Answer 11

LBBB
INF Axis
Adenosine terminates
Benign
Automatic - therefore cant induce

Question 12

What drug terminates RVOT VT

Answer 12

Adenosine

Question 13

During LV VT, is LV function normal

Answer 13

Yes - normal function is preserved

Question 14

Three hallmarks of LV VT

Answer 14

RBBB
Normal LV function
Left Axis Deviation

Question 15

What two things must patients have to qualify for a VT stim study

Answer 15

NSVT + Frequent VE’s

Question 16

What two other factors are there as indications for VT stim study

Answer 16

Low EF

Symptomatic VEs

Question 17

If I increase the yield, what happens to specificity

Answer 17

It reduces

Question 18

Name two ways to increase yield

Answer 18

Increase Agressiveness

Introduce second stim

Question 19

Give 5 complications of VT stim

Answer 19

Pneumothorax
Haemothorax
Stroke
Pulmonary embolism
Tamponade
Requiring cardioversion

Question 20

Example the protocol

Answer 20

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

Question 21

Where is the TOC located

Answer 21

Superficial Paraseptal endocardium of RA

Question 22

What 3 things make up the TOC

Answer 22

Coronary Sinus Ostium
Tendon of Todaro
Septal leaflet of TV

Question 23

Where does the CS Ostium sit in relation to the TOC

Answer 23

Posteriorly

Question 24

Where does the compact AV node sit in relation to the TOC

Answer 24

Superiorly, right on the top of triangle

Question 25

What two things cause the size to differ

Answer 25

Age and Gender

Question 26

What does the tendon of Todaro do

Answer 26

Connects valve of inferior vena cava ostium to central fibrous body