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cardiac arrhythmias

Cardio 3

irregular rhythm, no Ps, variable ventricular rate A fib
regular (or regularly irregular) rhythm, >300bpm A flutter
2 important results of AFFIRM rate > rhythm & anticoagulation
mitral stenosis 2 points
CVA 2 points
HTN 1 point
DM 1 point
age >75 1 point
CHF 1 point
LV systolic dysfunction 1 point
CHADS2 0-1 treatment ASA 325 mg/day
CHADS2 2 treatment favor ASA unless had CVA, then use warfarin
CHADS2 3-6 treatment warfarin unless contraindicated
regular ventricular rhythm PVST
palpitations, dizziness, dyspnea, chest pain, fatigue, syncope PVST sx
vagal maneuvers, adensosine, verapamil/diltiazem, beta blockers, ablation treatment for PVST
disorder of impulse formation w/3 different P waves, >100bpm MAT
associated with MAT COPD
disorder of impulse formation w/3 different P waves, <100bpm wandering atrial pacemaker
self-sustaining electrical circuit that repeated depolarizes a region of cardiac tissue reentry rhythm
short PR and delta waves due to AV bypass tract WPW
palpitations, syncope, SCD WPW sx
not treated w/AV blocking agents WPW
treatment of choice for WPW ablation
drug of choice for WPW procainamide
premature contraction, no P wave, wide QRS complex w/compensatory pause and ST opposite QRS PVC
ventricular stimulus causes premature depolarization of cells that have not been completely repolarized R on T phenomenon
reentry rhythm due to structurally abnormal heart or triggered activity VF/VT
electrical wavefront travels thru zone of slow conduction (usually damaged muscle protected by scar), allowing the rest of the circuit time to repolarize. The wavefront breaks out of the scar, activates the ventricle, and reenters the slow conduction zone reentry - structurally abnormal
most commonly involved sites are the RV outflow tract, LV outflow tract, LV septum, and the aortic root abnormal automaticity (triggered activity)
CAD, severe electrolyte derangements (alcoholics), structurally abnormal heart (MI), brugada syndrome commonly associated w/VF/VT
kind of VT treated w/amiodarone and/or lidocaine >30 s but stable
kind of VT treated with defibrillation unstable, pulseless
type of VT w/polymorphic QRSs torsades de pointes
hypoK+, hyperMg++, malnourishment, some antipsychotics, tricyclic, erythromycin, long QT can cause torsades de pointes
IV Mg++ and K+, and stop offending drugs treatment for stable torsades
isoproteronol and/or cardiac pacing treatment for acute torsades
used to control a fib/flutter rate verapamil, diltiazem, digoxin, metoprolol
Created by: drhermy