Cardiac Electrophysiology IV--evaluation and tx
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| What is the first tool used in the evaluation of a patient with palpitations? | show 🗑
|
||||
| show | painless, widely available, inexpensive; single 10 sec recording of the heart rhythm
🗑
|
||||
| If the heart beat doesn't occur within the 10 sec of an ECG, what can be used to monitor for up to 24 hours (noninvasive)? | show 🗑
|
||||
| show | Useful if symptoms less frequent (once ever 2-6 weeks); patient wears recorder and activates it (must be conscious) when they get symptoms; information transmitted via telephone to central station
🗑
|
||||
| What's an alternative to a loop recorder if the patient is frail or if the symptom includes frank syncope? | show 🗑
|
||||
| When is signal averaged ecg useful? What types of ECG abnormalities affect the reliability of the measurement? | show 🗑
|
||||
| What is heart rate variability (HRV) technique useful for? | show 🗑
|
||||
| show | increased mortality; inspect using Heart rate variability (HRV)
🗑
|
||||
| show | Looks at microvolt changes in T-wave amplitude; studies suggest that negative predictive power of test could be used to identify low risk population
🗑
|
||||
| show | The electrophysiology study (EP); invasive
🗑
|
||||
| show | Assessment of 1) SA and AV node function, 2) intracardic conduction times and localization of heart block 3) reproducing reentrant arrhythmias 4) mapping of circuits reponsible for abnormal rhythm, 5) 3D mapping of heart circuits
🗑
|
||||
| show | Essentially Na+ Channel blockers: Procainamide, Quinadine, Disopyramide
🗑
|
||||
| Vaughn-Williams Class II drugs | show 🗑
|
||||
| Vaughn-Williams Class III | show 🗑
|
||||
| Vaughn-Williams Class IV | show 🗑
|
||||
| What 2 notable antiarrhythmics do not fit in the Vaughn-Williams classification? | show 🗑
|
||||
| show | increase AP duration and ERP, increased QRS and QT duration, decreased slope phase 0
🗑
|
||||
| show | decreased AP and QT duration; no change in ERP; decreased slope phase 0
🗑
|
||||
| show | no change in ERP and A duration; decreased slope phase 0 & 4
🗑
|
||||
| Vaughn-Williams Class II drug actions | show 🗑
|
||||
| Vaughn-Williams Class III drug actions | show 🗑
|
||||
| Vaughn-Williams Class IV drug actions | show 🗑
|
||||
| show | GI distress, CNS symptoms, allergic reactions, lupus, thrombocytopenia, pro-arrhythmias, syncope
🗑
|
||||
| Vaughn-Williams Class II side effects | show 🗑
|
||||
| show | Amidarone: pulmonary toxicity, bradycardia, GI symptoms, thyroid and liver abnormalities. Sotalol: All class II side effects + proarrhythmia. Dofetilidie: torsade de Pointes
🗑
|
||||
| Vaughn-Williams Class IV side effects | show 🗑
|
||||
| show | VW Class Ia, Ic, and III drugs; II and IV if AV ivolved; Ib do not appear useful
🗑
|
||||
| show | Prevent embolic complications and treat abnormal rhythm
🗑
|
||||
| With afib, what risk factors are associated with high risk for stroke? Moderate? Low? | show 🗑
|
||||
| What two drugs have been shown to been effective in reducing the risk of stroke in patients with afib? | show 🗑
|
||||
| show | Prior stroke or TIA (high); Age>75 yoa, hypertension, diabetes mellitus, heart failure
🗑
|
||||
| How should you treat a patient with afib that is symptomatic and unstable? Minimally or asymptomatic? | show 🗑
|
||||
| show | recurrent paroxysmal atrial fibrillation and recurrent persistent atrial fibrillation
🗑
|
||||
| Antiarrhythmic drug therapy is needed for A.fib. patients if: | show 🗑
|
||||
| show | Anticoagulation and rate control
🗑
|
||||
| show | Advantages: inexpensive, widely available. Disadvantages: poorly controls rate during activity, digitalis toxicity serious problem
🗑
|
||||
| What are some of the advantages + disadvantages of using beta and calcium channel blockers for rate control during a.fib.? | show 🗑
|
||||
| What are some of the advantages + disadvantages of using amiodarone for rate control during a.fib.? | show 🗑
|
||||
| What are some of the advantages + disadvantages of using AV node ablation for rate control during a.fib.? | show 🗑
|
||||
| show | AVOID DIGOXIN, as blocking AV node allows atrial activity to escape through accessory pathway; treat with procainamide to slow both AV node and accessory pathway
🗑
|
||||
| show | ICD shown to be more effective than drug therapy (amiodarone not as effective as ICD in both ischemic and non-ischemic pop)
🗑
|
||||
| show | Ablation therapy: radiofrequency energy applied to critical portion of the tachycardia circuit; very low morbidity and almost no mortality
🗑
|
||||
| Ablation therapy can be used to treat... | show 🗑
|
||||
| Brady Theray-pacemaker therapy | show 🗑
|
||||
| Tachy therapy--defibrillator (ICD) therapy | show 🗑
|
||||
| How would you treat a patient with BBB and 1) Class III or IV CHF despite optimal medical therapy, 2) Ejection fraction less than 36%, and 3) QRS that is at least 120 ms in duration | show 🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
karkis77
Popular Physiology sets