Term
| How are supra-ventricular arrhythmias, bradycardia, and heart block treated? |
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Definition
|
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Term
| How is sinus tachycardia treated? |
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Definition
| Remove the offending cause |
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Term
| What are the therapeutic objectives when treating Paroxysmal AV nodal reentry? |
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Definition
1. break the reentry circuit (NSR)
2. Prevent recurrence |
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Term
| What is the choice drug for immediately treating paroxysmal AV nodal reentry? |
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Definition
| Adenosine 6mg IV, 12mg IV, 12mg IV |
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Term
| When treating paroxysmal AV nodal reentry with adenosine some concerning pt variables are... |
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Definition
| Asthma - b/c of broncho-constriction |
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Term
| What is the antidote to adenosine? |
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Definition
|
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Term
| T/F Massaging the carotid arteries could treat paroxsymal AV nodal reentry? |
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Definition
| True - increases vagal tone, slows HR, resolves problem |
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Term
| What are the choice drugs for chronically treating paroxysmal AV nodal reentry? |
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Definition
| Verapamil, diltiazem, metoprolol |
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Term
| When a pt is in atrial flutter what two problems exist? |
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Definition
Rhythm control
Rate control |
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Term
| What is the best way to resolve the rate control problem in atrial flutter? |
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Definition
|
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Term
| What is the best way to resolve the rhythm control problem in atrial flutter? |
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Definition
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Term
| What is the definition of atrial fibrillation? |
|
Definition
supraventricular
tachycardia
disorganized atrial excitation
uncoordinated atrial contraction
erratic ventricular response |
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Term
|
Definition
1. New-onset
2. Paroxysmal - self terminating w/in 7d
3. Permanent - not self terminating |
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Term
| Describe an EKG of a pt with A. Fib |
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Definition
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Term
| When controlling rate in a. fib, at what site do BB, CCB, or Dig work at? |
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Definition
|
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Term
| Is rate control better than rhythm control in an a. fib pt |
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Definition
| NO difference AFFIRM, HOT-CAFE, RACE trials |
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Term
| Aside from cardioversion, what other ways are available to correct rhythm in a. fib? |
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Definition
| Catheter-based pulmonary vein ablation |
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Term
| A. fib treatment algorithm (assume the a. fib. is not new-onset) |
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Definition
1. TEE (trans esophageal echo)
2. If thrombus present than anticoagulates for 3 weeks
3. When/if thrombus free - Cardioversion
4. 4 weeks of anticoagulants |
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Term
| Rate control BPM objectives? |
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Definition
60-80 @ rest
90-155 @ moderate exercise |
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Term
|
Definition
| Kept pts at strict rate control, and they died. This resulted in a new goal of <110 BPM |
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Term
| T/F BB used to treat arrhythmias should have ISA properties |
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Definition
| False - thus we use esmolol, metoprolol, propranolol |
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Term
| Which CCB is better at sinus rate control, and which CCB is commonly used for AV node rate control` |
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Definition
| Diltiazem - it is better at sinus node control as opposed to av node, but it is much easier to give than verapamil, so everyone uses diltazem IV |
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Term
|
Definition
|
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Term
| In what way is therapeutic efficacy determined in digoxin pts? |
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Definition
Dig levels are irrelevant in terms of therapeutic efficacy…it will be higher than this number b/c you need more to decrease conduction through the AV node than you do for myocardial contractility
Therapeutic efficacy is determined by ventricular rate? |
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Term
| The most important objective in a. fib. pts is... |
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Definition
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Term
| In relation to cardioversion...Most TEs occur... |
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Definition
|
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Term
| ]An a. fib. pts long term need for anti-coagulation therapy will be determined by... |
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Definition
|
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Term
| The most common drug used in rhythm control at a hospital is |
|
Definition
dofetilide PO
ibutilide IV |
|
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Term
| T/F a pt must be hospitalized to start dofetilide for rhythm control? |
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Definition
|
|
Term
| The most common drug used in a. fib. rhythm control is... |
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Definition
|
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Term
|
Definition
|
|
Term
| Amiodorone monitoring/counseling points |
|
Definition
1. turn blue in the sun
2. corneal deposits
3. 40% iodine
4. nausea common |
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Term
| Which two drugs are reserved for pts with normal hearts anf a. fib? |
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Definition
| flecainide (150-300mg) & propafenone (600mg) |
|
|
Term
| The CAST study determined... |
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Definition
| PVCs were not such a big deal b/c of pt death, and reduced the use of Clkass 1C drugs |
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