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26 Cards in this Set
- Front
- Back
- 3rd side (hint)
Class I anti-arrhythmics 1) Drug names 2) Indications |
1) Quinidine, procainamide, disopyramide 2)Pre-excited atrial fibrillation (procainamide) Brugada syndrome (quinidine) SVT, atrial fibrillation Ventricular arrhythmias |
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Class IB anti-arrhythmics 1) drug names 2) Indications |
Lidocaine, mexiletine Ventricular arrhythmias |
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Class IC anti-arrhythmics 1) Drug names 2) Indications |
1) Propafenone (Rytmonorm), flecainide 2) Atrial fibrillation, SVT Ventricular arrhythmias avoid with CAD or structural heart disease. |
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Class III anti-arrhythmics 1)drug names 2) indication |
Sotalol, difetilide Atrial fibrillation, atrial flutter, ventricular arrhythmias; avoid in CKD. |
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Avoid anti-arrhytmics 1) in Structural heart disease 2)in CAD 3) in pre-excitation Afib 4) in CKD 5) in long QT |
1) class I 2) class IC: flecainide, propafenone 3) CCB, beta blockers 4) class III 5) class III |
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Patients on amiodarone require lower doses of |
Warfarin, statin and digoxin |
3 answers |
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Sinus bradycardia: Causes |
most common intrinsic: aging and myocardial fibrosis most common extrinsic: drugs Right coronary ischemia intracranial HTN postsurgical scarring Infiltrative or inflammatory disorders such as sarcoidosis |
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Permanent pacing indications |
Symptomatic bradycardia without reversible cause Asymptomatic bradycardia with significant pauses (>3 seconds in sinus rhythm) or persistent heart rate <40/minAtrial fibrillation with 5-second pauses Asymptomatic 3rd degree AVB or Mobitz type 2 Alternating bundle branch block |
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treatment of SVTs (excluding fib and flutter) |
/adenosine, maneuvers, synchronised electroversion beta blockers and non dihidropyridine CCB to prevent recurrence ablation to avoid long term treatment of if no repsonse to node blockers flecainide propafenone can be used if no response to other treatment modalities |
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types of AVRT: circuit, ecg, response to adenosine and vagal maneuvers |
orthodromic: Av node then accessory pathway, narrow qrs, responds to vagal maneuvers and adenosine antidromic: accessory then av node, delta wave, doesnt respond to adenosine and vagal maneuvers |
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when are adenosine and nodal blockers CI in AVRT |
antidromic AVRT and atrial fibrillation, it leads to Vfib |
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risk factor for VF in AVRT |
WPW, rapid conduction through accessory pathway, ebstein anomaly, multiple bypass tracts |
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treatment of AVRT |
1st line catheter ablation (EP studies help assess speen of conduction and location) 2nd line antiarrhythmics nodal blockers only in orthodromic AVRT |
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oral anticoagulation drugs |
warfarin dabigatran (pradaxa) rivaroxaban (xarelto) apixaban (eliquis) |
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CHA2DSVasc2 |
1 point for: HF \ HTN \ DM \ female vascular disease age 65 to 74 years. Two points: previous stroke/transient ischemic attack/thromboembolic disease age ≥75 years. 0 (none) 1 (none, asa or OAG) 2 and more (oag) |
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new OAG 1) compared to warfarin 2) CI 3) Antidote |
1) better in decreasing stroke Less IC bleed, More GI bleed 2) ESRD 3) Idarucizumab |
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treatment of refractory symptomatic tachy in Afib |
AV node ablation + pacemaker |
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Afib epidemio |
In patients older than 40 years, the lifetime risk of atrial fibrillation is 1 in 4. More than 10% of persons aged 80 years and older have atrial fibrillation. fivefold increased risk of stroke as well as an increased risk of heart failure and dementia |
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Afib classification |
First detected Paroxysmal atrial fibrillation starts and stops spontaneously. Persistent atrial fibrillation lasts for 7 days or more and requires electrical or pharmacologic cardioversion. Long-standing persistent atrial fibrillation is persistent atrial fibrillation that is more than 1 year in duration. |
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work up for detected afib |
tsh r\o OSA TTE to r\o valvulopathy |
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duration of anticoagulation before cardioversion if afib onset >48 hrs |
3 weeks |
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when is aximal need for anticoagulation in afib |
during and 4 weeks after cardioversion |
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when to avoid CCB in rate control |
in ventricular dysfunction |
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treatment of choice in pre excitated afib |
procainamide |
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Afib pharmacological cardioversion drugs in pts without structural heart disease |
flecainide, propafenone, ibutilide |
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conditons where oral anticoagulation for afib regardless of score |
mitral stenosis or rheumatic heart disease prior systemic embolism a prosthetic heart valve left atrial appendage thrombus hypertrophic cardiomyopathy |
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