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45 Cards in this Set

  • Front
  • Back
precipitating factors for arrhythmia
ischemia,
pH and electrolyte abnormalities,
excessive mycardial fiber stretch,
excessive release or sensitivity to neurotransmitters,
drugs/toxins
electrolyte abnormalities causing arrhythmia: "the big one"
pottassium

also, fad diets
condition caused by drugs that prolong the QT interval
Torsades de pointes
mechanisms of arrhythmogenesis
altered automaticity,
re-entry,
after depolarizations
automaticity is altered b/c the slope of phase ___ is altered
4
decrease in phase 4 slope of pacemaker cell allows ______cell to become dominant
another pacemaker
increase in phase 4 slope of nonpacemaker cell allows dominant to ______cell
normal pacemaker cell
conditions nec. for re-entry
1-unidirectional block,
2-electrical recovery of tissue adjacent to site of unidirectional block to allow conduction of re-entering impulse
conditions favoring developent of re-entry arrhythmias
1-long conductin pathways
2-short ERPs (effective refractory period)
3-slowed conduction
what do antiarrhythmic drugs attempt to do.
converting unidirectional block to bidirectional block
Wolff-Parkinson-White syndrome
conduction problem where atrial signals reach the ventricle without going thru AV node
QT_c?
corrected
etiology of sinus bradycardia
1-young, athletic
2-incr. vagal tone (Vom, naus)
3-pharm. (Ca ch or beta blockers)
4-inferior MI
Ca ch blocker causing sinus bradycardia
verapamil
causes of sinus tachycardia
pain, fever, stress
SVT?
supraventricular tachycardia
EKG sign of SVT
narrow QRS, rapid
cause of SVT
reentry or an ectopic pacemaker above the bifurcation of the His bundle
atrial BPM of atrial flutter
250-350 bpm
atrial flutter is common in what disease?
IHD
EKG characteristics of atrial flutter
sawtooth waves best in II, III, aVF
quinidine is bad for atrial flutter why?
quinidine facilitates AV node conduction
treatment of atrial flutter that is > 48 hrs
anticoag + Ca ch or beta blockers
treatment of unstable atrial flutter
electrocardioversion
holiday heart?
alcoholic induced arrhythmias or cardiomyopathy
- disorganized multiple ectopic discharges
- loss of atrial kick
atrial fibrillation
atrial fib chance of stroke?
incr. 5% yearly and 25% lifetime
what drugs are used for rated control in atrial fib?
beta blockers and digoxin
pt age that decides anticoag therapy during atrial flutter
<75 : aspirin

>75 : coumadin
EKG sign of 1st degree block
prolonged PR interval greater than 0.2s (5 blocks)
is 1st degre block clinically significant?
no
Dropped QRS and
increasing PR interval
shortening RR intervals
constant PP interval
2nd degree AV block
(Mobitz type I or Wenckebach)
dropped QRS
fixed PR interval
PRS slightly wide
2nd degree AV block
(Mobitz type II)
No AV condution
ventricular escape rhythm
narrow QRS
3rd degree AV block
which is more dangerous Mobitz 1 or 2?
2
No p wave
wide QRS
PVC

(preventricular contractions)
(premature ventricular contractions)
ventricular bigeminy
PVCs alternating with sinus beats
treatment for PVC and ventricular bigeminy
none, usually benign
"monomorphic" EKG (no p waves)
wide QRS
high rate
ventricular tachycardia
no p waves or QRS waves
ventricular arrhythmias
Major MOA
Na channel blockade
SNS blockade
ERP prolongation
Ca channel blockade
Antiarrhythmic Drug Actions Decrease automaticity of _________ more than SA node
ectopic pacemakers
Antiarrhythmic Drug Actions Reduce conduction and excitability in depolarized tissue more than normally polarized tissue
Selective blockade of ______channels of depolarized tissue
Na and Ca
Antiarrhythmic Drug Actions:
ERP increased more in depolarized tissue than in
____________
normal polarized tissue
Ca blockers have greater affinity for activated channels (phase 0) or inactivated channels (phase 2) and low affinity for ____________ [use-dependent or state dependent action]
rested channels