10434814
| Question | Answer |
| T/F: Heart rhythm can be generated anywhere within the electrical conduction system. | T. |
| What is the normal depolarization sequence of the heart? | 1. SA node 2. AV node 3. bundle of his 4. left/right branches 5. purkinje network |
| What is the benefit of the pause at AV node? | 1. Allowing ventricles to relax and refill 2. allow atrial contraction before ventricular contraction (atrial kick) |
| Why can the pacemakers depolarize spontaneously? | They have unstable resting membrane potentials. |
| During the absolute refractory period of cardiac cells, the Na channels are ______. Cell is hence unable to generate _______. | Closed. Unable to generate AP. |
| What are the 4 underlying causes of arrythmia? | 1. excitability problem 2. myocardial heterogeneity 3. conduction problems 4. repolarization problems |
| How can ischemia result in arrhythmia? | ischemia --> affects electrolyte balance --> generation of spontaneous or abnormally conducted impulses |
| How does thyroid disease tigger arrhythmia? | 1. altered level of T3 and T4 2. activtion of RAAS system 3. increased preload 4. increased cardiac output |
| Mechanical stretch increases/decreases Ca2+ overload, RAAS activation, endothelin-1, natriuretic peptides, oxidative stress, heat shock proteins. | Increases. |
| What are some clinical presentations of atrial tachy? | 1. rapid pulse rate and palpitation 2. dyspnea, dizziness, syncope 3. impaired diastolic filling and SV, chest pressure |
| A dysrhythmia that is highly associated with CAD, CHF, and valvular heart disease is ________. | A-fib |
| The impaired atrial contribution to LV end-diastolic volume results in reduced ____ and hence ________. Resulting in symptoms such as SOB, lightheadedness, fatigue, exercise intolerance. | Reduced SV and hence CO. |
| What is another coagulation-related problem associated with a-fib? | embolic stroke |
| Paroxysmal AF is usually managed by _____ control, while permanent AF is managed by ________ control. Persistent AF is managed by _______. | Paroxysmal: rhythm control permanent: rate control persistent: either |
| T/F: there is no p-wave in v-tach ECG. | F. P wave is present but not discernable. |
| Ventricular rate during v-tach is about ___bpm. | 110 - 250 |
| What are some clinical presentation of V-tach? | 1. palpitation, anxiety, tachypnea 2. lightheadedness, syncope, hypotension 3. may deteriorate into ventricular fibrillation |
| T/F: V-fib is usually associated with cardiac arrest. | T. |
| Sinus bradycardia has a P: QRS rate of _______. | 1:1 |
| T/F: Sinus bradycardia is always symptomatic. | F. Maybe in trained athletes/ patient on BB. |
| What are some symptoms of bradycardia? | 1. dizziness, lightheadedness, syncope 2. chest pain, SOB, exercise intolerance |
| Junctional rhythm is also called ______ rhythm. Symptoms include ______, ______ and _______. P wave (leads/follows) QRS complex. | Nodal rhythm. Symptoms: palpitation, fatigue, presyncopal symptoms. P wave [follows] QRS. |
| If the R is far from P, then you have a _______ | First degree |
| Longer, longer, longer, drop! Then you have a _____ | Wenkebach (second degree, mobitz I) |
| If some Ps don't get through, then you have ________. | Mobitz II |
| If P and Qs don't agree, then you have a ____________. | Third degree. |
| Palpitation is more common in second degree mobitz ____ while syncope is more common in mobitz ___. | Palpitation: Mobitz I. Syncope: Mobitz II. |
| Drug used for cardioversion is usually ________. | adenosine |
| When patient is undergoing electrical cardioversion, the discharge is delivered during ________. | Systole |
| Electrical defibrillation is only used for which two conditions? | 1. V-fib 2. V-tach |
| Which implanted device is the best for bradycardia alone and which one is the best for brady and tachy? | 1. pacemaker is god for brady alone 2. AICD (automatic implantable cardioverter defibrillator) is good for both |
| What is the theory behind radiofrequency ablation? | To remove irritable foci to suppress tachyarrhythmia |
| What is the theory behind maze procedure? | To make incisions in RA and sewn it closed, so that the abnormal impulses cannot pass through. (best for A-Fib) |
| What maneuver can be used to slow/ convert supraventricular tachys? | Vagal maneuver. (gagging, valsava, immersion face in ice water, carotid massage, coughing, pressing firmly over eyelids. |
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