229 Ch 22 management of pts with arrhythmias and conduction problems

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What are arrhythmias?

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52 Terms

1

What are arrhythmias?

Disorders of formation or conduction of electrical impulses within the heart.

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2

What do arrhythmias receive their name from?

The site of origin.

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3

What are some risk factors for arrhythmias?

Sleep apnea, smoking, and a recent myocardial infarction (MI).

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4

What is the normal electrical conduction pathway in the heart?

SA Node, AV Node, Bundle of His, Right and Left Bundle Branches, Purkinje Fibers.

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5

What does depolarization lead to in the heart?

The contraction or systole.

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6

What does repolarization lead to in the heart?

The relaxation or diastole.

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7

What is a standard method of monitoring the heart's electrical activity?

Electrocardiogram (ECG).

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8

What are the types of ECG's mentioned?

Bedside ECG, standard 12 lead ECG, hardwire monitoring, Holter monitor, and loop recorder.

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9

What are Holter monitors used for?

They are worn for a specified amount of time to document activity.

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10

What is Sinus Bradycardia?

A heart rate of 60 bpm, occurs when the SA node creates an impulse at a slower than normal rate.

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11

What are some symptoms of Sinus Bradycardia?

Exercise intolerance, fatigue, dizziness, headache, nausea, palpitations, and chest pain.

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12

How is Sinus Bradycardia treated?

With an artificial pacemaker, medications like Atropine or Warfarin.

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13

What is Sinus Tachycardia?

A heart rate of 100 bpm, occurs when the sinus node creates an impulse faster than normal.

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14

What can trigger Sinus Tachycardia?

Fear, anxiety, exercise, blood loss, shock, or pain.

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15

How are Orthostatic Hypotension and POTS Syndrome related?

POTS is a condition where the body does not compensate fast enough, causing dizziness, sweating, fatigue, and other symptoms.

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16

What are PACs?

Premature Atrial Complexes, which occur when an electrical impulse starts in the atrium before the next normal impulse from the sinus node.

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17

What is Atrial Fibrillation?

A condition characterized by heart palpitations, fatigue, shortness of breath, and irregular rapid pulses from different foci.

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18

What medication should be given if Afib does not resolve in 48 hours?

Warfarin.

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19

What is the primary risk factor for stroke in patients with Afib?

Risk for thromboembolism.

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20

What is Premature Ventricular Complex (PVC)?

An impulse that starts in a ventricle and is conducted through the ventricle before the next normal sinus impulse.

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21

What are the two types of Ventricular Tachycardia?

Monomorphic and polymorphic.

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22

What is the treatment for Ventricular Fibrillation?

Immediate defibrillation and CPR.

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23

What is the definition of Ventricular Asystole?

A flatline; no heartbeat, no palpable pulse, and absent QRS.

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24

What does a first-degree AV block indicate?

All atrial impulses are conducted through the AV node at a slower than normal rate.

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25

What is the treatment for symptomatic AV blocks?

IV bolus of atropine, temporary transcutaneous pacing, or a permanent pacemaker if it persists.

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26

What is the purpose of electrical cardioversion?

To revert arrhythmias back into rhythm.

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27

What should patients avoid following placement of a pacemaker?

Avoid lifting the arm on the side where the pacemaker is implanted.

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28

What is LAAO?

Left Atrial Appendage Occlusion, a procedure to block or close the opening of the LAA.

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29

What is an Implantable Cardioverter-Defibrillator (ICD)?

An electronic device that detects and terminates life-threatening episodes of tachycardia or fibrillation.

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30

What should patients with atrial flutter expect to see on their ECG?

A sawtooth pattern indicating rapid, regular atrial impulses.

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31

What can cause Atrial Flutter?

Excessive alcohol consumption, thyroid problems, age, or cardiovascular disease.

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32

What is the significance of abnormal ECG findings?

It may indicate the presence of arrhythmias that require further evaluation.

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33

What is the role of anticoagulants in treating Afib?

To prevent thromboembolism.

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34

What is cath lab used for in cardiac care?

For evaluating and treating arrhythmias.

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35

What should be monitored post-procedure for cardiac patients?

Rhythm, pulse, incision site and symptoms of complications.

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36

What medications may be given for arrhythmias?

Amiodarone, lidocaine, and magnesium.

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37

What is the primary symptom of Ventricular Tachycardia (VT)?

Three or more PVCs in a row at a rate of 100 bpm.

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38

What is a common cause of Ventricular Fibrillation?

Untreated or unsuccessfully treated VT.

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39

What should be done if a patient goes into Ventricular Asystole?

Initiate high-quality CPR and establish IV access.

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40

What is the purpose of transesophageal echocardiogram in cardiac evaluation?

To evaluate for thrombi.

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41

What defines a temporary pacemaker?

A device used to regulate heart rate temporarily.

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42

What is a common complication of pacemaker implantation?

Dislodgement of pacing electrode.

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43

What is atrial flutter characterized by?

Atrial flutter is characterized by a rapid, regular atrial rate and may produce a 'sawtooth' pattern on an ECG.

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44

What is the heart rate in atrial fibrillation?

In atrial fibrillation, the heart rate can vary widely, often exceeding 100 bpm.

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45

How does myocardial infarction relate to arrhythmias?

Myocardial infarction can damage heart tissue, leading to disturbances in electrical conduction and increasing the risk of arrhythmias.

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46

What is the role of a Holter monitor in cardiac assessment?

A Holter monitor records the heart's electrical activity over 24-48 hours to capture arrhythmias that may not occur during a standard ECG.

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47

Which arrhythmia is often referred to as 'skipping beats'?

Premature Atrial Complexes (PACs) are often described as 'skipping beats' from early atrial impulses.

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48

What can the presence of a first-degree AV block indicate?

First-degree AV block suggests that there is a delay in conduction through the AV node, which may not require treatment unless symptomatic.

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49

What medication is typically used for rate control in atrial fibrillation?

Beta-blockers or calcium channel blockers are commonly used for rate control in atrial fibrillation.

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50

What is the potential complication of untreated atrial fibrillation?

The primary complication of untreated atrial fibrillation is an increased risk of stroke due to thromboembolism.

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51

In the context of arrhythmias, what does the term 'synchronized cardioversion' refer to?

Synchronized cardioversion is a procedure used to convert an arrhythmia to normal sinus rhythm using an electrical shock, timed with the heart's rhythm.

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52

What is the significance of a patient experiencing symptoms like syncope or near-syncope in relation to arrhythmias?

Symptoms like syncope or near-syncope may indicate significant arrhythmias that require urgent evaluation and intervention.

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