Cardio Mod 1 Treatments

Just the treatments for the arrhythmias and such since I can't just shock everybody

avoid triggers, Beta blockers, catheter ablation

Treatment for a patient throwing PACs with palpitations

valsava maneuver, carotid massage

What vagal maneuvers can be used to treat AVNRT

Adenosine

What medication use to treat AVNRT blocks AV nodal conduction and works in about 80% of cases (C/I w/ asthma or COPD)

verapamil, dilitiazem, metroprolol, digoxin

Other meds for AVNRT

catheter ablation

What surgery can be used to treat subsequent episodes of AVNRT that is invasive, but definitive if it works?

cardiovert, chemical cardiovert w/Ibutilide

How do you control/convert the rhythm in atrial flutter?

verapamil, dilitiazem, esmolol, digoxin

How do you control the rate of atrial flutter?

radiofrequency catheter ablation

What is the definitive treatment for atrial flutter?

unstable patient (hypotension, ongoing ischemia, severe HF, stroke)

When is cardioversion used in atrial fib

rate control (drugs that slow AV node)

For our older patients with a fib what is the game plan

Rhythm control w/ cardioversion and anti-arrhythmics

For our younger patients with a fib what is the game plan

Anti-coag meds started

If we are going to cardiovert a STABLE patient in a.fib what must be done first?

treat underlying (vagal tone changes, digoxin tox, inflammation of atrial tissue, valvular heart disease)

How does one treat a wandering atrial pacemaker?

Underlying cause, verapamil

How does one treat MAT?

underlying cause, beta blockers if patient reports palpitations

How does one treat PVCs in a healthy person?

treat underlying, ICD (implanted defib)

How does one treat PVCs in someone with advanced structural heart disease?

underlying cause, pacemaker, support CO, DO NOT SUPPRESS!!!!

How do you treat an idioventricular rhythm?

tincture of time, underlying cause, pacemaker, support CO, DO NOT SUPPRESS!!!!

How do you treat an accelerated idioventricular rhythm?

elective cardiovert, procainamide/amiodarone, IV mag (for stable torsades)

Game plan for a stable patient with V tach?

ACLS, cardiovert immediately (torsades = defib)

Game plan for an unstable patient with V tach?

ICD, ablation, beta blockers, CCB

Long term treatments for V tach peeps?

Magnesium sulfate, isoproterenol, lidocaine, phenytoin, sodium bicarb

What medications can we used to treat a patient in torsades as a result of long QT syndrome?

Defib and convert it

Short term treatment for V fib

ICD

Long term treatment for V fib?

Find the underlying, ACLS, NO SHOCK

Treatment for asystole?

pacemaker, underlying cause

Treatment of a patient with sick sinus syndrome that is symptomatic and bradycardic?

antiarrythmics, pacemaker

Treatment of tachy-brady syndrome?

Beta blockers, CCBs, class IA, IC and III antiarrhythmic drugs

Treatment of PAT?

none

Treatment of a 1st degree AV block

treat the bradycardia

Treatment of a Wenckebach

PACEMAKER (unless caused by meds), symptomatic treatment of bradycardia while waiting

Treatment plan for mobitz

PACEMAKER, symptomatic treatment of bradycardia while waiting

Treatment plan for 3rd degree

pacemaker

Bifascicular block treatment

beta blockers

For patients with dilated cardiomyopathy and acceleration-dependent LBBB what is the treatment?

cardiac resynchronization therapy

What is recommended for patients with a BBB, depressed systolic function, heart failure, and a QRS greater than 3 small blocks

underlying cause

BBB treatment

procainamide

Whats the game plan for WPW (either orthodromic or antidromic)?

symptomatic tachyarrhythmias, occupations in which others are at risk, children

Which patients with WPW are eligible for surgical treatment?