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?