Cardiology

describe sinus arrhythmia rhythm pattern

normal sinus rhythm that varies w respirations

increases w inspiration

Decreases w expiration

what meds cause slowing of heart rate

1. beta blockers

2. CCB

3. digoxin

4. adenosine

5. narcotics

what meds increase heart rate for severe sinus brady

1. atropine

2. epinephrine

3. dopamine

MCC of sick sinus syndrome

degenerative fibrosis

what does sick sinus syndrome look like on EKG

alternating bradycardia and atrial arrhythmia

(tachy-brady syndrome)

what is the most helpful part to look at on EKG to determine presence of AV block

PR interval

normal PR interval vs AV block

Normal PR: 0.12-0.2 seconds

AV block: >0.20 seconds

preferred initial diagnostic for atrial flutter

transthoracic echo

drug of choice for acute pharmacologic cardioversion of atrial flutter

ibutilide

types of a.fib

1. paroxysmal: stops within 7 days

2. persistent: doesnt stop within 7 days (requires intervention)

3. permanent: persistent AF >12 months

4. lone: any type of a.fib w/o evidence of heart dz

how long anticoagulation fo cardioversion of a.fib

3 weeks before and 4 weeks after

(if a.fib for <48 hours then dont have to wait 3 weeks, just need anticoagulation for 4 weeks after tho)