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Syncopal attack
Fatigue
Tachycardia
Frog sign
Chest pain
Seizure
Hypotension
Ancilary procedures :
Holter monitoring
Stress test
EP study
Electrolyce disorders
mainly Involve
the heart rhythm
Arrhytmia mechanism :
Impulse initiation :
Automaticity :
Tachycardia and bradyardia
Conduction disorders :
Reentry :
Microreentrant
Macroreentrant
Acessory pathway
Automaticity :
If, ICa-L, ICa-T, IK, IK1
Suppression/acceleration of phase 4
Sinus bradycardia, sinus tachycardia
Triggered automaticity
Calcium overload, ITI
DADs Digitalis toxicity, reperfusion VT
ICa-L, IK, INa
EADs Torsades des pointes, congenital and
acquired
Pathomechanism of reentry
Most common mechanism of arrhytmia
Reentry :
Unifocal
Multifocal multifocal VT
Microreentrant :
Most of cardiac arrhytmias:
SVT, AF
Marcroreentrant :
Atrial fluter sawtooth appearance
Acessory pathway :
WPW sydrome deltra wave
Atrial
tachycardias
SVT / AVNRT
Atrial fibrilation
Atrial Flutter
Multifocal atrial
tachycardias
Ventricular
tachycardias
Monomorfic
ventricular
tachycardias
Polymorfic
ventricular
tachycardias
Management :
Specific to the current abnormalities
AVNRT / SVT
Digoxin, verapamile, diltiazem, adenosine
MAT :
Digoxin
AF / A flu :
Rate control
Rhythm control
Anticoagulation
VT
Anti arrhytmic agent : amiodarone
Magnesium sulfate
LQT1
LQT2
LQT3
LQT4
LQT6
LQT7
LQT8
Brugada syndrome
ST segment elevation in V1 to V3 that
typically can be provoked with the
sodium channel-blocking drugs
ajmaline, flecainide, and
procainamide and a risk of
polymorphic ventricular arrhythmias
Specific treatment :
ICD implantation.
Bradyarrhytmias :
Extrinsic :
Autonomic
Drugs
Hypothyroidism
Hypotermia
Vagal manouvers
Increase ICP
Intrinsic
AV node disease
CAD
Vasovagal
Drug related
Infectious
Congenital
Inflamatory
Infiltrative
Neoplastic
Degenerative
Pacemaker mnemonics:
The first letter indicates the chamber(s) that is
paced (O, none; A, atrium; V, ventricle; D,
dual; S, single).
The second is the chamber(s) in which sensing
occurs (O, none; A, atrium; V, ventricle; D,
dual; S, single),
The third is the response to a sensed event (O,
none; I, inhibition; T, triggered; D, inhibition +
triggered)
Pacemaker
Transcutaneous
Transvenous
Permanent