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Atrial Fibrillation (A-Fib) + treatment
known as the "irregularly irregular" rhythm, no distinct P
waves only fibrillatory waves and a variable ventricular rate,
controlled if between 60-100 bpm
SA node isn't directing hearts electrical rhythm, rather different
impulses are firing at the same time
turbulent flow causing blood clots → warfarin, apixaban;
maintain control of rhythm/restore sinus rhythm → beta
blockers, calcium channel blockers
,Atrial Flutter + treatment
known for it's "saw tooth" flutter waves, atrial activity is approx.
300 bpm, ventricular response is variable (may appear regular
if a fixed AV block or irregular if a variable conduction block)
rate control (beta-blockers, non DHP calcium channel blocker),
cardioversion (external activity to reset rhythm), heart-healthy
lifestyle choices (eating healthy, exercising, lowering stress,
smoking cessation)
Ventricular Tachycardia (VT) + treatment
a broad complex tachycardia, hr >100, qrs >160ms, no P waves
code blue, shock, put on ground or bed to prepare for intervention,
amiodarone
Ventricular Fibrillation + treatment
chaotic, irregular deflections with a rate of 150-500 bpm, no
normal looking complexes, amplitude decreases with duration
(coarse to fine VF)
CPR, epinephrine, shock. Check if all leads are on. (patient may
present as unconscious, apneic, or no pulse)
,asystole + treatment
flat line, no complexes
epinephrine, CPR
1st Degree AV Block + treatment
Prolonged but consistent PR interval
often no treatment necessary, pacing, prophylactic antiarrhythmic
drug therapy
2nd Degree AV Block + treatment
Type 1 (Wenckeback): PR interval increases until a complex is
dropped
often no treatment necessary, pacing, prophylactic antiarrhythmic
drug therapy
Type 2 (Mobitz): Sporadic loss of conduction
NOT atropine for type 2 → wont improve conduction through
AV node as it acts on SA node which is firing properly,
dopamine (alpha 1 stimulation, protects cardiac output by
vasoconstricting), pacemaker, treat s&s, electric
cardioversion
, 3rd Degree AV Block + treatment
Complete AV dissociation
pacemaker, catecholamines
3 ways to treat arrhythmias
Rate control: pacemaker (back up generator if pharm
management causes drop in HR), ablation
Anticoagulation (reduce risk of stroke, new gen has no
antidote, INR must be monitored with old gen): pharmacology
(calcium channel blockers like amlodipine, hold metoprolol if
HR too high and BP too low), bridging
Rhythm control (risk with a fib -> sinus rhythm = kickback = stroke
risk): cardio version, pharmacology
Goal of pharm management for arrhythmias
Controlling SA & AV node activity by altering adrenergic
activation, Na/Ca influx, K efflux, and Na/K pump -> slow down
or lengthen the AP, or speed up conduction/shorten AP