What is the hallmark ECG feature of atrial fibrillation?
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Learn about common arrhythmias such as AFib, AV block, and VT, including their ECG features and treatment options.
Mastering this deck will enable you to accurately identify various arrhythmias on ECG, understand their underlying mechanisms, and select appropriate management strategies, thereby improving patient care and outcomes.
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| # | Front | Back | Hint |
|---|---|---|---|
| 1 | What is the hallmark ECG feature of atrial fibrillation? | Irregularly irregular rhythm with absence of distinct P waves; fibrillatory waves may be visible. | Think 'irregular and chaotic' for AFib |
| 2 | What are the common risk factors for developing atrial fibrillation? | Hypertension, heart failure, valvular heart disease, coronary artery disease, age, diabetes, and hyperthyroidism. | Remember 'HAT' (Hypertension, Age, Thyroid) as a mnemonic |
| 3 | Describe the ECG characteristic of atrioventricular (AV) block type I (Mobitz I/Wenckebach). | Progressive prolongation of the PR interval until a QRS complex is dropped; pattern repeats cyclically. | Think 'PR gradually gets longer until a drop' for Mobitz I |
| 4 | What distinguishes Mobitz II AV block from Mobitz I on ECG? | Constant PR interval with sudden dropped QRS complexes; PR interval does not prolong before the drop. | Note 'fixed PR' with sudden QRS loss in Mobitz II |
| 5 | What is the typical ECG finding in third-degree (complete) AV block? | No association between P waves and QRS complexes; atria and ventricles beat independently (AV dissociation). | Remember 'AV dissociation' as a key feature |
| 6 | What is the most common type of ventricular tachycardia (VT)? | Monomorphic VT, characterized by uniform QRS morphology and rate typically 100-250 bpm. | Think 'monomorphic' = same shape QRS complexes |
| 7 | Which ECG feature indicates ventricular tachycardia? | Wide QRS complexes (>120 ms), rapid rate, often regular; may have AV dissociation. | Wide QRS = ventricular origin |
| 8 | What is the acute management of stable ventricular tachycardia? | Antiarrhythmic medications such as amiodarone or lidocaine; synchronized cardioversion if unstable. | Assess stability before treatment approach |
| 9 | What is atrial flutter and how does it appear on ECG? | Rapid, regular atrial activity with 'sawtooth' flutter waves, typically at 250-350 bpm; AV conduction determines ventricular rate. | Think 'sawtooth' for flutter waves |
| 10 | How can atrial flutter be distinguished from atrial fibrillation on ECG? | Atrial flutter has a regular atrial pattern with sawtooth waves; AFib has irregularly irregular rhythm without distinct P waves or flutter waves. | Regular (flutter) vs. irregular (AFib) |
| 11 | What is the typical treatment for atrial fibrillation? | Rate control (beta-blockers, calcium channel blockers), rhythm control (antiarrhythmics), and anticoagulation for stroke prevention. | Balance rate, rhythm, and stroke risk |
| 12 | What is the mechanism underlying torsades de pointes? | Prolonged QT interval leading to early afterdepolarizations that trigger polymorphic VT with twisting QRS morphology. | Think 'twisting' QRS in QT prolongation |
| 13 | Which medications are common causes of QT prolongation leading to torsades? | Antiarrhythmics (e.g., sotalol, amiodarone), certain antibiotics (e.g., macrolides), and antidepressants. | Check for QT-prolonging drugs |
| 14 | What is the first-line treatment for torsades de pointes? | Intravenous magnesium sulfate; correcting underlying cause and discontinuing QT-prolonging drugs. | Magnesium stabilizes cardiac membranes |
| 15 | What is Wolff-Parkinson-White (WPW) syndrome and its ECG hallmark? | Presence of an accessory pathway causing pre-excitation; ECG shows a short PR interval, delta wave, and widened QRS complex. | Remember 'short PR + delta wave' for WPW |
| 16 | How does AV nodal reentrant tachycardia (AVNRT) typically present on ECG? | Sudden onset and termination of a narrow complex tachycardia at 150-250 bpm; P waves may be hidden or inverted after QRS. | Common in young, healthy individuals |
| 17 | Which treatment options are available for AVNRT? | Vagal maneuvers, adenosine (acute), and catheter ablation for definitive therapy. | Adenosine is the drug of choice for acute episodes |
| 18 | What is the typical response of atrial flutter to AV nodal blocking agents? | They slow AV conduction, decreasing ventricular rate but do not affect the atrial flutter circuit itself. | Control ventricular rate to reduce symptoms |
| 19 | What are the indications for implantable cardioverter defibrillator (ICD) placement in arrhythmia patients? | History of sustained VT/VF, high risk of sudden cardiac death, or certain cardiomyopathies with reduced ejection fraction. | ICD prevents sudden death |
| 20 | What is the significance of a wide QRS complex in tachyarrhythmias? | Indicates ventricular origin or aberrant conduction; important for differentiating ventricular from supraventricular tachycardias. | Wide QRS = ventricular or aberrant conduction |
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