What is the hallmark ECG feature of atrial fibrillation?
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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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| 1 | 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.
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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