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robbypowell's version from 2016-10-21 15:08

Arrhythmias

Question Answer
____ million americans have some sort of Cardiovascular Disease90 million
T/F: Patients with cardiovascular disease usually have more than one cardiovascular disease (e.g. HTN, coronary artery disease)True
T/F: Patients with cardiovascular disease rarely have more than one cardiovascular diseaseFalse (they usually have more than one)
the ____ _____ is the pacemaker for the myocardiumSA Node
_____ fibers are often studied because aspects of action potential phases are easily seenPurkinje fibers
The SA node is found in the floor of what heart compartment?Right Atrium floor
Automaticity refers to phase ____ of action potentialPhase 4
______ period is the period when heart does not react to stimulusRefractory
_______-ness: rate and extent of activity of heart → refers to membrane diastolic potential, threshold potential, and slope of phase 4 of action potentialRESPONSIVEness
Fast Sodium channels are associated with Phase ____ of action potentials and is very dependent on influx od sodiumPhase 0
Phase 0 of action potential of heart is very dependent on influx of ______Sodium (Fast Sodium channels)
Slow Calcium channels are associated with Phase ____ of AP of heartPhase 2
Potassium channels are associated with Phase ____ of AP of heartPhase 3 (repolarization)
Cardiac arrhythmias can be caused by abnormal ____ _____ or abnormal _____Impulse generation or conduction
Cholinergic pathways (increase/decrease) myocardial activity and affect what phase specifically?decrease; phase 4 (slow down HR by increasing refractory period)
__________ are electrical activity in diff sites after spike potential has already occurred (aberrant electrical activity) (and can be caused by inc Ca or Digitalis Glycosides)Afterpotentials
Abrnormal conduction Type _____ has prolonged time between P wave and QRS waveType 1
the same rate between SA node and ventricular contraction rate would be described as _______Normal
Atrial _____ with ______ block would show as too many impulses generated erratically in ventricle, and no discernable QRS complexAtrial FIBRILLATION; Secondary Block
____ ______: very Effective non-pharm treatment of re-entry arrhythmias (atrial fib, ventricular fib, atrial flurry, ventricular tachycardia) simultaneous depolarization of entire myocardium and allows for synchronous repolarization and resumption of sinus rhythmic activityElectrical Cardioversion
T/F: both Na and Ca affect phase 0 of cardiac APTrue (but Na mainly important for phase 0)
T/F: both Na and Ca affect phase 4 of cardiac APFalse (Na only phase 0)
memorize

specific anti-arrhythmic drugs... what type # are they and what channels do they affect

Question Answer
QuinidineType 1A; Na (medium channels), K channels, Calcium channels
ProcainamideType 1A; Na (medium channels), K channels
DispyramideType 1A; Na (medium channels), K channels
Lidocaine (IV)Type 1B; Na Fast channel blocker
Phenytoin (anti convulsant)Type 1B; Na Fast channel blocker
TocainideType 1B; Na Fast channel blocker
Mexiletine (oral version of Lido)Type 1B; Na Fast channel blocker
FlecainideType 1C; SLOW Na channels
PropafenoneType 1C; SLOW Na channels
MoricizineType 1C; SLOW Na channels
PropranololType 2; Beta-receptor blockage
EsmololType 2; Beta-receptor blockage
AmiodaroneType 3; Block K channels
BretyliumType 3; Block K channels
SotalolType 3; Block K channels
VerapamilType 4; Ca channel blockers
DilitazemType 4; Ca channel blockers
AdenosineNot one of 4 types; A1 receptor stimulation, inc K conductance
All anti-arrhythmic drugs treat supraventricular & ventricular EXCEPT type _____, type ____ and miscellaneous (ones that don't fall into types e.g. Digitalis and Adenosine) these treat EITHER Supraventricular or Ventricular ArrhythmiasType 1B (only Ventricular), Type 4 (only SUPRAventricular) and miscellaneous (only SUPRAventricular)
memorize

Von Williams 4 categories (pharmacotherapy of Arrhythmias)

Question Answer
Na Channel blockers affecting Phase 0Type 1
Beta BlockersType 2
Agents that increase refractory period ... affecting Phase 3Type 3
Ca Channel blockers... affect phase 0, 2 & 4Type 4
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