Acute and Chronic Treatment for SVT. DrJo Jo Hai
|
|
- Baldwin Russell
- 7 years ago
- Views:
Transcription
1 Acute and Chronic Treatment for SVT DrJo Jo Hai
2 Supraventricular Tachycardia SVT -generally reserved for AVNRT, AT, AP mediated tachycardia Can be narrow / wide complex Acute treatment -principally determined by whether it is narrow / wide complex tachycardia
3 Acute Management
4 HaemodynamicallyUnstable Cardioversion/ Defibrillation
5 Common Narrow Complex Tachycardia AV nodal reentrant tachycardia OrthodromicAV reentrant tachycardia Atrial tachycardia CP
6 RP Classification of Narrow Complex Short RP (RP < PR) Tachycardias Long RP (RP > PR) RP <70 ms - Typical AVNRT RP >70ms AVNRT or OAVRT You can t exclude Atrial tachycardia Junction tachycardia is always a ddx to typical AVNRT Sinus tachycardia Atrial tachycardia Atypical AVNRT Permanent junctional reciprocating tachycardia
7 Others P wave morphology Septal: narrow and sharp Free wall: Bifid and wide Polarity of P on II, III, avf Mode of induction & termination etc Patient s demographics Medical / surgical history
8 Vagal maneuvers / Adenosine Both diagnostic and therapeutic
9 Vagal maneuvers / Adenosine Carina Blomström-Lundqvist, JACC 2003
10 AV nodal reentrant tachycardia OrthodromicAV reentrant tachycardia Atrial tachycardia CP
11 Occasionally can terminate the atrial activity Last atrial firing conducts through AVN to the ventricle and ends with QRS If the last beat ends with P => concomitant AVN blockade HIGHLY UNLIKELY!!!
12 Other Agents Longer acting AVN blockers IV BB IV CCB Class I / Class III agents IV Procainamide IV Flecainide Add AVN blockers!
13
14 Any SVT with BBB SVT with Wide QRS AntidromicAV reentrant tachycardia Accessory pathway Any SVT (inclaf) with AP Accessory pathway Risk of rapid conduction and sudden cardiac death!!! CP
15 Carina Blomström-Lundqvist, JACC 2003
16 Carina Blomström-Lundqvist, JACC 2003
17 Definite SVT SVT with BBB As for narrow complex tachycardia Pre-excited SVT Class I / Class III agents IV Procainamide IV Flecainide Add AVN blockers!
18 Unknown Wide Complex Tachycardia IV Amiodarone(espif LVEF poor) IV Sotalol IV Lidocaine IV Procainamide
19 If any doubt / treatment unsuccessful Cardioversion/ Defibrillation
20 Chronic Management
21 AV Node Reentry Determined by frequency and tolerability of attacks Vagal maneuvers Pill-in-the-pocket BB + CCB Flecainide LA BB, CCB Class IC and class III agents Always add AVN blockers with class IC agents Digoxin CP
22 AV Node Reentry Complete suppression by medical treatment ~30% Catheter ablation >95% effective Risk of AVB ~1% Risk of recurrence ~3-7% Can be offered as 1 st line treatment if patient prefers Preferred treatment if medically refractory or poorly tolerated CP
23 Pathway-mediated tachycardia Wolff-Parkinson-White Syndrome = Preexcitation + tachycardia With Pre-excitation: Class IC / Class III agents can be considered Without Pre-excitation: BB can also be considered (Class Iib recommendation) Vagal maneuvers / pill-in-the-pocket (BB + CCB) in patients with infrequent attacks and without pre-excitation By all means avoid CCB and digoxin!!!
24 Pathway-mediated tachycardia Effectiveness of medical treatment ~70-90% Catheter ablation >95% effective Risk depends on site (L vs R? distance from AVJ?) Serious Cx ~1-2% Most common Tamponade and AV block Risk of recurrence ~5% CP
25 Accessory Pathway Preferred treatment except in patients with infrequent attacks and without pre-excitation The only acceptable treatment in patients with pre-excited AF and rapid conduction (CL <250 ms) or poorly tolerated AVRT CP
26 Asymptomatic Pre-excitation Risk of SCD ~ in 3-10 yrs Risk Factors Shortest RR <250ms during AF Multiple AP Ebstein s anomaly Familial WPW Catheter ablation can be considered CP
27 Atrial Tachycardia BB, CCB is the 1 st line treatment Class IC / Class III agents can be considered No therapy is acceptable if nonsustained and asymptomatic CP
28 Atrial Tachycardia Catheter ablation is the 1 st line treatment for recurrent or incessant AT Success rate 89% R > L Recurrence Single > multiple Inc with age Serious Cx ~ 1% Most common perforation, phrenic nerve palsy, SN dysfx CP
29 Summary Diagnostic clues for narrow and wide complex SVT Acute and chronic medical management of SVT Catheter ablation is almost always an alternative option!
Presenter Disclosure Information
2:15 3 pm Managing Arrhythmias in Primary Care Presenter Disclosure Information The following relationships exist related to this presentation: Raul Mitrani, MD, FACC, FHRS: Speakers Bureau for Medtronic.
More informationTachyarrhythmias (fast heart rhythms)
Patient information factsheet Tachyarrhythmias (fast heart rhythms) The normal electrical system of the heart The heart has its own electrical conduction system. The conduction system sends signals throughout
More informationPRACTICAL APPROACH TO SVT. Graham C. Wong MD MPH Division of Cardiology Vancouver General Hospital University of British Columbia
PRACTICAL APPROACH TO SVT Graham C. Wong MD MPH Division of Cardiology Vancouver General Hospital University of British Columbia CONDUCTION SYSTEM OF THE HEART SA node His bundle Left bundle AV node Right
More informationIntroduction to Electrophysiology. Wm. W. Barrington, MD, FACC University of Pittsburgh Medical Center
Introduction to Electrophysiology Wm. W. Barrington, MD, FACC University of Pittsburgh Medical Center Objectives Indications for EP Study How do we do the study Normal recordings Abnormal Recordings Limitations
More informationHTEC 91. Topic for Today: Atrial Rhythms. NSR with PAC. Nonconducted PAC. Nonconducted PAC. Premature Atrial Contractions (PACs)
HTEC 91 Medical Office Diagnostic Tests Week 4 Topic for Today: Atrial Rhythms PACs: Premature Atrial Contractions PAT: Paroxysmal Atrial Tachycardia AF: Atrial Fibrillation Atrial Flutter Premature Atrial
More informationAtrial Fibrillation in the Wolff-Parkinson-White Syndrome. John Whitaker, Conn Sugihara and Michael Cooklin (Guy s and St Thomas NHS Foundation Trust)
Atrial Fibrillation in the Wolff-Parkinson-White Syndrome John Whitaker, Conn Sugihara and Michael Cooklin (Guy s and St Thomas NHS Foundation Trust) A 38 year old paramedic was admitted with symptoms
More informationATRIAL FIBRILLATION (RATE VS RHYTHM CONTROL)
ATRIAL FIBRILLATION (RATE VS RHYTHM CONTROL) By Prof. Dr. Helmy A. Bakr Mansoura Universirty 2014 AF Classification: Mechanisms of AF : Selected Risk Factors and Biomarkers for AF: WHY AF? 1. Atrial fibrillation
More informationEvaluation and Initial Treatment of Supraventricular Tachycardia
T h e n e w e ngl a nd j o u r na l o f m e dic i n e clinical practice Evaluation and Initial Treatment of Supraventricular Tachycardia Mark S. Link, M.D. This Journal feature begins with a case vignette
More informationCatheter Ablation. A Guided Approach for Treating Atrial Arrhythmias
Catheter Ablation A Guided Approach for Treating Atrial Arrhythmias A P A T I E N T H A N D B O O K This brochure will provide an overview of atrial arrhythmias (heart rhythm problems affecting the upper
More informationAn Introduction to Tachyarrhythmias R. A. Seyon MN, NP, CCN(C) & Dr. R. G. Williams
Arrhythmias 1 An Introduction to Tachyarrhythmias R. A. Seyon MN, NP, CCN(C) & Dr. R. G. Williams Things to keep in mind when analyzing arrhythmias: Electrical activity recorded in 12 and 15 leads Examine
More informationAtrial & Junctional Dysrhythmias
Atrial & Junctional Dysrhythmias Atrial & Junctional Dysrhythmias Atrial Premature Atrial Complex Wandering Atrial Pacemaker Atrial Tachycardia (ectopic) Multifocal Atrial Tachycardia Atrial Flutter Atrial
More informationSupraventricular tachycardia (SVT), by definition, includes. Supraventricular Tachycardia: Diagnosis and Management
SYMPOSIUM SUPRAVENTRICULAR ON TACHYCARDIA: CARDIOVASCULAR DIAGNOSIS AND MANAGEMENT DISEASES Supraventricular Tachycardia: Diagnosis and Management DAVID J. FOX, BMSC, MBCHB, MRCP; ALEXANDER TISCHENKO,
More informationWide-Complex Tachycardias in the ED: Myths and Pitfalls
Wide-Complex Tachycardias in the ED: Myths and Pitfalls, FACEP, FAAEM Professor and Vice Chair Director, Emergency Cardiology Fellowship Department of Emergency Medicine University of Maryland School of
More informationDiagnosis Code Crosswalk : ICD-9-CM to ICD-10-CM Cardiac Rhythm and Heart Failure Diagnoses
Diagnosis Code Crosswalk : to 402.01 Hypertensive heart disease, malignant, with heart failure 402.11 Hypertensive heart disease, benign, with heart failure 402.91 Hypertensive heart disease, unspecified,
More informationElectrophysiology Daymar College. Lisa H. Young, RN, BSN, MAE 2011
Electrophysiology Daymar College Lisa H. Young, RN, BSN, MAE 2011 Electrical Conduction Pathway Chemical Basis for Impulse Formation Cardiac Action Potential Phases http://www.youtube.com/watch?v=oqpffilde0e
More informationJAPI VOL. 52 NOVEMBER 2004 www.japi.org 883
Review Article Wide Complex Tachycardia : Recognition and Management in the Emergency Room IB Ray Abstract Cardiac arrhythmias often present as urgent medical conditions requiring immediate care. Patient
More informationPRO-CPR. 2015 Guidelines: PALS Algorithm Overview. (Non-AHA supplementary precourse material)
PRO-CPR 2015 Guidelines: PALS Algorithm Overview (Non-AHA supplementary precourse material) Please reference Circulation (from our website), the ECC Handbook, or the 2015 ACLS Course Manual for correct
More informationGUIDELINE 11.9 MANAGING ACUTE DYSRHYTHMIAS. (To be read in conjunction with Guideline 11.7 Post-Resuscitation Therapy in Adult Advanced Life Support)
AUSTRALIAN RESUSCITATION COUNCIL GUIDELINE 11.9 MANAGING ACUTE DYSRHYTHMIAS (To be read in conjunction with Guideline 11.7 Post-Resuscitation Therapy in Adult Advanced Life Support) The term cardiac arrhythmia
More informationPatient Information Sheet Electrophysiological study
Patient Information Sheet Electrophysiological study Your doctor has recommended performing an electrophysiological study (also called EPS). EPS is a diagnostic procedure designed to test and evaluate
More informationRecurrent AF: Choosing the Right Medication.
In the name of God Shiraz E-Medical Journal Vol. 11, No. 3, July 2010 http://semj.sums.ac.ir/vol11/jul2010/89015.htm Recurrent AF: Choosing the Right Medication. Basamad Z. * Assistant Professor, Department
More informationElectrophysiology Heart Study - EPS -
Electrophysiology Heart Study - EPS - What is an EPS? EPS is short for ElectroPhysiology heart Study. This procedure looks at the electrical system of your heart. An EPS will show if you have a heart rhythm
More informationWolff-Parkinson-White Syndrome
Wolff-Parkinson-White Syndrome Introduction and epidemiology Supraventricular tachycardias (SVTs) denote all tachyarrhythmias that originate from supraventricular tissue or require it to be a part of the
More informationPresent : PGY 王 淳 峻 Supervisor: F1 王 德 皓 991109
Present : PGY 王 淳 峻 Supervisor: F1 王 德 皓 991109 Interventions to prevent cardiac arrest + Airway management + Ventilation support + Treatment of bradyarrhythmias & Tachyarrhythmias Treat cardiac arrest
More informationPalpitations & AF. Richard Grocott Mason Consultant Cardiologist THH NHS Foundation Trust & Royal Brompton & Harefield NHS Foundation Trust
Palpitations & AF Richard Grocott Mason Consultant Cardiologist THH NHS Foundation Trust & Royal Brompton & Harefield NHS Foundation Trust Palpitations Frequent symptom Less than 50% associated with arrhythmia
More informationCardiac Arrhythmias. Introduction. Sinus Rhythms. Premature Beats. Secondary article. John A Kastor, University of Maryland, Baltimore, Maryland, USA
John A Kastor, University of Maryland, Baltimore, Maryland, USA Cardiac arrhythmias are disturbances in the rhythm of the heart manifested by irregularity or by abnormally fast rates ( tachycardias ) or
More informationTOP 5. The term cardiac arrhythmia encompasses all cardiac. Arrhythmias in Dogs & Cats. Sinus Arrhythmia. TOP 5 Arrhythmias Seen in Dogs & Cats
Top 5 ardiology Peer reviewed TOP 5 rrhythmias in Dogs & ats shley Jones, DVM mara Estrada, DVM, DVIM (ardiology) University of Florida The term cardiac arrhythmia encompasses all cardiac rhythms other
More information22 Arrhythmias. C. Scharf and F. Duru. Siegenthaler, Differential Diagnosis in Internal Medicine (ISBN9783131421418), 2007 Georg Thieme Verlag
22 22 Arrhythmias C. Scharf and F. Duru 22 712 Arrhythmias 22.1 Differential Diagnosis of Arrhythmias 714 Medical History 714 Clinical Examination 714 Electrocardiogram (ECG) 715 Additional Tools for the
More informationCOVERAGE GUIDANCE: ABLATION FOR ATRIAL FIBRILLATION
COVERAGE GUIDANCE: ABLATION FOR ATRIAL FIBRILLATION Question: How should the EGBS Coverage Guidance regarding ablation for atrial fibrillation be applied to the Prioritized List? Question source: Evidence
More information8 Peri-arrest arrhythmias
8 Peri-arrest arrhythmias Introduction Cardiac arrhythmias are relatively common in the peri-arrest period. They are common in the setting of acute myocardial infarction and may precipitate ventricular
More informationThe abbreviation EKG, for electrocardiogram,
CLIN PEDIATR OnlineFirst, published on January 28, 2010 as doi:10.1177/0009922809336206 Simplified Pediatric Electrocardiogram Interpretation Clinical Pediatrics Volume XX Number X Month XXXX xx-xx 2009
More informationCurrent Management of Atrial Fibrillation DISCLOSURES. Heart Beat Anatomy. I have no financial conflicts to disclose
Current Management of Atrial Fibrillation Mary Macklin, MSN, APRN Concord Hospital Cardiac Associates DISCLOSURES I have no financial conflicts to disclose Book Women: Fit at Fifty. A Guide to Living Long.
More informationFIMS Position Statement
FIMS Position Statement Wolff-Parkinson-White syndrome and sport March 2004 by Prof. Dr. Hans-H. Dickhuth Medical Clinic and Polyclinic, Dept. of Sportsmedicine University of Freiburg, Germany Priv. Doz.
More informationTachyarrhythmias in the ICU
Tachyarrhythmias in the ICU ACNP/PA Critical Care Boot Camp Vanderbilt University Medical Center September 21, 2015 Ariel Kappa RN, MSN, ACNP-BC Acute Arrhythmias are the gremlins of the ICU because they
More informationAtrial Fibrillation: Drugs, Ablation, or Benign Neglect. Robert Kennedy, MD October 10, 2015
Atrial Fibrillation: Drugs, Ablation, or Benign Neglect Robert Kennedy, MD October 10, 2015 Definitions 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary.
More informationCARDIAC ELECTROPHYSIOLOGY, ARRHYTHMIAS AND PACING. Medical Knowledge. Goals and Objectives PF EF MF LF Aspirational
Know the histology and gross anatomy of the normal sinoatrial node, atrial conduction pathways, atrioventricular (AV) junction and nod, His bundle, conduction fascicles and terminal intra-ventricular conduction
More informationNgaire has Palpitations
Ngaire has Palpitations David Heaven Cardiac Electrophysiologist/Heart Rhythm Specialist Middlemore, Auckland City and Mercy Hospitals Auckland Heart Group MCQ Ms A is 45, and a healthy marathon runner.
More informationGuideline for the management of arrhythmias
Guideline for the management of arrhythmias The following guideline is approved only for use at University College London Hospitals NHS Foundation Trust. It is provided as supporting information for the
More informationthe basics Perfect Heart Institue, Piyavate Hospital
ECG INTERPRETATION: the basics Damrong Sukitpunyaroj MD Damrong Sukitpunyaroj, MD Perfect Heart Institue, Piyavate Hospital Overview Conduction Pathways Systematic Interpretation Common abnormalities in
More informationNEONATAL & PEDIATRIC ECG BASICS RHYTHM INTERPRETATION
NEONATAL & PEDIATRIC ECG BASICS & RHYTHM INTERPRETATION VIKAS KOHLI MD FAAP FACC SENIOR CONSULATANT PEDIATRIC CARDIOLOGY APOLLO HOSPITAL MOB: 9891362233 ECG FAX LINE: 011-26941746 THE BASICS: GRAPH PAPER
More informationAtrial Fibrillation The High Risk Obese Patient
Atrial Fibrillation The High Risk Obese Patient Frederick Schaller, D.O.,F.A.C.O.I. Professor and Vice Dean Touro University Nevada A 56 year old male with a history of hypertension and chronic stable
More informationBASIC CARDIAC ARRHYTHMIAS Revised 10/2001
BASIC CARDIAC ARRHYTHMIAS Revised 10/2001 A Basic Arrhythmia course is a recommended prerequisite for ACLS. A test will be given that will require you to recognize cardiac arrest rhythms and the most common
More informationCopyright 2006 Blaufuss Multimedia. All rights reserved. Page 1
Copyright 2006 Blaufuss Multimedia. All rights reserved. Page 1 002 Sinus Rhythm, atrial rate 90 Mobitz II AVB, Ventricular rate 50 Left Atrial Enlargement Left Ventricular Hypertrophy RBBB a) Long R-R
More informationAblation For Atrial Fibrillation. Bill Petrellis Electrophysiologist
Ablation For Atrial Fibrillation Bill Petrellis Electrophysiologist AF is the most common arrhythmia in the Western world Prevalence 1.1% in Australia conservative estimate - 240,000 June 2009 AF is an
More information(CHRS) WRITING COMMITTEE MEMBERS
PACES/HRS Expert Consensus Statement on the Management of the Asymptomatic Young Patient with a Wolff-Parkinson-White (WPW, Ventricular Preexcitation) Electrocardiographic Pattern Developed in partnership
More informationAtrial Fibrillation The Basics
Atrial Fibrillation The Basics Family Practice Symposium Tim McAveney, M.D. 10/23/09 Objectives Review the fundamentals of managing afib Discuss the risks for stroke and the indications for anticoagulation
More informationAtrial Fibrillation and Cardiac Device Therapy RAKESH LATCHAMSETTY, MD DIVISION OF ELECTROPHYSIOLOGY UNIVERSITY OF MICHIGAN HOSPITAL ANN ARBOR, MI
Atrial Fibrillation and Cardiac Device Therapy RAKESH LATCHAMSETTY, MD DIVISION OF ELECTROPHYSIOLOGY UNIVERSITY OF MICHIGAN HOSPITAL ANN ARBOR, MI Outline Atrial Fibrillation What is it? What are the associated
More informationThe Emerging Atrial Fibrillation Epidemic: Treat It, Leave It or Burn It?
The Emerging Atrial Fibrillation Epidemic: Treat It, Leave It or Burn It? Indiana Chapter-ACC 17 th Annual Meeting Indianapolis, Indiana October 19, 2013 Deepak Bhakta MD FACC FACP FAHA FHRS CCDS Associate
More informationAnti Arrhythmic Agents
Introduction to Antiarrhythmic Agents Munther K. Homoud, MD Tufts-New England Medical Center Spring 2008 Anti Arrhythmic Agents Introduction to anti arrhythmic agents Mechanisms of arrhythmogenesis Management
More informationQRS Complexes. Fast & Easy ECGs A Self-Paced Learning Program
6 QRS Complexes Fast & Easy ECGs A Self-Paced Learning Program Q I A ECG Waveforms Normally the heart beats in a regular, rhythmic fashion producing a P wave, QRS complex and T wave I Step 4 of ECG Analysis
More informationManaging the Patient with Atrial Fibrillation
Pocket Guide Managing the Patient with Atrial Fibrillation Updated April 2012 Editor Stephen R. Shorofsky, MD, Ph.D. Assistant Editors Anastasios Saliaris, MD Shawn Robinson, MD www.hrsonline.org DEFINITION
More informationACLS Rhythms for the ACLS Algorithms
ACLS Rhythms for the ACLS Algorithms The Basics 1. Anatomy of the cardiac conduction system: relationship to the ECG cardiac cycle. A, Heart: anatomy of conduction system. B, P-QRS-T complex: lines to
More informationAtrial Fibrillation Based on ESC Guidelines. Moshe Swissa MD Kaplan Medical Center
Atrial Fibrillation Based on ESC Guidelines Moshe Swissa MD Kaplan Medical Center Epidemiology AF affects 1 2% of the population, and this figure is likely to increase in the next 50 years. AF may long
More informationRadiofrequency Ablation for Atrial Fibrillation. A Guide for Adults
Radiofrequency Ablation for Atrial Fibrillation A Guide for Adults Fast Facts n There are different ways to treat atrial fibrillation (A-fib). One kind of treatment involves putting the heart back into
More informationMULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
Exam Name MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) What term is used to refer to the process of electrical discharge and the flow of electrical
More informationIntroduction 2/9/2015
Thomas Haffey, D.O. FACC, FACOI, FNLA, CSOM February, 2015 Atrial Tachycardias Diagram summarizing types of atrial tachycardias often encountered in patients with a history of AF, including those seen
More informationDISCLOSURE. Atrial Fibrillation Management An Evidence-based Approach OBJECTIVES BACKGROUND AFFIRM 9/16/2015
Death (%) Mortality (%) 9/16/2015 DISCLOSURE Atrial Fibrillation Management An Evidence-based Approach Jonathon Adams, MD, FHRS Relevant Financial Relationship(s) None Off Label Usage None OBJECTIVES What
More informationBIPOLAR LIMB LEADS UNIPOLAR LIMB LEADS PRECORDIAL (UNIPOLAR) LEADS VIEW OF EACH LEAD INDICATIVE ECG CHANGES
BIPOLAR LIMB LEADS Have both a distinctive positive and negative pole. Lead I LA (positive) RA (negative) Lead II LL (positive) RA (negative) Lead III LL (positive) LA (negative) UNIPOLAR LIMB LEADS Have
More informationElectrolyte Physiology. Something in the way she moves
Electrolyte Physiology Something in the way she moves me Electrolyte Movement CONCENTRATION GRADIENT ELECTRICAL GRADIENT DRIVING FORCE NERNST NUMBER (E-ion) CONDUCTANCE (G-ion) PERMEABILITY CHANNELS: small
More informationIntroduction to Electrocardiography. The Genesis and Conduction of Cardiac Rhythm
Introduction to Electrocardiography Munther K. Homoud, M.D. Tufts-New England Medical Center Spring 2008 The Genesis and Conduction of Cardiac Rhythm Automaticity is the cardiac cell s ability to spontaneously
More informationOriginal Article Is the Measurement of Accessory Pathway Refractory Period Reproducible?
www.ipej.org 93 Original Article Is the Measurement of Accessory Pathway Refractory Period Reproducible? Celine Oliver, Beatrice Brembilla-Perrot Department of cardiology, University Hospital of Brabois,
More informationManagement of Atrial Fibrillation in Heart Failure
Disadvantages of AV Junction Ablation Persistent AFib- no AV synchrony Ongoing risk of thromboembolism Life-long dependency on pacemaker Comparison of LA Ablation vs. AVN Ablation LA Ablation AVN Ablation
More informationManagement of Atrial Fibrillation in the Emergency Department
Management of Atrial Fibrillation in the Emergency Department Ref: Emergency Medicine Clinics of North America, 2005 Introduction AfAf is most common cardiac arrhythmia Sequelae: : range from none to devastating:
More informationATRIAL FIBRILLATION AND ANAESTHESIA
ATRIAL FIBRILLATION AND ANAESTHESIA Dr AD Theron, SHO in Anaesthesia, Royal Devon and Exeter Hospital, Exeter, UK. E-mail: drabrietheron@yahoo.co.uk Atrial fibrillation (AF) is one of the commonest arrhythmias.
More informationAtrial Fibrillation 2012: Latest Approaches to Diagnosis, Treatment, and Stroke Prevention
Atrial Fibrillation 2012: Latest Approaches to Diagnosis, Treatment, and Stroke Prevention Michael G. Clark, PA-C, MPAS, Ph.D., AACC Fisher Cardiology and Electrophysiology Bedford, Texas Disclosures Speakers
More informationTABLE 1 Clinical Classification of AF. New onset AF (first detected) Paroxysmal (<7 days, mostly < 24 hours)
Clinical Practice Guidelines for the Management of Patients With Atrial Fibrillation Deborah Ritchie RN, MN, Robert S Sheldon MD, PhD Cardiovascular Research Group, University of Calgary, Alberta Partly
More informationEquine Cardiovascular Disease
Equine Cardiovascular Disease 3 rd most common cause of poor performance in athletic horses (after musculoskeletal and respiratory) Cardiac abnormalities are rare Clinical Signs: Poor performance/exercise
More informationACLS PHARMACOLOGY 2011 Guidelines
ACLS PHARMACOLOGY 2011 Guidelines ADENOSINE Narrow complex tachycardias or wide complex tachycardias that may be supraventricular in nature. It is effective in treating 90% of the reentry arrhythmias.
More informationBy the end of this continuing education module the clinician will be able to:
EKG Interpretation WWW.RN.ORG Reviewed March, 2015, Expires April, 2017 Provider Information and Specifics available on our Website Unauthorized Distribution Prohibited 2015 RN.ORG, S.A., RN.ORG, LLC Developed
More informationAtrial Fibrillation Peter Santucci, MD Revised May, 2008
Atrial Fibrillation Peter Santucci, MD Revised May, 2008 Atrial fibrillation (AF) is an irregular, disorganized rhythm characterized by a lack of organized mechanical atrial activity. The atrial rate is
More information2 Clinical Cardiac Electrophysiology
2 Clinical Cardiac Electrophysiology Andrew C. Rankin F. Russell Quinn Alan P. Rae 2.1 Introduction... 54 2.2 History of Clinical Electrophysiology... 54 2.3 Methodology... 55 2.3.1 Electrophysiological
More informationACUTE ATRIAL FIBRILLATION TREATMENT IN THE SURGICAL PATIENT
DISCLAIMER: These guidelines were prepared by the Department of Surgical Education, Orlando Regional Medical Center. They are intended to serve as a general statement regarding appropriate patient care
More informationUnrestricted grant Boehringer Ingelheim
ED Management of Recent Onset tat Atrial Fibrillation and Flutter (RAFF) Canadian Cardiovascular Society Guidelines 2010 CAEP St John s 2011 Ian Stiell MD MSc FRCPC Professor and Chair, Dept of Emergency
More informationAntiarrhythmic drug pharmacology
Antiarrhythmic drug pharmacology Samuel C. Dudley, Jr., M.D., Ph.D. 6/7/2003 1 Setting the membrane potential Nernst E eq [ S] = 61log i [ S] o Current I Na Equil. Pot. +60 mv Effect on E m Depolarize
More informationCatheter ablation of drug resistant supraventricular tachycardia in neonates and infants
ORIGINAL ARTICLE Cardiology Journal 2013, Vol. 20, No. 3, pp. 241 246 DOI: 10.5603/CJ.2013.0068 Copyright 2013 Via Medica ISSN 1897 5593 Catheter ablation of drug resistant supraventricular tachycardia
More informationAtrial fibrillation (AF) care pathways. for the primary care physicians
Atrial fibrillation (AF) care pathways for the primary care physicians by University of Minnesota Physicians Heart, October, 2011 Evaluation by the primary care physician: 1. Comprehensive history and
More informationTreating AF: The Newest Recommendations. CardioCase presentation. Ethel s Case. Wayne Warnica, MD, FACC, FACP, FRCPC
Treating AF: The Newest Recommendations Wayne Warnica, MD, FACC, FACP, FRCPC CardioCase presentation Ethel s Case Ethel, 73, presents with rapid heart beating and mild chest discomfort. In the ED, ECG
More informationNormal Sinus Rhythm. Sinus Bradycardia. Sinus Tachycardia. Rhythm ECG Characteristics Example (NSR) & consistent. & consistent.
Normal Sinus Rhythm (NSR) Rate: 60-100 per minute Rhythm: R- R = P waves: Upright, similar P-R: 0.12-0.20 second & consistent P:qRs: 1P:1qRs Sinus Tachycardia Exercise Hypovolemia Medications Fever Hypoxia
More informationA 35 yo female presents increasing fatigue and shortness of breath for several days. She is found to be in atrial fibrillation.
Ryan G. Aleong Cardiology Department University of Colorado A 35 yo female presents increasing fatigue and shortness of breath for several days. She is found to be in atrial fibrillation. 1. Initiation
More informationACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias*
2003 by the American College of Cardiology Foundation, the American Heart Association, Inc., and the European Society of Cardiology ACC/AHA/ESC PRACTICE GUIDELINES FULL TEXT ACC/AHA/ESC Guidelines for
More informationMRI Case Study MRI Cervical Spine
MRI Case Study MRI Cervical Spine Jewish Hospital Louisville, KY The Revo MRI SureScan pacing system is MR Conditional designed to allow patients to undergo MRI under the specified conditions for use.
More informationLead avr: The Neglected Lead
Chapter 22 Lead avr: The Neglected Lead M Chenniappan INTRODUCTION Lead avr, one of the 12 electrocardiographic leads, is frequently ignored in clinical medicine. In fact, many clinicians refer to the
More informationAtrial Fibrillation Management Across the Spectrum of Illness
Disclosures Atrial Fibrillation Management Across the Spectrum of Illness NONE Barbara Birriel, MSN, ACNP-BC, FCCM The Pennsylvania State University Objectives AF Discuss the pathophysiology, diagnosis,
More informationSyncope. enough to include disorders such as epileptic seizures and concussion. January 14-15, 2011 SCA Conference 1
Syncope and Atypical Seizures Ravi Mandapati, M.D., FACC.; FHRS Director, Specialized Program for Arrhythmias in Congenital Heart Disease UCLA Cardiac Arrhythmia Center David Geffen School of Medicine
More informationEpisode 20 Atrial fibrillation Prepared by Dr. Lucas Chartier
Episode 20 Atrial fibrillation Prepared by Dr. Lucas Chartier Most common dysrhythmia seen in ED, and incidence increasing with ageing population Presentation Common presentations: younger patients often
More informationVentricular Arrhythmias and the Prevention of Sudden Cardiac Death. Management of Patients With. Learn and Live SM. ACC/AHA/ESC Pocket Guideline
Learn and Live SM ACC/AHA/ESC Pocket Guideline Based on the ACC/AHA/ESC 2006 Guidelines Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death September 2006 Special
More informationNew in Atrial Fibrillation
New in Atrial Fibrillation September 2011 Stroke prevention more options Rhythm Control -drugs - alternatives to drugs; ablation Rate Control - pace + ablate A-FIB Dell Stroke Risk AFib Two Principles
More informationMedtronic Cardiac Rhythm and Heart Failure ICD-10 Coding for Physicians
Medtronic Cardiac Rhythm and Heart Failure ICD-10 Coding for Physicians May 19, 2015 Disclaimer This presentation is intended for educational use. Any duplication is prohibited without written consent
More informationMEDICATIONS USED IN ADULT CODE BLUE EMERGENCIES. Source: ACLS Provider Manual. American Heart Association. 2001, 2002. Updated 2003.
MEDICATIONS USED IN ADULT CODE BLUE EMERGENCIES Source: ACLS Provider Manual. American Heart Association. 2001, 2002. Updated 2003. 1 ET Administration Atropine o First drug for symptomatic sinus bradycardia
More informationATRIAL FIBRILLATION (AF) PATIENT INFORMATION
ATRIAL FIBRILLATION (AF) PATIENT INFORMATION The Heart Rhythm Charity Promoting better understanding, diagnosis, treatment and quality of life for individuals with cardiac arrhythmias www.heartrhythmcharity.org.uk
More informationAtrial fibrillation. Quick reference guide. Issue date: June 2006. The management of atrial fibrillation
Quick reference guide Issue date: June 2006 Atrial fibrillation The management of atrial fibrillation Developed by the National Collaborating Centre for Chronic Conditions Contents Contents Patient-centred
More information2013 Medicare Physician Coding and Reimbursement Changes
2013 Medicare Physician Coding and Reimbursement Changes Disclaimer This presentation is intended for educational use. Any duplication is prohibited without written consent of Medtronic s Economic Strategies
More informationQuiz 4 Arrhythmias summary statistics and question answers
1 Quiz 4 Arrhythmias summary statistics and question answers The correct answers to questions are indicated by *. All students were awarded 2 points for question #2 due to no appropriate responses for
More informationCardiac Syncope. spot it, stop it! Syncope is Tranient Loss of Consciousness (T- LOC) due to: transient global cerebral hypoperfusion
Definition Cardiac Syncope spot it, stop it! David Gareth Jones Heart Rhythm Centre Royal Brompton & Harefield NHS Foundation Trust Syncope is Tranient Loss of Consciousness (T- LOC) due to: transient
More informationTreatments to Restore Normal Rhythm
Treatments to Restore Normal Rhythm In many instances when AF causes significant symptoms or is negatively impacting a patient's health, the major goal of treatment is to restore normal rhythm and prevent
More informationPractical Management of Atrial Fibrillation
Practical Management of Atrial Fibrillation UPDATED JULY 2014 Adapted from the AHA/ACC/HRS 2014 Guideline for the Management of Patients with Atrial Fibrillation Editor: Bradley P. Knight, MD, FACC, FHRS
More informationThe debate: Should all AF patients see an EP consultant?
The debate: Should all AF patients see an EP consultant? Pre-debate show of hands in favour of the motion The argument for the motion: Dr Nick Kelland The argument against the motion: Dr Andy McCoye Discussion
More informationThe Patient s Guide to the Electrophysiologic Study (EPS) and Catheter Ablation
The Patient s Guide to the Electrophysiologic Study (EPS) and Catheter Ablation 2 P a g e Table of Contents Introduction How the Heart Works 3 How the Heart s Electrical System Works 3 Commonly Used Heart
More informationRATE VERSUS RHYTHM CONTROL OF ATRIAL FIBRILLATION: SPECIAL CONSIDERATION IN ELDERLY. Charles Jazra
RATE VERSUS RHYTHM CONTROL OF ATRIAL FIBRILLATION: SPECIAL CONSIDERATION IN ELDERLY Charles Jazra NO CONFLICT OF INTEREST TO DECLARE Relationship Between Atrial Fibrillation and Age Prevalence, percent
More informationHOW TO READ AN ECG. Rate = 300 / big squares 1 line = 300 2 line = 150 3 line = 75 4 line = 60 5 line = 50 6 line = 42 7 line = 38
HOW TO READ AN ECG Pathophysiology Pacemaker Rates: SAN 60-100 AVN 40-60 Ventricle 20-40 Areas of ECG Horizontal scale: 1mm = 0.04s 5mm = 0.2s Calculating Rate Rate = 300 / big squares 1 line = 300 2 line
More informationKaren Bain James Cook University Hospital Middlesbrough
Karen Bain James Cook University Hospital Middlesbrough Electrophysiology Electrophysiology... Is the study of the heart s electrical system Assesses the function of each component of cardiac conduction
More information