Pharmacotherapy for Specific Arrhythmias

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Questions and Answers

Which primary endpoint is most important in the pharmacotherapy of atrial fibrillation?

  • Alleviating symptoms
  • Reducing the risk of ischemic stroke (correct)
  • Preventing heart failure
  • Improving quality of life

In Australia, which two agents are specifically mentioned for stroke prevention in atrial fibrillation?

  • Amiodarone and verapamil
  • Warfarin and diltiazem
  • Dabigatran and warfarin (correct)
  • Verapamil and diltiazem

Which of the following is a characteristic of dabigatran in comparison to warfarin for stroke prevention in atrial fibrillation?

  • Direct competitive inhibitor of thrombin (correct)
  • Vitamin K dependent
  • Less effective than warfarin
  • Higher bleeding risk than warfarin

Why is amiodarone preferred for atrial fibrillation treatment according to the text?

<p>Maintains sinus rhythm effectively (B)</p> Signup and view all the answers

What should be considered before using diltiazem or verapamil for rate control in atrial fibrillation?

<p>Impaired ventricular function (D)</p> Signup and view all the answers

What significant risk is associated with combined antiarrhythmic drug therapy and anticoagulation for atrial fibrillation?

<p>Enhanced risk of bleeding (D)</p> Signup and view all the answers

What is the main goal of pulmonary vein isolation in catheter ablation for atrial fibrillation?

<p>To prevent the initiation of chaotic impulses (C)</p> Signup and view all the answers

Which of the following is NOT mentioned as a method for eradicating atrial fibrillation?

<p>Surgical isolation of pulmonary veins (C)</p> Signup and view all the answers

In which part of the heart is energy typically delivered during a pulmonary vein isolation procedure?

<p>Right atrium (D)</p> Signup and view all the answers

What is the primary purpose of AV nodal ablation/bundle branch ablation with pacemaker implantation?

<p>To prevent rapid heart rate associated with atrial fibrillation (C)</p> Signup and view all the answers

Which strategy has evolved significantly in recent years in relation to atrial fibrillation?

<p>Rhythm control strategies (A)</p> Signup and view all the answers

What medication is highly effective in reducing the risk of recurrence of ventricular tachycardia (VT)?

<p>Amiodarone (D)</p> Signup and view all the answers

Which medication is the only antiarrhythmic drug shown to increase survival in patients with ventricular arrhythmias?

<p>Amiodarone (A)</p> Signup and view all the answers

What emerges as an important strategy for preventing ventricular arrhythmias in patients with left ventricular dysfunction?

<p>Beta blockers (A)</p> Signup and view all the answers

'Class I recommendation' in guidelines indicates what level of recommendation for a particular intervention?

<p>'Definitely recommended' (C)</p> Signup and view all the answers

What is the most common cause for a ventricular arrhythmia during short-term therapy with an inotrope or vasopressor?

<p>Acute myocardial infarction' (B)</p> Signup and view all the answers

What is the classification of ventricular tachycardia based on?

<p>QRS complex shape (B)</p> Signup and view all the answers

Why might any adverse effect on heart rate or rhythm necessitate discontinuation of amiodarone?

<p>It exacerbates a preexisting conduction abnormality (C)</p> Signup and view all the answers

What is the most appropriate treatment for ventricular tachycardia?

<p>Anti-arrhythmic drugs (A)</p> Signup and view all the answers

Which therapy has been shown to have a higher success rate than drug therapy for some ventricular tachycardia patients?

<p>Rapid Fibrillator (RFA) therapy (B)</p> Signup and view all the answers

What is a common cause of sudden cardiac death primarily affecting middle-aged to elderly populations?

<p>Ventricular fibrillation (A)</p> Signup and view all the answers

What is a significant limitation in the development of efficacious therapies for ventricular fibrillation prevention?

<p>Unfamiliarity with the electrophysiological mechanisms of VF initiation (A)</p> Signup and view all the answers

What is the role of implantable cardioverter defibrillator (ICD) therapy in ventricular tachycardia management?

<p>Preventing sudden cardiac death (A)</p> Signup and view all the answers

What is the recommended treatment for pronounced symptoms or spontaneous heart rate falls in patients with bradycardia?

<p>Permanent pacing (C)</p> Signup and view all the answers

Which type of pacemaker maintains the normal beating sequence of the heart to reduce the risk of complications like heart failure?

<p>Dual-chamber pacemaker (A)</p> Signup and view all the answers

In patients with bradycardia and heart failure, what effect can pacing have on the left ventricle?

<p>Improve ejection fraction (B)</p> Signup and view all the answers

For which type of arrhythmia is ablation most effective in preventing recurrence?

<p>Ventricular tachycardia (A)</p> Signup and view all the answers

Which patient group is at substantial risk for recurrent ventricular arrhythmias despite successful ablation?

<p>Patients with structural heart disease (C)</p> Signup and view all the answers

What is the ideal time for defibrillation in ventricular fibrillation?

<p>During the 1-5 minutes when the heart is in a shockable rhythm (A)</p> Signup and view all the answers

What is the correct treatment for patients with a slow heart rate due to severe conduction block at the SA node, AV node, or His-Purkinje system?

<p>Permanent pacing (B)</p> Signup and view all the answers

What is the preferred treatment for patients with chronotropic incompetence who have bradycardia?

<p>Dual chamber pacing (B)</p> Signup and view all the answers

Which type of strategies focus on overdrive atrial pacing?

<p>Atria strategies (D)</p> Signup and view all the answers

What is a common procedure effective in preventing recurrence of atrial fibrillation?

<p>Catheter ablation (B)</p> Signup and view all the answers

What did the AFFIRM study find regarding long-term outcomes between rate control and rhythm control strategies?

<p>No difference in mortality or cardiovascular morbidity (B)</p> Signup and view all the answers

Which procedure requires threading a catheter from a vein in the leg to specific areas of the heart?

<p>Catheter ablation (B)</p> Signup and view all the answers

What is the main purpose of rate control strategies in atrial fibrillation management?

<p>To reduce the use of the AV node (B)</p> Signup and view all the answers

'Rate control for aggregate or multi-flow traffic' is related to what area in networking according to the text?

<p>Network resource allocation mechanisms (B)</p> Signup and view all the answers

'The most appropriate target heart rate for rate control' has not been established in a controlled clinical trial according to the text. What is the impact of this lack of establishment?

<p>Lack of clear delineation on specific cardiovascular outcomes (D)</p> Signup and view all the answers

'Joint switching and multiple path routing for ATM networks' require controlling input traffic on a given path to conform to what agreed-upon factor?

<p>'Rate-based scheduling algorithms' (D)</p> Signup and view all the answers

What is the purpose of antiarrhythmic drugs in atrial fibrillation management?

<p>To suppress AF through electrophysiological effects (C)</p> Signup and view all the answers

Which strategy focuses on impeding the AV node in atrial fibrillation management?

<p>Rhythm control strategies (A)</p> Signup and view all the answers

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