VT

Question 1

management of pulseless VT or VF

Answer 1

resuscitation

Question 2

management of pt with unstable sustained VT tachycardia, who continue to deteriorate with signs of hypotension or reduced CO

Answer 2

direct current cardioversion to restore sinus rhythm

if this fails, IV adenosine and then repeat direct current cardioversion

Question 3

Patients with sustained ventricular tachycardia who are hemodynamically stable can be treated with

Answer 3

IV antiarrhythmic drugs
○ Preferred: amiodarone
○ Others include flecainide, proprafneone
○ Less effective: lidocaine HCl

Question 4

Patients with sustained ventricular tachycardia who are hemodynamically stable can be treated with IV antiarrhythmic drugs. If sinus rhythm has not restored, what should you consider

Answer 4

consider direct current cardio version or pacing
catheter ablation is an alternative if cessation of arrhythmia is not urgent

Question 5

Non sustained ventricular tachycardia can be treated with

Answer 5

BB

Question 6

Following restoration of sinus rhythm, patients who remain at high risk of cardiac arrest will require maintenance therapy. What will it consist of

Answer 6

• Most patients will be treated with implantable cardioverter defibrillator
• BB or sotalol, or amiodarone (in combination with standard BB) can be used in addition to the device in some patients
• Alternatively they can be used alone when use of implantable cardioverter defibrillator not appropriate

Question 7

what is TDP

Answer 7

Ventricular tachycardia associated with prolonged QT interval

Question 8

how does TDP tend to occur

Answer 8

Usually drug induced
Other factors including hypokalemia, severe bradycardia, genetic predisposition are also implicated

Question 9

what can TDP cause

Answer 9

• Episodes are usually self limiting, but are frequently recurrent and can cause impairment or loss of consciousness
• If not controlled, the arrhythmia can progress to ventricular fibrillation and sometimes death

Question 10

treatment of TDP

Answer 10

IV infusion of magnesium sulfate usually effective

Question 11

IV infusion of magnesium sulfate usually effective for TDP. what else can you consider?

Answer 11

• A BB (not sotalol) and atrial (or ventricular) pacing can be considered