Arrhythmia Recognition & Classification Flashcards
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Torsades de pointes is a form of polymorphic ventricular tachycardia most commonly associated with:
Answer: Prolonged QT interval
Torsades de pointes ('twisting of the points') occurs in the setting of a prolonged QT interval and is characterized by QRS complexes that twist around the isoelectric baseline.
Which ECG finding is most characteristic of hyperkalemia contributing to a bradyarrhythmia?
Answer: Peaked, narrow, tall T waves with widening QRS
Hyperkalemia produces peaked, tall, narrow T waves early, and progressive QRS widening, which can degrade into a sine-wave pattern and cardiac arrest.
A patient has an irregular rhythm with no discernible P waves and a variable ventricular rate of 90–140 bpm. The most likely diagnosis is:
Answer: Atrial fibrillation
Atrial fibrillation is characterized by an irregularly irregular rhythm, absence of distinct P waves, and fibrillatory baseline activity (f waves).
Premature ventricular contractions (PVCs) are characterized on the ECG by:
Answer: Wide QRS >0.12 s without a preceding P wave, followed by a full compensatory pause
PVCs arise from ectopic ventricular foci, producing wide, bizarre QRS complexes without a preceding P wave, typically followed by a compensatory pause.
The Brugada pattern on an ECG is characterized by which of the following?
Answer: Coved ST elevation in V1–V2 with right bundle branch block pattern
Brugada syndrome shows a distinctive coved-type ST elevation (>2 mm) in the right precordial leads (V1–V2) with a right bundle branch block-like pattern, predisposing to ventricular fibrillation.
Which arrhythmia is described as three or more consecutive PVCs at a rate greater than 100 bpm lasting less than 30 seconds?
Answer: Non-sustained ventricular tachycardia
Non-sustained VT is defined as three or more consecutive ventricular beats at ≥100 bpm that self-terminate within 30 seconds.
In a patient with known digoxin toxicity, which ECG finding is most characteristic?
Answer: Bidirectional ventricular tachycardia
Bidirectional ventricular tachycardia, where the QRS axis alternates beat to beat, is highly specific for digitalis toxicity.