Cardiovascular Essentials for Advanced Practice Providers-Electrophysiology

Video Transcription
Video Summary
The video discusses electrophysiology for the cardiovascular advanced practice provider. The presenter aims to share pearls of information specific to disease states encountered in clinical practice. The main objectives include atrial arrhythmias, paroxysmal supraventricular tachycardia, ventricular tachycardia, and pacemakers and defibrillators. For premature atrial contractions (PACs), it is important to differentiate them from other contractions as they may progress to sustained atrial arrhythmias. Frequent PACs may warrant additional testing such as ambulatory Holter monitoring. Risk factors for atrial fibrillation include excess sympathetic stimulation, ischemia, valvular heart disease, structural heart disease, diabetes mellitus, and hypertension. Management options for PACs include rate-slowing medications such as beta blockers and calcium channel blockers. Atrial fibrillation is the most common sustained arrhythmia worldwide and is associated with age, sleep apnea, hypertension, obesity, and diabetes. Diagnosis and management of atrial fibrillation involve evaluating symptoms, conducting EKGs, ambulatory Holter monitoring, and echocardiograms. Anticoagulation should also be considered for stroke prevention. Paroxysmal supraventricular tachycardia (PSVT) is defined as a driving circuit of a focus that lies in tissues originating above the ventricle and may cause sudden symptoms. Diagnosis involves evaluating an EKG, Holter monitoring, and electrophysiology study. Treatment options for PSVT include rate control medications and ablation procedures. Ventricular arrhythmias such as premature ventricular contractions (PVCs) and ventricular tachycardia (VT) are associated with hypokalemia, structural heart disease, and ischemia. Evaluation includes monitoring PVC burden and assessing symptoms. Management options include beta blockers, antiarrhythmic medications, and ablation procedures. In cases of VT, defibrillation may be required. Pacemakers are indicated for symptomatic bradycardia and come in various modes, such as single chamber, dual chamber, or biventricular. A defibrillator may be necessary in cases of high-risk ventricular arrhythmias. The video provides a comprehensive overview of electrophysiology for advanced practice providers in cardiovascular care.
Keywords
electrophysiology
cardiovascular
atrial arrhythmias
ventricular tachycardia
pacemakers
defibrillators
ambulatory Holter monitoring
anticoagulation