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Antiarrhythmic Therapy UTHSCSA Pediatric Resident Curriculum for the PICU
Antiarrhythmic Therapy Empiric Arrhythmia Diagnosis Interventions Clinical Outcomes Pathophysiologic Arrhythmia Diagnosis Known or suspected mechanisms Critical components Vulnerable parameters Targeted subcellular units BLACK BOX Interventions Clinical Outcomes
Antiarrhythmic Therapy Pathophysiologic Arrhythmia Diagnosis Interventions Clinical Outcomes Known or suspected mechanisms Critical components Vulnerable parameters Targeted subcellular units AV node reentrant tachycardia AV node reentry Anatomical fast/slow pathway AV node (slow conduction) AV nodal action potential L-type Ca ++  channel Ca ++  channel blocker  -blocker Sinus rhythm
Vaughn-Williams Classification ,[object Object],[object Object],[object Object],[object Object],[object Object]
Antiarrhythmic Therapy Empiric Arrhythmia Diagnosis BLACK BOX ,[object Object],[object Object],[object Object],Interventions Clinical Outcomes
Arrhythmia Types ,[object Object],[object Object],[object Object],[object Object],[object Object]
Arrhythmia-focused Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Arrhythmia-focused Therapy ,[object Object],[object Object],[object Object],[object Object]
Arrhythmia-focused Therapy ,[object Object]
Antiarrhythmic Agents Vaughn-Williams Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Action Potential Phase 0 Phase 4 Phase 3 Phase 2 Phase 1 - 90 mV 0 mV 30 mV
Class I    Na+ Channel Blockers ,[object Object],[object Object],[object Object],Affects Phase 0 1 0 2 3 4 ERP RRP
Class IA -  Na+ Channel Blockers Procainamide/Quinidine/Disopyramide ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class IA - Na+ Channel Blockers   Procainamide ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Arrhythmia-focused Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class IB Lidocaine/Mexiletine/Phenytoin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class IB Lidocaine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class IB Lidocaine ,[object Object],[object Object],[object Object],[object Object]
Class IB Mexiletine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class IB Phenytoin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Arrhythmia-focused Therapy ,[object Object],[object Object],[object Object],[object Object]
Class IC Flecainide/Propafenone/Ethmozine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class IC Flecainide ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class IC Flecainide ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Arrhythmia –focused Therapy ,[object Object]
Class II Agents Beta-blockers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class II Propranolol ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class II Propranolol ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Arrhythmia-focused Therapy ,[object Object],[object Object]
Class III  K +  - channel blockers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Arrhythmia-focused Therapy ,[object Object],[object Object]
Purinergic Agonists Adenosine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Purinergic Agonists Adenosine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Purinergic Agonists Adenosine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Digoxin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Digoxin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Digoxin Toxicity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Digoxin Toxicity Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Proarrhythmia Torsades de Pointes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
60 Cycle Interference
Atrial Flutter
SVT
Ventricular Tachycardia
Ventricular Fibrillation

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anti-arrhythmics

  • 1. Antiarrhythmic Therapy UTHSCSA Pediatric Resident Curriculum for the PICU
  • 2. Antiarrhythmic Therapy Empiric Arrhythmia Diagnosis Interventions Clinical Outcomes Pathophysiologic Arrhythmia Diagnosis Known or suspected mechanisms Critical components Vulnerable parameters Targeted subcellular units BLACK BOX Interventions Clinical Outcomes
  • 3. Antiarrhythmic Therapy Pathophysiologic Arrhythmia Diagnosis Interventions Clinical Outcomes Known or suspected mechanisms Critical components Vulnerable parameters Targeted subcellular units AV node reentrant tachycardia AV node reentry Anatomical fast/slow pathway AV node (slow conduction) AV nodal action potential L-type Ca ++ channel Ca ++ channel blocker  -blocker Sinus rhythm
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  • 44. SVT

Editor's Notes

  1. 1