Premium NEET PG medical study infographic poster on ARRHYTHMIAS. White background. Structured cheat sheet layout with colored section boxes. TOP HEADER: Large bold title "⚡ ARRHYTHMIAS" with subtitle "NEET PG High-Yield Cheat Sheet" on a deep navy blue banner. Include a small ECG wave graphic. SECTION 1 - DEFINITION (light blue box): "Abnormal cardiac rhythm due to disturbances in impulse formation, conduction, or both. Rate <60 = bradyarrhythmia | Rate >100 = tachyarrhythmia" SECTION 2 - CLASSIFICATION (yellow-orange box): Title: "🗂️ CLASSIFICATION" Two columns: TACHYARRHYTHMIAS (>100 bpm): - Supraventricular (SVT): Sinus tach, AF, Atrial Flutter, AVNRT, AVRT, MAT - Ventricular: VT, VF, Torsades de Pointes BRADYARRHYTHMIAS (<60 bpm): - Sinus bradycardia, Junctional rhythm, Idioventricular rhythm - AV Blocks: 1st, 2nd (Mobitz I/II), 3rd degree SECTION 3 - PATHOPHYSIOLOGY (purple box): Title: "🔬 MECHANISMS" Three columns: 1️⃣ Abnormal Automaticity - Enhanced: DADs/EADs (Digitalis, ischemia) | Suppressed: Drugs, ischemia 2️⃣ Re-entry Circuit - Most common! Requires: unidirectional block + slow conduction + excitable gap | Examples: AVNRT, VT in scar tissue, AF, WPW 3️⃣ Triggered Activity - EADs → Torsades de Pointes | DADs → Digitalis toxicity, VT SECTION 4 - CAUSES/RISK FACTORS (green box): Title: "⚠️ CAUSES - Mnemonic: PIRATES" P - Pulmonary disease (COPD, PE) I - Ischemia / Infarction (MI) R - Rheumatic heart disease / Valvular A - Autonomic dysfunction / Anesthesia T - Thyroid disorders (hyper/hypo) E - Electrolyte imbalance (K+, Mg2+, Ca2+) S - Structural/Systemic (cardiomyopathy, drugs, HF) SECTION 5 - ECG FINDINGS TABLE (red-pink box): Title: "📊 ECG DIAGNOSIS TABLE" Table with columns: Arrhythmia | Rate | P Wave | PR Interval | QRS | Key Feature - Sinus Brady | <60 | Normal | Normal | Normal | Athletes, vasovagal - 1st Degree AV Block | Normal | Normal | >200ms | Normal | Prolonged PR always - Mobitz I (Wenckebach) | Normal | Normal | Progressively ↑ | Normal | Dropped beat pattern - Mobitz II | Normal | Normal | Fixed | Normal | Sudden dropped beat ⚠️ - 3rd Degree (CHB) | 20-60 | Dissociated | Variable | Wide | P & QRS independent ⚠️ - SVT/AVNRT | 150-250 | Hidden in QRS | Short | Narrow | "No P visible" - Atrial Flutter | 250-350 | Sawtooth | Variable | Narrow | 2:1 or 4:1 block - Atrial Fibrillation | 100-180 | Absent | Irregular | Narrow | Irregularly irregular - VT | >100 | Dissociated | Variable | Wide (>120ms) | AV dissociation ⚠️ - Torsades | Variable | N/A | Long QT | Twisting wide | QTc >500ms ⚠️ - VF | Chaotic | None | None | Chaotic | No pulse - EMERGENCY SECTION 6 - MANAGEMENT (teal box): Title: "💊 MANAGEMENT" Two columns: BRADYARRHYTHMIAS: - Atropine 0.5-1mg IV (first line) - Transcutaneous pacing (if unstable) - Dopamine / Epinephrine infusion - Permanent pacemaker: Mobitz II, CHB TACHYARRHYTHMIAS: - Unstable → Synchronized Cardioversion - VF/Pulseless VT → Defibrillation (unsynchronized) - SVT → Vagal maneuvers → Adenosine 6mg IV - AF: Rate control (BB/CCB) + Anticoagulation (CHADS₂-VASc) - VT (stable): Amiodarone 150mg IV / Lidocaine - Torsades: Magnesium sulfate 2g IV ⭐ SECTION 7 - ANTIARRHYTHMIC DRUG TABLE (dark blue box): Title: "💊 VAUGHAN-WILLIAMS CLASSIFICATION" Table: Class | Mechanism | Drugs | Key ADR IA | Na+ block (intermediate) | Quinidine, Procainamide, Disopyramide | QT prolongation, Lupus (Procainamide), Cinchonism (Quinidine) IB | Na+ block (fast) | Lidocaine, Mexiletine | CNS toxicity, seizures - Acts on ischemic tissue only IC | Na+ block (slow, potent) | Flecainide, Propafenone | Proarrhythmic! CAST trial - avoid post-MI II | Beta blocker | Metoprolol, Atenolol, Esmolol | Bradycardia, bronchoconstriction III | K+ block | Amiodarone*, Sotalol, Dofetilide | Amiodarone: Pulmonary fibrosis, thyroid, corneal deposits, blue skin IV | Ca2+ block | Verapamil, Diltiazem | AV block, constipation. NEVER in WPW+AF Other | Adenosine (AV node block) | Adenosine 6mg bolus | Flushing, chest pain, bronchospasm SECTION 8 - HIGH-YIELD PEARLS (gold box): Title: "⭐ HIGH-YIELD EXAM PEARLS" • Wenckebach (Mobitz I) = Nodal = Benign | Mobitz II = Infranodal = Needs pacemaker ⚠️ • WPW: Short PR + Delta wave + wide QRS → NEVER give AV nodal blockers (adenosine, verapamil, digoxin) in WPW+AF → can cause VF! • Torsades = Polymorphic VT with QTc >500ms → Treat with Magnesium sulfate 2g IV • AF most common sustained arrhythmia | Most common cause = HTN • CAST Trial: Class IC drugs ↑ mortality post-MI despite suppressing PVCs • Digoxin toxicity ECG = Downsloping ST depression "scooping" + any arrhythmia possible • Long QT causes: Hypo K/Mg/Ca, Drugs (quinidine, TCAs, antipsychotics, macrolides) • AV dissociation with capture/fusion beats = diagnostic of VT • Adenosine DOC for acute SVT/AVNRT | Half-life = 10 seconds SECTION 9 - MNEMONICS (orange box): Title: "🧠 MEMORY TRICKS" • WPW = "W-P-W = Wolff got Pre-excited with a Delta wave" • Torsades causes (QT prolongation): "HALT AMQT" = Hypokalemia, Amiodarone, Lithium, TCAs, Antimicrobials (macrolides, fluoroquinolones), Methadone, QT drugs • AV Block degrees: "1st = just delayed, 2nd = sometimes skips, 3rd = complete chaos" • Class IC = "IC = I Contraindicate post-MI" (CAST trial) • AF stroke risk: "CHADS₂-VASc" → Score ≥2 → Anticoagulate • Adenosine for SVT: "ADENOSINE = A Dose Ends Nearly Every SVT IN Narrow Episodes" SECTION 10 - COMPLICATIONS (red box): Title: "🚨 COMPLICATIONS" • Stroke/Thromboembolism (AF → LAA thrombus) • Heart failure (tachycardia-induced cardiomyopathy) • Sudden cardiac death (VF, Torsades) • Syncope / Presyncope • Hemodynamic collapse BOTTOM FOOTER: "📚 Sources: Braunwald's Heart Disease | Tintinalli's EM | Harrison's | Katzung Pharmacology" on dark navy bar Style: Modern, clean, professional medical infographic. 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