ARRYTHMIA 1 Flashcards
arrhythmia
any deviation
from this normal system of electrical
impulse formation and conduction
arrhythmias occur when
electrical impulse arises outside of the
sinus node, or is conducted abnormally
through the electrical conduction system
types of arrhythmia
w Ectopic beats w Atrial fibrillation (AF) and flutter w Supraventricular tachycardia (SVT) w Ventricular tachycardia (VT) w Ventricular fibrillation (VF)
Ectopic beats
single electrical impulses arising outside of
the sinus node.
Ectopy
is a medical term meaning outside
of the normal place or position.
single ectopic beats
are a normal phenomenon and do
not require medical treatment.
Ectopic beats recognise?
types
w They are normally seen during sinus rhythm, which causes it to appear irregular at times w All ectopic beats occur earlier than the next sinus beat would be expected Atrial ectopics Junctional ectopics Ventricular ectopics
Atrial ectopics
are preceded by P-wave with a different shape to the sinus beats. The P-wave may distort the T-wave of the previous beat if the ectopic is very early. The QRS complex is narrow
Junctional ectopics
have an inverted
P-wave. This may occur before or after the
QRS complex, or may be hidden by it. As
with atrial ectopics, the QRS is narrow
Ventricular ectopics
are not preceded by a P-wave. The QRS complex is wide and bizarre. The T-wave is discordant; in other words, it travels in the opposite direction to the QRS.
AF what is it?
triggered by?
is a disease of the left atrium. The
arrhythmia is triggered by ectopic beats arising from the pulmonary veins where they
enter the left atrium
AF has a number of key
features that make it easy to recognise
w P-waves are replaced by fibrillation waves;
these distort the baseline of the ECG in a
constant, uneven pattern
w The rhythm is completely irregular; in
other words, there is no regular interval
between the QRS complexes
w The QRS complex is narrow, unless conduction in the ventricles is abnormal (e.g.
as a result of bundle-branch block)
w In some patients, fibrillation waves are
very small or cannot be seen; AF can still
be diagnosed by the lack of P-waves and
completely irregular rhythm.
The treatment of AF depends
on presentation, symptoms and individual risk factors. All patients should be assessed for
stroke risk, and anticoagulation should be
commenced if risk factors are present
types of AF treatment
terminate the rhythm using
either a coordinated electric shock through
the chest wall (direct-current (DC) cardioversion) or antiarrhythmic drugs, such as
amiodarone or flecainide
catheter ablation
is rapidly gaining acceptance as an effective
treatment,