Cardiac Rhythm Disturbance Flashcards
Bradycardia:
A ventricular rate <60bpm.
Bradycardia and the risk of asystole - Adverse signs:
Systolic BP <90mmhg.
Ventricular rate <40bpm.
Ventricular arrythmia comproming BP requiring treatment.
Heart failure.
(Bradycardia) If one of more adverse signs are present relating to bradycardia and the risk of asystole:
Follow O2 guidelines
Gain IV access
Administer atropine and repeat as necessary
Continuous ECG monitoring
(Bradycardia) Risk of asystole:
Previous episode of asystole
Mobitz II AV block
Complete AV block, especially with broad QRS or ventricular rate <40bpm.
Ventricular pause of >3seconds.
A regular Narrow Complex Tachycardia is likely to be (3):
Tachycardia, Supraventricular Tachycardia SVT, Atrial Flutter
A Narrow Complex is:
A QRS <120ms
Sinus tachycardia is:
A physiological response to pain, fever, sepsis or blood loss. Treating the cause can reduce the tachycardia.
SVT is:
Sudden increase in heartrate (over 100bpm) that can last from minutes to hours.
It originates at or above the AV node.
Characterised by a narrow complex QRS <120ms.
Fortunately, it is rarely life threatening.
AVNRT (AV nodal reentrant tachycardia / paroxysmal SVT) is intermittent SVT without provoking factors, and is typically 140-280bpm.
Atrial Flutter is:
Narrow complex tachycardia QRS <120ms
REGULAR atrial activity at approx 300bpm
Loss of the isoelectric baseline
“Saw-tooth” pattern of inverted flutter waves in leads II, III, aVF.
Ventricular rate varies by case.
Can you have a variable AV conduction ratio in Atrial Flutter?
Yes. It may mimic atrial fibrillation, but on closer inspection may be alternating 2:1 3:1 4:1 ratios.
Atrial flutter with a 1:1 conduction can occur, and is associated with (2) :
Severe haemodynamic instability and progression to VF
