CH9 Ventricular Dysrhythmias Flashcards
ventricular pacemaker cells are found within ___
Purkinje Fibers
inherent rate of the purkinje fibers
20-40 bpm
Ventricular rhythms occurring within the range of the Purkinje network (20-40 bpm) are occasionally referred to as ____
Ventricular Escape Rhythms
What does PVC stand for
Premature Ventricular Complex
What is a PVC
An ectopic impulse that occurs early in the cycle and originates from the ventricles
How to identify a PVC
Early QRS complex that measures 0.12 secs or longer, and has a wide and bizarre appearance.
No P wave
Unifocal PVC
rhythm strip shows multiple PVCs have a similar shape
Suggests only one irritable focus present
Multifocal PVC
PVCs have varied shapes and forms
suggests more than 1 irritable focus
Interpolated PVC
PVC occurs during the normal R-R interval without interrupting the rhythm
Occasional PVC
Less than 6 PVCs per minute
Frequent PVC
6 or more PVCs per minute
Bigeminy PVC
Every other complex is a PVC
Trigeminy PVC
Every 3rd complex is a PVC
Quadgeminy PVC
Every 4th complex is a PVC
R-on-T PVC
PVC occurs on the T wave
Coupling PVC
2 PVCs that occur back to back
Run of Ventricular Tachycardia
3 or more PVCs in a row at 100+ bpm
aka. triplet PVC
Paroxysmal event
Witnessed change in any cardiac rhythm
ex. change from sinus rhythm to SVT (supraventricular tachycardia)
Agonal Rhythm
occur when essentially all of the pacemakers in the heart have failed.
How to identify an agonal rhythm
absence of P waves
ventricular rate of less than 20 bpm
wide and bizarre QRS complexes
Are patients unconscious when an agonal rhythm is seen
yes
idioventricular rhythm
occur when the SA and Junctional pacemakers fail to initiate an impulse and all that remains is the slow ventricular pacemaker (20-40 bpm)
how to identify an idioventricular rhythm
absence of p waves
slow ventricular rate of 20-40 bpm
wide and bizarre QRS complexes
accelerated ventricular rhythm
occur when SA and junctional pacemakers fail to initiate an impulse and all that is remaining is the slow ventricular pacemaker, which is now faster at a range of (40-100 bpm)
how to identify an accelerated idioventricular rhythm
the accelerated idioventricular rhythm has an absence of P waves
ventricular rate of 40-100 bpm
wide and bizarre QRS complexes
Ventricular Tachycardia
occurs when 3 or more PVCs occur in a row and the ventricular rate is greater than 100 bpm
Torsades de pointes
type of ventricular tachycardia where the morphology of the PVCs change and look like a twisty ribbon
How to identify Ventricular Tachycardia
Wide and bizarre QRS complexes with a Sawtooth appearance
100+ bpm. And No P Waves
Ventricular Fibfrillation
Chaotic, asynchronous electrical activity within the ventricular tissue
The entire myocardial quivers
How to identify Ventricular Fibrillation
Absence of organized electrical activity
Tracing is disorganized or chaotic in appearance
Will every patient experiencing V Fib be unconscious, unresponsive, and apneic?
Yes
Asystole
Absence of ventricular activity and depolarization. Straight line or flat line rhythm
How to identify asystole?
No waveforms. Flat.
No P, QRS, T, U
