Chapter 9 Flashcards
Ventricular rhythms
generate wide and bizarre QRS complexes
last more than 0.12 seconds
Premature Ventricular Contraction (PVC)
Characteristics:
mostly benign in nature
Clinical significance:
Commonly seen in old age and structural heart disease
Also in electrolyte imbalance, acidosis, CHF, acute myocardial infarction, drug toxicity
Magnesium deficiency common to PVC
Treatment:
correction of electrolytes, amiodarone, and beta blockers
Idioventricular rhythm
Characteristics:
Heart rate 20-40 bpm
sign of imminent life threatening events
AKA ventricular escape rhythm
Clinical significance:
May or may not produce a pulse
Management:
basic and ACLS measures warranted
Agonal rhythm
Characteristics:
Worst possible cardiac rhythm second to asystole with impending death
heart rate less than 20 bpm
Clinical significance:
last possible impulses before asystole
severe and massive cardiac compromise
Management:
aggressive life support
Ventricular Tachycardia (V-tach/VT)
Characteristics:
3 or more PVC’s in a row & ventricular rate exceeds 100 bpm
If duration is less than 30 secs, Non-sustained ventricular tachycardia (NSVT)
More than 30 secs, known as sustained VT, which can be classified as monomorphic and polymorphic(torsades) VT.
Clinical significance:
Does not provide time for effective ventricular contraction
cardiac output is condiserably reduced
Treatment:
asynchronous DC cardioversion, lidocaine, or amiodarone
Torsades de Pointes (TDP)
Characteristics:
polymorphic VT with varying QRS morphology
French term meaning “twisting of the points”
Clinical significance:-
Considered one of the lethal arrhythmias b/c it can degrade into ventricular fibrillation
Treatment:
IV magnesium
Ventricular Fibrillation (V Fib)
Characteristics:
only shockable rhythm
completely disorganized and chaotic ventricular rhythm
Clinical significance:
emergent defibrillation
Management:
amiodarone and lidocaine after defibrillation
Asystole
Characteristics:
Complete ventricular standstill
no cardiac output
Flat line appears, no pacemaker activity happening anywhere in the heart
Management:
Aggressive resuscitative efforts with epinephrine, atropine and CPR
