Ventricular Dysrhythmias Flashcards
Ventricular escape beat
Due to temporary cessation of heartbeat, like in sinus arrest, or when the rate of the underlying rhythm falls to less than the rate of the ventricles. The higher pacemaker fails to initiate heartbeat, so a lower one kicks in
Ventricular escape beat rhythm
irregular because of the pause
Ventricular escape beat P wave
hidden in QRS
Ventricular escape beat PR
absent
Ventricular escape beat QRS
wide and bizarre looking, inverted
Ventricular escape beat ST
depressed or elevated. Not normal
Ventricular escape beat T wave
opposite of R wave
Ventricular escape beat QT
not measured
Ventricular escape beat effects
hypotension, syncope
Ventricular escape beat treatment
treat the underlying condition, maintain an airway. If symptomatic, may give atropine or can use transcutaneous pacing.
Ventricular escape beat contraindications
DO not give lidocaine or amiodarone.
Idioventricular rhythm
person is about to go into cardiac arrest, will see one beat every 5-6 seconds
Idioventricular rhythm rate
20-40 bpm
Idioventricular rhythm rhythm
regular
Idioventricular rhythm P wave
hidden in QRS
Idioventricular rhythm PR
absent
Idioventricular rhythm QRS
wide, inverted
Idioventricular rhythm ST
Depressed, or elevated
Idioventricular rhythm T wave
opposite Q
Idioventricular rhythm QT
prolonged
Idioventricular rhythm causes
MO, Digoxin toxicity, etc.
Idioventricular rhythm treatment
support airway, deliver O2, monitor, atropine or transcutenaous pacing. If no pulse, treat like a PEA.
Idioventricular rhythm contraindications
Do not give lidocaine or amiodarone
Accelerated idioventricular rhythm
it is a rhythm that exceeds the inherent rate of the ventricles, like 40-100bpm, may appear that nothing is wrong.
Accelerated idioventricular rate and rhythm
40-100 bpm and regular
Accelerated idioventricular P wave
hidden in QRS
Accelerated idioventricular PR interval
absent
Accelerated idioventricular QRS
wide
Accelerated idioventricular ST segment
depressed, or elevated
Accelerated idioventricular T wave
opposite R
Accelerated idioventricular QT interval
prolonged
Accelerated idioventricular causes
same causes as idioventricular rhythm (MI, digoxin toxicity, drugs) but it is often seen after administering thrombolytic medications (so it is a reperfusion dysrhythmia). Commonly seen following an MI.
Accelerated idioventricular treatment
if symptomatic (decreased CO, sustained) may give atropine. If it is sustained may install a permanent pacemaker. No pulse, treat it as a PEA
Accelerated idioventricular contraindications
Do not give lidocaine or amiodarone
Ventricular tachycardia
a fast dysrhythmia that arises from the ventricles.
Ventricular tachycardia rate and rhythm
100-250 bpm, regular
Ventricular tachycardia P waves
hidden in QRS
Ventricular tachycardia PR
absent
Ventricular tachycardia QRS
wide and bizzare
Ventricular tachycardia ST
depressed or elevated
Ventricular tachycardia T
opposite of R
Ventricular tachycardia QT
prolonged
Ventricular tachycardia causes
it is increased Myocardial irritability that is causes by enhances automaticity (from MI or ischemia), Re-entry loops from the purkinje system, or from PVC’s that are R on T. Stimulant drugs, Digoxin, hypokalemia and acid-base imbalance may also cause.
Ventricular tachycardia effects
always significant. compromised CO and decreased coronary and cerebral perfusion.
Ventricular tachycardia treatment
Maintain airway, give O2, place IV line. If stable can treat with amiodarone, procanamide or stall. If unstable, do cardioversion. If pulseless, treat as though it is V-Fib.
Torsades
Long QT syndrome. Caused by QT prolongation medications and/or electrolyte imbalances. Can be caused by amiodarone, quinidine, procainamide). Will see a twisted ribbon-like Vtach on ECG.
Torsades effects
Pallor, Diaphoresis, Syncope, loss of consciousness.
Torsades treatment
manage like it is VFib with an initial unsynchronized shock. If the pt is stable and did not have prolonged QT on previous ECG strip, may give amiodarone. If pt is stable and did have prolonged QT on previous strip, give magnesium sulfate.
Ventricular fibrillation
result of chaotic firing of multiple sites in the ventricles. Causes the heart muscle to quiver, rather than contract, giving no effective CO.
Ventricular fibrillation rate and rhythm
both irregular
Ventricular fibrillation cause
MI, trauma, acid base imbalance, CAD, untreated vtach, R on T phenomena, drugs like epi, cocaine.
Ventricular fibrillation effects
will lead to death if left untreated.
Ventricular fibrillation treatment
follow ACLS guidelines–> CPR, defib, epinephrine or vasopressin and amiodarone or lidocaine.
Asystole
absence of any cardiac activity, flatline
Ventricular standstill
see p waves only. When the atria continue to beat but the ventricles do not.
Pulseless electrical activity, PEA
organized ECG rhythm, but patient is pulseless and apneic.
Ventricular Escape Beat ECG

Idioventricular rhythm ECG

Accellerated iidioventricular rhythm ECG

Ventricular Tachycardia ECG

Torsades ECG

Ventricular fibrillation ECG

Ventricular standstill ECG
