Ventricular Rhythms

Question 1

Name ventricular rhythms (8)

Answer 1

• Complexe ventriculaire prématuré (PVC’s)
• Agonal Rhythm
• Rythme idioventriculaire
• Rythme idioventriculaire acceléré
• Tachycardie ventriculaire
• Fibrillation ventriculaire
• Asystolie
• Asystolie ventriculaire

Question 2

Describe : Complexe ventriculaire prématuré (3)

Answer 2

• may occur for a number of different reasons i.e., diet, fatigue, stress, disease, ischemia to name a few.
• frequently occur in bradycardic rhythms, but may occur almost any time.
• PVC’s occur when an early electrical impulse occurs from a location in either ventricle.

Question 3

Describe EKG of Complexe ventriculaire prématuré (4)

Answer 3

• causes an early cardiac complex which disrupts the underlying rhythm.
• Absence of P wave + wide, bizarre QRS complex.
• PVC’s can occur occasionally or frequently.
• PVC’s can be observed with or without a pattern

Question 4

Describe : Agonal Rhythm (5)

Answer 4

• Life-threatening dysrhythmia. Often the last ordered semblance of organized electrical activity in the heart prior to death.
• Heart rate is less than 20 bpm
• **Without P waves **
• Wide, bizarre QRS complex.
• The rate is often so slow, that on a singular six-second rhythm strip it will be impossible to determine whether the rhythm is regular or irregular. There must be at lest three complexes on the tracing to make this call. Many times there will only be one or two complexes captured on the ecg strip.

Question 5

Describe : Idioventricular Rhythm

Answer 5

• No P wave, wide and bizarre QRS.
• The heart rate is between 20 – 40 bpm.

Question 6

Describe : Accelerated Idioventricular

Answer 6

• No P wave, wide and bizarre QRS.
• The heart rate is between 40 – 100 bpm.
• Note the abnormal shape and width of the QRS complexes.
• Patients with this dysrhythmia may actually be hemodynamically stable when the heart rate is within the “normal” range. This rhythm must always be reported whether the patient can tolerate it or not.

Question 9

Describe : Ventricular Tachycardia (3)

Answer 9

• No P wave, wide and bizarre QRS.
• Ventricular Tachycardia occurs when the rate exceeds 100 bpm.
• Approximately 50% of patients become unconscious at the onset of ventricular tachycardia.

Question 10

Describe tx : Ventricular Tachycardia

Answer 10

• Although patients in V Tach may be treated with a defibrillator, not all patients in Ventricular Tachycardia require this level of treatment.
• Depending upon their level of consciousness and blood pressure. The patient may be treated with medications, synchronized cardioversion or in the worst case scenario a defibrillator and BLS/ACLS response.

Question 11

Describe EKG : Ventricular Fibrillation (3)

Answer 11

• No P wave and no QRS complexes.
• Chaotic waveform which reflects the electrical chaos occurring within the heart.
• Fibrillatory waves may be coarse or very fine. This is based upon their size. The longer V Fib occurs, the smaller the waveforms are likely to be.

Question 12

Describe : Ventricular Fibrillation (4)

Answer 12

• The heart is not actually beating as we know it. The chaos occurs as a result of small regions of tissue which are independently depolarizing.
• This rapid disorganized electrical activity actually makes the heart appear to quiver in response to this activity. Some have described it as shaking like Jello.
• Life-threatening = requires, immediate, effective, and aggressive care.
• If your patient is talking to you when you see this on the monitor, then your patient is not in V Fib. Always, check your patient first, but there will likely be a loose or disconnected lead wire or electrode.

Question 13

Differenciate coarse and fine V Fib

Answer 13

• Coarse Ventricular Fibrillation (coarse V Fib) is when a majority of the waveforms measure 3 mm or greater
• Fine V Fib (fine vfib) is when a majority of the waveforms measure less than 3 mm

Question 14

Identify

Answer 14

Asystole