Ventricular Rhythms Flashcards
What is the rate of V-Tach?
150 to 250 bpm
What are the 5 Ventricular Rhythms discussed in Walraven and what do all 5 have in common?
1) Premature Ventricular Complex (PVC)
2) Ventricular Tachycardia
3) Ventricular Fibrillation
4) Idioventricular Rhythm
5) Asystole
* All 5 have QRS complexes greater 0.12 secs
Describe an Idioventricular Arrhythmia.
A rhythm initiated by the ventricles in the absence of a stimulus from a higher focus. It has an intrinsic rate of 20-40 bpm and is usually regular.
What a the 5 mentioned causes of PVCs?
1) Damage to ventricles (MI)
2) Hypoxemia
3) Acidosis
4) Hypokalemia or Hypomagnesemia
5) Meds (i.e., digoxin, catecholamines, and stimulants)
In which 6 instances should PVCs be treated medically?
1) Greater than 6 PVCs per minute
2) Bigemny/Trigeminy
3) Coupled or runs/bursts of VT
4) Multifocal PVCs
5) Chest pain with PVCs
6) R on T phenomenon
What are the 6 drugs used to treat PVCs?
1) Oxygen
2) Procainamide
3) Lidocaine IV
4) Amiodarone IV
5) Quinidine
6) Sodium Bicarbonate
What are the 6 main SxS of V-Tach experienced by the patient as a result of ⬇ cardiac output?
1) Anxiety
2) Angina
3) Shock
4) Siezures
5) Cyanosis
6) ⬇ LOC
What is a Holter/24 hr monitor?
A mobile EKG worn by a patient experiencing symptomatic V-Tach. The patient usually keeps a diary of their activities while wearing the monitor.
What are the 5 mentioned treatments for V-Tach?
1) CPR if Pulseless
2) Automatic Inplantable Cardioverter/Defibrillator (AICD)
3) Meds (OPLAQS)
4) Precordial thump
5) Cardioversion/Defibrillation
When would you use Cardioversion Vs Defibrillation on a patient with V-Tach?
Cardioversion - If the patient has a pulse
Defribillation - If the patient does not have a pulse
What is Torsades de Pointe? What is the Tx for it?
Torsades de Pointe is multifocal V-Tach that isn’t V-Fib (V tach with multiform QRS waves). The Tx is Magnesium IV.
What are the 6 mentioned causes of V-Fib?
1) MI
2) Hypoxemia
3) Electrolyte Imbalance
4) Electric Shock
5) Meds
6) ⬆ Vagal Stimulation
What are the 7 mentioned causes of Asystole?
1) Vagal stimulation
2) MI
3) Hypoxia
4) Hypokalemia or Hyperkalemia
5) Pre-existing Acidosis
6) Drug overdose
7) Hypothermia
Describe an Accelerated Idioventricular Rhythm.
An Idioventricular rhythm with a rate of 60-120 bpm.
What is Ventricular Standstill? What is its clinical significance and what are the causes?
1) Ventricular standstill is the absence of any ventricular activity for more than a few seconds. P waves may be present.
2) Clinical Significance - Patient becomes pulseless and apneic if standstill persists, leading to asystole.
3) Causes - Hypoxemia, hyper or hypokalemia, drug overdose, MI, hypothermia, or ventricular rupture.
