Ventricular Rythms Flashcards
QRS
> .12 if initiated in the ventricles
a beat >.12 isn’t necessarily initiated in the ventricles
PVC
Wide and bizarre >.12 QRS
Interpolated PVC
doesn’t affect rythm. falls in the middle of 2 beats
Compensatory pause
PVC interrupts normal rhythm
sinus brady with bigeminal PVC’s
electrical twice the mechanical
Run of PVC’s (or burst)
3 or more PVC’s in a row
Couplet of PVC’s in a row
2 PVC’s in a row
electrical doesn’t match mechanical pulse
Pulsus deficit
Frequent PVC’s are = to
6 or more per minute
Ventricular escape beats
A. Ectopic occurs after pause in which supraventricular pacemaker fails to initiate impulse
B. Protective mechanism
VTAK
Heart extremely irritable
Ventricular focus could speed up and over ride pacer sites
Polymorphic vs. monomorphic
Sustained VTAK
> 30 seconds
Nonsustained VTAK
<30 seconds
6 characteristics of VTAK
- Rate is 150-250
- Rhythm is regular
- P wave none usually, if there doesn’t conduct
- PRI—none
- QRS
a. wide bizarre
b. > .12 sec - T wave—–not seen
> 40 IVR
accelerated idioventricular rhythm
5 H’s
Hypovolemia Hypoxia Hydrogen-ion(acidosis) Hypo/hyperkalemia Hypothermia
5 T’S
Tablets (OD) Tamponade Tension Pheumo Thrombosis (coronary) Thrombosis (emboli)
LIDO
protocol
NACO3
protocol
Amiodarone
protocol
S127
protocol
etiology of PVC
- Damage to His-Purkinje system
- Increased sympathetic tone
- Hypoxia or Acidosis
- AMI or myocardial ischemia or CHF
- Electrolyte imbalances (K, Ca++, Mg)
- Digitalis toxicity
- Use of cyclic antidepressants, phenothiazines
- Stimulate uses
Etiology of VTAK
Same causes as PVC's Ischemia Hypoxia Electrolytes Acid-base problems Increased sympathetic tone
Polymorphic VTAK
Torsades de Pointes
Torsades Itiology
Drug induced
Eating disorder
Electrolyte imbalances (magnesium, potassium, calcium)
V flutter
often degenerates to vfib
V Flutter symptoms
Palpitations Dyspnea
Dizziness Anxiety
Diaphoresis Angina
Seizures
V Fib Etiology
- Usually preceded by ventricular irritability
- Ventricular damage
- Hypoxia
- Electrolyte disturbances
- Electric shock
- Malfunctioning pacemaker
- Drugs
Often first rhythm following defibrillation
Idioventricular
