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CARDIAC ARRHYTHMIAS Clk. Alexander L. Gonzales II December 14, 2010

Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM >60bpm and

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Page 1: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

CARDIAC ARRHYTHMIAS

Clk. Alexander L. Gonzales IIDecember 14, 2010

Page 2: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

SINUS RHYTHM

>60bpm and <100bpm

P-wave in front of QRS

QRS is narrow Rhythm is regular

Page 3: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

CARDIAC ARRHYTMIAS

BRADYARRHYTHMIAS

Page 4: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

SINUS BRADYCARDIA

Slow heart beat (<60bpm)

Normal rhythm, but slow

P wave is present QRS is narrow

Page 5: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

SINUS PAUSE

SA node stops working

Pause in heart beat for 6-8s

Page 6: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

CARDIAC ARRHYTHMIAS

PREMATURE BEATS

Page 7: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

ATRIAL PREMATURE CONTRACTION QRS is normal P-wave is present

but looks different on the premature beat

Page 8: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

AV NODAL PREMATURE CONTRACTION = JUNCTIONAL

No P-wave before premature beat b/c originates in AV node, not atria

QRS is normal

Page 9: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

PREMATURE VENTRICULAR CONTRACTION

Every other beat is abnormal (ventricular bigemini)

One QRS complex and P-wave are normal

Next QRS is wide and T-wave is inverted (-) repolarization is abnormal

Page 10: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

CARDIAC ARRHYTMIAS

SUPRAVENTRICULAR TACHYCARDIAS

Page 11: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

SINUS TACHYCARDIA

>100bpm Normal P-wave Narrow QRS

Page 12: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

ATRIAL TACHYCARDIA

P-wave is inverted (-)

2 P-waves per every QRS complex

Page 13: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

AV NODAL REENTRANT TACHYCARDIA

No P-wave b/c it’s within QRS complex

QRS is narrow, looks normal but is faster

Regular rhythm

Page 14: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

PREEXCITATION: WOLFE PARKINSON WHITE SYNDROME

Slurred upslope on QRS and wider complex

PR is shorter -wave (pts. prone to

SVTs) Tachycardia pathway:

AV node accessory pathway atrium (-wave disappears, but will return once HR)

Page 15: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

SVT WITH SHORT RP (REFRACTORY PERIOD)

QRS is narrow 1:1 relationship

b/w P-wave and QRS

Can see P-wave before QRS

Page 16: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

ATRIAL FLUTTER

Regular and reproducible

QRS is narrow See (-) complexes Saw tooth pattern

Page 17: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

ATRIAL FIBRILLATION

Disorganized rhythm

Pulse is irregularly irregular/irregular rhythm

QRS is narrow No P-wave

Page 18: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

VENTRICULAR TACHYARRHYTHMIA

Occur in bottom chambers

>3 PVC in a row V-tach Nonsustained stops

after a certain time period

No P-waves Repolarization is

abnormal QRS complexes are wider More QRS than P-waves

Page 19: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

TORSADES DE POINTES

Long QT interval QRS complexes

are all over the place look abnormal

Page 20: Clk. Alexander L. Gonzales II December 14, 2010. SINUS RHYTHM  >60bpm and

VENTRICULAR FIBRILLATION

Complete disorganization

No P-waves No QRS complexes