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Cardiac Arrhytmias


TACHYARRHYTHMIAS
Atrial Flutter

Saw- tooth appearance
Regular heart rate ( atrial rate 280 - 350/min)

ATRIAL FIBRILLATION (AF )




Irregularly irregular rhythm
No visible p waves or abnormal p
Normal shape QRS

Treatment (Acute Fast Atrial Fibrillation)

- Oral or IV Digoxin
- B Blockers
- IV Amiodarone
- Electrical Cardioversion

SUPRAVENTRICULAR TACHYCARDIA (SVT)






1. Regular rhythm
2. Narrow QRS complex tachycardia
3. Presence of P wave abnormalities
- Deform p waves
- No visible p wave
( p occur simultaneously with QRS which is compatible with reentry in the AV N)
-P waves occurs after T ( compatible
with reentry utilizing accesory AVN)

Treatment

- IV Adenosine
- IV Verapamil
- IV Amiodarone
- Electrical Cardioversion

VENTRICULAR TACHYCARDIA (VT)





1. Broad QRS complex ( > 0.14 s)
2. Presence of atrioventricular dissociation
3. Bifid, upright QRS with a taller first peak in V1
4. Deep S wave in V6
5. A Concordant ( same polarity) QRS direction in all chest leads ( V1 - V6)


VT (Monomorphic)



VT (Polymorphic – Torsades Pointes)



VF


Treatment

- IV Lignocaine
- IV Amiodarone
- Electrical Cardoversion* Asynchronise electrical cardioversion is usually used in VF

BRADYARRHYTHMIAS

First Degree AV Block




Bradycardia, regular rhythm
Prolongation of PR interval > 0.22s

Second Degree AV Block

(1) Mobitz type 1 ( Wenckebach )




progressive prolongation of PR interval until a P wave fails to conduct.
Regularly irregular rhythm

(2) Mobitz type 2





PR interval of the conducted beat is constant with one p is not followed by a QRS complex.

Complete Heart Block








No relation between P and QRS complex
Abnormal shaped QRS complex

Treatment
- IV Atropine
- IV Isoprenaline
- Pacemaker – Temporary internal or external, Permenant

Further Reading : Atrial Ectopics, Ventricular Ectopics, AVRT & AVNRT, Junctional & Idioventricular Ryhtm, Bundle Branch Block, Hemiblock

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My Final Yr Project time undergrad buat psl Compression of ECG Signal using wavelet...tuk mudahkan para doctor n including patient yg using holter..but kat mesia tak de lg patient using holter

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holter adalah satu investigation yg perlu...holter ada di malaysia..bahkan ia biasa digunakan disini untuk pengetahuan puan. tp kami perlu merujuk pt pd physician dahulu sebelum holter dijlnkn..

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kt hospital raja perempuan zainab 11 kota bharu pun ada holter, anyway.

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biler tgk sumer ECG ni teringt pesal ACLS..mmg nk kena tahu baca ECG segala...huhuhu..

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wahidah,
in ACLS, ECG adalah penting. management adalah bergantung pd ECG in making diagnosis. kalu kita salah baca ECG dlm cardiac arryhtmia ia akan membahayakn pesakit tersebut.
Tip untuk staff nurse ECG perlu dilakukn dgn betul..check dkt lead AVR p wave MESTI negatif atau inversion or mirror image pd lead 11...kadang2 kita selalu buat siap. ST depression dh jadi ST elevation..x pasal2 pt terima STK(streptokinase)...

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