electrocardiographic monitoring various rhythms and dysrhythmias: ventricular fibrillation...
TRANSCRIPT
![Page 1: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/1.jpg)
ELECTROCARDIOGRAPHIC MONITORING
Various rhythms and dysrhythmias:• Ventricular Fibrillation• Ventricular Tachycardia• Atrial Fibrillation• Atrial Flutter• Supraventricular Tachycardia• Paroxysmal Supraventricular Tachycardia• Sinus Tachycardia• Normal Sinus Rhythm• Asystole• Sinus Bradycardia• Junctional rhythm• First degree AV block• Second degree AV block Type I aka second-degree mobitz and aka wenckebach• Second degree AV block type II• Third degree AV block or complete heart block• PVCs: Unifocal, multi-focal, couplets, bigeminy, trigeminy• PACs
![Page 2: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/2.jpg)
Atrial Fibrillation
• Irregular heart beat• The most common cardiac arrhythmia• Affects the atriaCauses• HTN• Heart disease• Lung disease• Excessive alcohol comsumption
![Page 3: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/3.jpg)
Causes
• Hyperthyroidism
• CO poisoning
• Dual chamber pacemakers
• Friedreich’s ataxia
progressive damage to the nervous system
![Page 4: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/4.jpg)
Pathophysiology
• Absence of P waves
• Electrical impulses are inundated by chaotic impulses originating in the atria and pulmonary veins
thus………
• Irregular impulses sent to ventricles creating an irregular pulse
![Page 5: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/5.jpg)
![Page 6: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/6.jpg)
![Page 7: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/7.jpg)
May result in• Palpitations• Fainting• Chest pain• CHF• StrokeDue to clots forming in the poorly contracted
artria forming blood clots
![Page 8: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/8.jpg)
• Controlled
• Uncontrolled
![Page 9: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/9.jpg)
Ventricular Tachycardia
Arrhythmia, or irregular type of heartbeat. It causes a rapid heartbeat, usually 150 to 200 beats per minute. It is usually indicative of a serious medical problem which may or may not relate directly to the heart. If untreated, it often progresses to cardiac arrest and death.
![Page 10: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/10.jpg)
![Page 11: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/11.jpg)
Causes• Early or late complication after having an
MI• Cardiomyopathy• Heart failure• Heart surgery• Myocarditis• Valvular Heart Disease
![Page 12: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/12.jpg)
Causes
• Anti-arrhythmic medications
• Changes in blood chemistry (such as a low potassium level)
• Changes in pH (acid-base)
• Lack of enough oxygen
![Page 13: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/13.jpg)
Symptoms
• Chest discomfort
• Syncope
• Light-headedness or dizziness
• Palpations
• Shortness of breath
![Page 14: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/14.jpg)
Atrial Flutter• Atrial flutter occurs when an abnormal
conduction circuit develops inside the right atrium, allowing the atria to beat excessively fast, about 250-300 beats per minute.
• These rapid contractions are slowed when they reach the AV node, but are still too fast (typically about 150 beats per minute, or every other atrial beat getting through the AV node to the ventricles).
![Page 15: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/15.jpg)
Causes
Atrial flutter may be caused by abnormalities or diseases of the heart itself, by a disease elsewhere in the body that affects the heart, or by consuming substances that change the way electrical impulses are transmitted through the heart. In a few people, no underlying cause is ever found.
![Page 16: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/16.jpg)
Causes• Ischemia• CAD• HTN• Cardiomyopathy• Abnormalities of the heart valves (especially the
mitral valve)• An abnormally enlarged chamber of the heart
(hypertrophy)• After open heart surgery
![Page 17: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/17.jpg)
Diseases elsewhere in the body that affect the heartinclude the following:• Hyperthyroidism• PE• COPDSubstances that may contribute to atrial flutter include the
following:• Alcohol (wine, beer, or hard liquor)• Stimulants such as cocaine, amphetamines, diet pills,
cold medicines, even caffeine
![Page 18: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/18.jpg)
![Page 19: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/19.jpg)
Supraventricular Tachycardia
• Above the ventricles
![Page 20: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/20.jpg)
Causes• Atherosclerosis• Heart Failure • Thyroid disease • Chronic lung disease • Pneumonia• Pulmonary emboli, or blood clots migrating into
the lung arteries from elsewhere in the body• Pericarditis
![Page 21: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/21.jpg)
Certain drugs and social habits • Cocaine abuse • Alcohol abuse• Smoking • Drinking too much caffeine in coffee, tea, or soft drinks• Emotional stress • Structural abnormalities, such as Wolff Parkinson White
syndrome, in which extra electrical tissue sets up abnormal electrical circuits
• Supraventricular tachycardia may also be a side effect of medications such as digitalis, asthma medications, or cold remedies. In some cases, the cause of supraventricular tachycardia is unknown
![Page 22: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/22.jpg)
![Page 23: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/23.jpg)
Sinus Tachycardia
• Fast heart beat
• Commonly asymptomatic
![Page 24: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/24.jpg)
Causes• Sinus tachycardia is usually a response to
normal physiological situations, such as exercise and an increased sympathetic tone with increased catecholamine release—stress, fright, flight, anger. Other causes include:
• Fever • Anxiety • Dehydration • Malignant hyperthermia • Hypovolemia with hypotension and shock
![Page 25: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/25.jpg)
Causes• Hyperthyroidism • Mercury poisoning • Kawasaki disease • Pheochromocytoma • Sepsis • Pulmonary embolism • Acute coronary ischemia and
myocardial infarction
![Page 26: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/26.jpg)
Causes• Chronic pulmonary disease • Hypoxia • Intake of stimulants such as caffeine,
nicotine, cocaine, or amphetamines • Hyperdynamic circulation • Electric shock • Drug Withdrawal
![Page 27: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/27.jpg)
Causes
•Anemia
•Heart Failure
![Page 28: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/28.jpg)
Kawasaki Disease
Pheochromocytoma
![Page 29: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/29.jpg)
![Page 30: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/30.jpg)
Sinus Bradycardia
• heart rhythm that originates from the sinus node and has a rate of under 60 bpm.
![Page 31: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/31.jpg)
Causes• Increased vagal tone. • Sleep • Hypothermia • Hypothyroidism • Intrinsic disease of the SA Node (Eg.
Sick Sinus Syndrome).
![Page 32: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/32.jpg)
![Page 33: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/33.jpg)
Junctional Rhythm
• Impulse generated at the AV node but does not happen by the normal pathway and instead is due to retrograde conduction (conduction comes from the ventricles or from the AV node into and through the atria)
• P wave is absent or inverted
![Page 34: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/34.jpg)
Causes
• Sick sinus syndrome (including drug-induced)
• Digoxin toxicity
• acute inferior infarction
• Acutely after cardiac surgery
• Acute inflammatory processes
![Page 35: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/35.jpg)
![Page 36: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/36.jpg)
Heart Blocks
![Page 37: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/37.jpg)
First Degree Heart Block
![Page 38: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/38.jpg)
Second Degree Heart Block Type I
![Page 39: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/39.jpg)
Second Degree Heart Block Type II
![Page 40: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/40.jpg)
Third Degree or Complete Heart Block
![Page 41: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/41.jpg)
Premature Ventricular Contractions (PVC)
• Impulse generated in the ventricle
![Page 42: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/42.jpg)
Causes
• Premature ventricular contraction can occur in a healthy person of any age, but becomes more frequent in the elderly, and is more commonly found in men. PVC frequently occurs spontaneously with no cause.
![Page 43: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/43.jpg)
Possible causes:
![Page 44: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/44.jpg)
Bigeminy
![Page 45: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/45.jpg)
Trigeminy
![Page 46: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/46.jpg)
Couplets
![Page 47: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/47.jpg)
Triplet
![Page 48: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/48.jpg)
• Unifocal
![Page 49: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/49.jpg)
R-On-T
![Page 50: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/50.jpg)
PACs
• Ectopic beats within the atria
• Benign
Causes
• unknown
![Page 51: ELECTROCARDIOGRAPHIC MONITORING Various rhythms and dysrhythmias: Ventricular Fibrillation Ventricular Tachycardia Atrial Fibrillation Atrial Flutter Supraventricular](https://reader035.vdocuments.mx/reader035/viewer/2022082206/56649e905503460f94b9568a/html5/thumbnails/51.jpg)
PAC