Cardiac Arrhythmias – Supraventricular tachycardia and Ventricular fibrillation —

SVT. A rapid, regular tachycardia in which the pacemaker is found in the sinus node, the atria, or the atrioventricular junction, i.e., above the ventricles

Cardiac Arrhythmias – Supraventricular tachycardia  ecg

Distinguishing features of SVT with wide QRS from VT —

• Triphasic QRS – rsR or qRs
• . Initial deflection identical to normal beat (RBBB pattern)
• Atrial ectopics precede the acidity
• Alternating BBB patterns
• Identical wide QRS pattern in previous ECG (not showing SVT) which was diagnosed as aberrant.
• These are Life threatening Cardiac Disorders

Slow Ventricular Tachycardia

• is another term used for an accelerated ventricular rhythm. Nonsustained VT is VT of less than 30 seconds.

Trorsades de ointes:

• Polymorphic VPBs with appearance of slow flutter without QRS complexes or T waves is called Torsades de pointes. The ventricular activity revolves around isoelectric line.

Ashman phenomenon:

• Aberration in the intraventricular conduction of an impulse that completes a short cardiac cycle following a long cycle because the long cycle results in delay of repolarization.

Concordance :

• Abnormal wide QRS complexes all in one direction in all 6 precordial leadsis called concordance of QRS.

Ventricular fibrillation —

Cardiac Arrhythmias –  Ventricular fibrillation ecg

• A treatable, but lethal dysrhythmia present in nearly half of all cases of cardiac arrest. It is marked on the electrocardiogram by rapid, chaotic nonrepetitive waveforms; and clinically by the absence of effective circulation of blood (pulselessness)

Causes of VF Ventricular fibrillation

• · IHD (Ischemic heart disease)
• · Antiarrhythmic drugs which prolong QT
• · Torsade de pointes
• · Severe hypoxia
• · WPW with AF with rapid ventricular response
• · Electric shock and Congenital long QT
• · HOCM (Hypertrophic obstructive cardiomyopathy)
• · Arryhthmogenic RV dysplasia
• · Brugada syndrome.
• VF is recognized by grossly irregular undulations of varying amplitude, contour, and rate.

Cardiac Arrhythmias –Ventricular fibrillation ecg

Treatment of Ventricular fibrillation

• Drugs – Same as for VT.
• Defibrillation – Asynchronized DC shock – 200 to 400 Joules.
• External electric cardioversion is performed by placing two paddles to the right of sternum at level of second rib and left anterior aXillary line in the fifth intercostal space.
• (Qiazepam is given in the conscious patient)