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

Supraventricular tachycardia 1

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

Ventricular fibrillation 3

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.
Ventricular fibrillation 2

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)


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