Ventricular arrhythmia
To determine arrhythmia
Atrial Ectopics
SVT
Ventricular premature beat (VPC)
Definition
VT (Pulse/ pulseless)
*If unconscious VT, treat as VF (ALS algorithm). VF same as pulseless VT
Torsades de Pointes
Source
Prof D McTaggart 2015
- Regular/ irregular
- What is exact rate?
- Width of QRS complex (wide = >2.5 small sq wide)
- Independent P waves?
Atrial Ectopics
- Abnornal P wave
- Unchanged QRS
- Short post extra-systolic pause
- NOT sign of disease
SVT
- Regular, high HR (180+), Normal QRS, no p waves
- Sudden onset/ offset
- Visible pulse
- Polyuria (atrial stretch --> senses "High" BP --> polyuria)
- Mx: Carotid massage, Valsava, acute: verapamil/ adenosine IV; prevention: BB, sotalol, verapamil, digoxin, RF ablation
- Mx: Flecainide
Ventricular premature beat (VPC)
Definition
- Premature
- No preceding P wave
- Long pause
- Happens w structural HD or IHD
- Risk of sudden death increased
- If normal heart, they are benign
VT (Pulse/ pulseless)
- PR 140-200
- Cause: CAD, MI
- 3 or more ectopic QRS complex
- In youth, in mitral prolapse, low K+, long QT syndrome, RV dysplasia. Drugs, IHD
- Rx: BB, amiodarone 300mg, electric cardioversion. If pulse present, give adrenaline.
*If unconscious VT, treat as VF (ALS algorithm). VF same as pulseless VT
Torsades de Pointes
- long QT syndrome
Source
Prof D McTaggart 2015