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Introduction to Arrhythmias: Difference between revisions
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A good stepwise approach to interprete the heart rhythm is to follow these steps: | A good stepwise approach to interprete the heart rhythm is to follow these steps: | ||
*What is the '''ventricular [[Rate|heart rate]]'''? | |||
**>100 bpm = tachycardia | |||
**<60 bpm = bradycardia | |||
**are there extra beats? -> [[Ectopic Beats]] | |||
* '''Cherchez le P''', French for ''find the P waves''. | * '''Cherchez le P''', French for ''find the P waves''. | ||
** Do you see P waves? Leads II and V1 are often most suitable to find P waves. | ** Do you see P waves? Leads II and V1 are often most suitable to find P waves. | ||
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* What is the '''relationship between P waves and QRS complexes'''? | * What is the '''relationship between P waves and QRS complexes'''? | ||
** Is there a 1:1 relation between P waves and QRS complexes? If not there may be [[AV dissociation]] due to a [[Ventricular arrhythmia]] or [[AV conduction|AV block]] | ** Is there a 1:1 relation between P waves and QRS complexes? If not there may be [[AV dissociation]] due to a [[Ventricular arrhythmia]] or [[AV conduction|AV block]] | ||
** Is every P wave followed by a QRS complex? And every QRS preceded by a P wave? | ** Is every P wave followed by a QRS complex? And every QRS preceded by a P wave? | ||
** What is the [[Conduction|PR interval]] and does it change? | ** What is the [[Conduction|PR interval]] and does it change? | ||
* What is the '''[[Conduction|QRS width]]'''? | * What is the '''[[Conduction|QRS width]]'''? | ||
**If the QRS < 120ms (i.e. a narrow complex), then it is either a [[Sinus node rhythms and arrhythmias|sinus arrhythmia]], [[Supraventricular Rhythms|supraventricular rhythm]] or a [[Junctional Tachycardias|junctional tachycardia]]. In tachycardias, this [[Media:narrow_tachycardia_flow.png|'''flowchart''']] will lead to the right diagnosis.<cite>ESCnarrowQRS</cite> | **If the QRS < 120ms (i.e. a narrow complex), then it is either a [[Sinus node rhythms and arrhythmias|sinus arrhythmia]], [[Supraventricular Rhythms|supraventricular rhythm]] or a [[Junctional Tachycardias|junctional tachycardia]]. In tachycardias, this [[Media:narrow_tachycardia_flow.png|'''flowchart''']] will lead to the right diagnosis.<cite>ESCnarrowQRS</cite> | ||