Introduction to Arrhythmias

From ECGpedia
Revision as of 07:07, 26 May 2012 by Googletrans (talk | contribs)
Jump to navigation Jump to search
Author(s) J.S.S.G. de Jong
Moderator J.S.S.G. de jong
Supervisor
some notes about authorship
Arrhythmias can be subdivided into supraventricular, nodal and ventricular arrhythmias

Arrhythmias (non-normal heart rhythms) can be a challenge to understand, but with a systematic approach, diagnosis is often less difficult than it may appear at first.

A good stepwise approach to interpret the heart rhythm is to follow these steps:

  • Is this my patient's ECG or is this an artifact? (applies especially in stressfull situations)
  • What is the ventricular heart rate?
    • >100 bpm = tachycardia
    • <60 bpm = bradycardia
    • Are there extra beats? -> Ectopic Beats
  • 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.
    • What is the rate of the P waves?
    • What is the P wave morphology?
  • What is the relationship between P waves and QRS complexes?
  • What is the QRS width?
  • What is the Heart Axis and did it change?
    • If the heart axis turns significantly when compared to the heart axis during sinus rhythm a ventricular origin of the rhythm is more likely.
  • What is the clinical setting?
    • A wide complex tachycardia in a hemodynamically unstable 70-year-old man with previous myocardial infarction should be considered a ventricular tachycardia until proven otherwise
    • A wide complex tachycardia in a 24-year-old woman with recurrent spells of tachycardia that respond to vagal maneuvers is most likely an AVNRT with aberrant conduction.

References

Error fetching PMID 14563598:
Error fetching PMID 2022022:
Error fetching PMID 17272358:
Error fetching PMID 17317697:
  1. Error fetching PMID 14563598: [ESCnarrowQRS]
  2. Error fetching PMID 2022022: [Brugada]
  3. Error fetching PMID 17272358: [vereckei]
  4. Error fetching PMID 17317697: [dendi]
All Medline abstracts: PubMed | HubMed