Introduction to Arrhythmias: Difference between revisions

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Arrhythmias (non-normal heart rhythms) can be a challenge to the person who tries to understand them. But with a systematical approach, diagnosis is often less difficult than it seems at the beginning.
Arrhythmias (non-normal heart rhythms) can be a challenge to the person who tries to understand them. But with a systematical approach, diagnosis is often less difficult than it seems at the beginning.


First look at the heart rate:
'''First look at the heart rate:'''
*>100 bpm = tachycardia
*>100 bpm = tachycardia
*<60 bpm = bradycardia
*<60 bpm = bradycardia
*are there extra beats? -> [[Ectopic Beats]]
*are there extra beats? -> [[Ectopic Beats]]


Secondly it is important to assess the origin of the arrhythmia:
Secondly it is important to assess the '''origin of the arrhythmia''':
*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.
*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.
*If the QRS > 120ms it is either a [[Ventricular Arrhythmias|ventricular tachycardia]] or a [[Supraventricular Rhythms|supraventricular rhythm]] with additional [[Intraventricular Conduction|bundle branch block]]. This is a challenging difficulty in arrhythmia diagnosis, therefore a [[media:wideQRS_tachycardia_flow.png|flowchart]] has been developed for this.<cite>brugada</cite>
*If the QRS > 120ms it is either a [[Ventricular Arrhythmias|ventricular tachycardia]] or a [[Supraventricular Rhythms|supraventricular rhythm]] with additional [[Intraventricular Conduction|bundle branch block]]. This is a challenging difficulty in arrhythmia diagnosis, therefore a [[media:wideQRS_tachycardia_flow.png|'''flowchart''']] has been developed for this.<cite>brugada</cite>


Normal heart rhythm is explained in:
Normal heart rhythm is explained in:
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<biblio>
<biblio>
#ESCnarrowQRS pmid=14563598
#ESCnarrowQRS pmid=14563598
#Brugada pmid=
#Brugada pmid=2022022
</biblio>
</biblio>

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