ARRHYTHMIA. Disturbance of cardiac rythumn Anatomy of the conducting system.
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Transcript of ARRHYTHMIA. Disturbance of cardiac rythumn Anatomy of the conducting system.
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ARRHYTHMIA
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• Disturbance of cardiac rythumn
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Anatomy of the conducting system
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Arrhythmias
• Common
• Often benign
• Often intermittent causing diagnostic difficulty
• Sometimes can cause cardiac compromise
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Cause of Arrhythmia
• Cardiac -MI,valvular heart disease,myocarditis,pericarditis, endocarditis
• Non cardiac-thyrotoxicosis,drugs,electrolyte imbalance
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Features
• Often asymptomatic ex-AF
• Palpitation
• Syncope
• Hypotension
• cardiac faliure
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classification
• Tachyarrythmias
• Bradyarrythmiass
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Bradyarrythmias
• Sinus Bradycardia
• Heart block
• Sick sinus syndrome
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Sinus bradycardia HR< 60 bpm
• Hypothyroidism
• Increased intracranial pressure
• Myocardial infarction
• Jaundice
• Athletes
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Heart block
• 3 types
• The depolarization wave originating in the atrium is not conducted to the ventricle
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Tachycardias
• Sinus tachycardia
• Atrial tachycardia-SVT/atrial flutter/atrial fibrillation
• Ventricular-VT/VF
•
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Sinus tacycardias HR > 100bpm
• Anxiety
• Hyperthyroidism
• Myocardial infarction
• Heart failure
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SINUS TACHYCARDIA
• Excessive discharge of SA node
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Atrial tachyardia
• Cardiac rhythm originates from a site within the atrium other than the SA node
• Ex-AV node
• Types-SVT,Atrial flutter,atrial fibrillation
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Atrial fibrillation
• Irregular atrial rhythm giving rise to an irregular ventricular rate
• Common in elderly
• Main risk is embolic stroke
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causes
• Hypertension
• Heart failure
• Valvular heart disease
• MI
• Pneumonia
• hyperthyroidism
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Treatment
• Find the cause and eliminate if possible
• Antiarrythmic drugs-rate control or rhythm control
• Anticoagulation
• cardioversion
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Ventricuar
• VT
• VF
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VF And pulseless VT are considered as forms of cardiac
arrest
• Medical emergency
• Needs CPR
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Ectopics
• What are atrial ectopics
• What are ventricular ectopics
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Treatment of arrythmias
• Anti arrythmic drugs
• Name one drug used to treat bradyarrythmias
• Name 3 drugs used to treat tachyarrythmias
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Non-drug therapy
• Cardioversion: For tachycardia especially hemodynamic unstable patient
• Radiofrequency catheter ablation (RFCA): For those tachycardia patients (SVT, VT, AF,)
• Artificial cardiac pacing: For bradycardia,
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Thank you….