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Electrophysiology of Arrhythmias

The document outlines the management of arrhythmias, detailing treatments for bradycardia and tachycardia, including the use of medications like atropine and adenosine, as well as pacing and cardioversion techniques. It categorizes arrhythmias based on stability and rhythm characteristics, providing specific treatment protocols for various types. Additionally, it emphasizes the importance of EKG as a diagnostic tool to assess rate, rhythm, axis, intervals, and morphologies.

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mmanyapu
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92 views3 pages

Electrophysiology of Arrhythmias

The document outlines the management of arrhythmias, detailing treatments for bradycardia and tachycardia, including the use of medications like atropine and adenosine, as well as pacing and cardioversion techniques. It categorizes arrhythmias based on stability and rhythm characteristics, providing specific treatment protocols for various types. Additionally, it emphasizes the importance of EKG as a diagnostic tool to assess rate, rhythm, axis, intervals, and morphologies.

Uploaded by

mmanyapu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Arrhythmias

Brady

Atropine, adrenaline, noradrenaline

Unstable: pacing (cutaneous or transvenous pacing)

 Sinus brady
 Heart blocks
o Type 1 – PR prolonged but constant (tx : observation)
o Mobitz type 1 (Wenckebach) – PR prolonged and increasing, with
dropped beat (tx: observation)
 Symptomatic – pacemaker
o Mobitz type 2 – PR constant, prolonged, with dropped beat (tx:
atropine, pacemaker)
o Complete – no connection between P and QRS (tx: atropine,
pacemaker)

Sick sinus syndrome (tachy - brady)

 Tx: supportive, pacemaker


 Elderly

Tachy

Stable: BP, still responsive


Unstable: low BP, hypotensive, AMS

 Wide
o Irregular (polymorphic)
 Ventricular fibrillation (tx defibrillation 100J)
 Torsades (tx magnesium, defibrillation)
 Risk factor: prolonged QT
o Regular (monomorphic)
 Monomorphic ventricular tachycardia (tx synchronized
cardioversion, amiodarone, lidocaine, procainamide)
 SVT with aberrancy (antidromic) (tx: adenosine,
procainamide)
 Narrow
o Regular
 Sinus tachycardia (treat underlying cause)
 Aflutter (tx: beta blockers, calcium channel blockers,
synchronized cardioversion)
 With variable conduction (2:1, 3:1, 4:1)
 SVT (AVNRT) (orthodromic) (tx: vagal maneuvers, carotid
massage, adenosine 6-12-18, synchronized cardioversion,
underlying cause)
 WPW (procainamide)
o Irregular
 WPW with aberrancy/afib (tx: procainamide NOT
AMIODARONE, cardioversion)
 MAT (multifocal atrial tachycardia) – more than 3 p wave
morphologies (tx: underlying cause, oxygen –
COPD/asthma/chronic hypoxia)
 Afib with RVR (tx: rate- beta blockers/calcium channel
blockers, rhythm- amiodarone—treat underlying cause,
anticoagulation; cardioversion, increased risk
thrombus, anticoagulation, beta blockers and
calcium channel blockers)

Diagnostic Tool:

EKG

1) Rate
2) Rhythm
a. Irregular vs regular
3) Axis
a. Right or left or normal
4) Intervals
a. PR (short or long)
i. Depression
b. QT (short or long)
c. RR
5) Morphologies
a. QRS
b. P
c. T
6) ST segments
a. Elevation
b. Depression
7) Q WAVES?
8) Patterns:
a. RBB
b. LBB
c. Brugada
d. Kent Bundles
e. Wellens – v2-v4, upslope
f. Low voltage
g. Alternans
h. De Winter’s
i. S1q3t3
j. HOCM
9) Other waves:
a. U wave
b. Osborne
c. Q waves
d. RR’ Prime
e. Delta (WPW)

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