Common Arrhythmias

Multifocal PVC


 

Ventricular Bigeminy


 

Atrial Fibrillation (Afrib): Atrial activity is fast (400-600 atrial beats/min) and poorly defined; may see course (amplitude >0.5mm) or fine (amplitude <0.5mm) undulations or no atrial activity at all. Ventricular rate/response is irregularly irregular and may be fast (HR >100 bpm, indicates inadequate rate control), moderate(HR = 60-100 bpm), or slow. May see isoelectric line variance.


 

1st Degree AV Node Block: PR>0.20 sec,may be physiologic in younger patients with high vagal tone and in well-trained athletes.Rarely symptomatic and no treatment is usually required, but further investigation may be indicated when it accompanies another heart disorder or appears to be caused by drugs


 

2nd Degree AV Node Block Mobitz 1 (Wenckebach): increasing PR interval until a QRS complex is dropped, usually benign may be present in endurance athletes. Will produce a regularly irregular rhythm on manual exam of pulses.


 

2nd Degree AV Node Block Mobitz 2: QRS dropped without any progressive increase in PR interval (i.e., PR interval is constant but still >0.20 sec). May produce an irregularly irregular rhythm on manual exam of pulses.


 

3rd Degree AV Node Block Complete heart block: atria and ventricles are electrically dissociated from each other (P waves and QRS complexes occur independent of each other). P-P normal and R-R normal however P-R variable. May see wide QRS complex. Serious condition, most often due to myocardial ischemia/infarction may deteriorate into Vfib, asystole and sudden cardiac death


 

S-T Elevation


 

Ventricular Tachycardia (VTach)


 

Ventricular Fibrillation (VFib)


 

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