ARRHYTHMIA

• Disturbance of cardiac rythumn

Anatomy of the conducting system

Arrhythmias

• Common

• Often benign

• Often intermittent causing diagnostic difficulty

• Sometimes can cause cardiac compromise

Cause of Arrhythmia

• Cardiac -MI,valvular heart disease,myocarditis,pericarditis, endocarditis

• Non cardiac-thyrotoxicosis,drugs,electrolyte imbalance

Features

• Often asymptomatic ex-AF

• Palpitation

• Syncope

• Hypotension

• cardiac faliure

classification

• Tachyarrythmias

• Bradyarrythmiass

Bradyarrythmias

• Sinus Bradycardia

• Heart block

• Sick sinus syndrome

Sinus bradycardia HR< 60 bpm

• Hypothyroidism

• Increased intracranial pressure

• Myocardial infarction

• Jaundice

• Athletes

Heart block

• 3 types

• The depolarization wave originating in the atrium is not conducted to the ventricle

Tachycardias

• Sinus tachycardia

• Atrial tachycardia-SVT/atrial flutter/atrial fibrillation

• Ventricular-VT/VF

•

Sinus tacycardias HR > 100bpm

• Anxiety

• Hyperthyroidism

• Myocardial infarction

• Heart failure

SINUS TACHYCARDIA

• Excessive discharge of SA node

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

Atrial fibrillation

• Irregular atrial rhythm giving rise to an irregular ventricular rate

• Common in elderly

• Main risk is embolic stroke

causes

• Hypertension

• Heart failure

• Valvular heart disease

• MI

• Pneumonia

• hyperthyroidism

Treatment

• Find the cause and eliminate if possible

• Antiarrythmic drugs-rate control or rhythm control

• Anticoagulation

• cardioversion

Ventricuar

• VT

• VF

VF And pulseless VT are considered as forms of cardiac

arrest

• Medical emergency

• Needs CPR

Ectopics

• What are atrial ectopics

• What are ventricular ectopics

Treatment of arrythmias

• Anti arrythmic drugs

• Name one drug used to treat bradyarrythmias

• Name 3 drugs used to treat tachyarrythmias

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,

Thank you….