Kamlya balgoon2009

Ventricular Rhythms General characteristics Wide QRS. NO P wave Mostly very fast Could be Lethal

kemo 2009

Ventricular Rhythms Premature Ventricular Contraction

( PVC )Ventricular Tachycardiaventricular Fibrillation ( V-tach.) No electrical Activity ( Asystole )

kemo 2009

1 -Premature Ventricular Contraction ( PVC )

It impulse start ventricle before next normal sinus impulse

Premature = comes early with bizarre shape.

Most of the time accompany sinus rhythm.

PVCs (early,

wide and bizarre)kemo 2009

PVCs … continued

Multifocal ( different shape )

kemo 2009

Premature Ventricular Contraction ( PVC )

Unifocal

kemo 2009

PVCs … continued

3- Couplets ,tow in arow pair

Couplets

kemo 2009

PVCs … continued4- Bigeminy every other beat is PVC

kemo 2009

PVCs … continued5- Trigeminy every third complex is PVC

kemo 2009

Premature Ventricular Contraction ( PVC )Ventricle & a trial rate : depend on rhythm

Ventricle & a trial rhythm : irregular due to early QRS creating PR interval is shorter

QRS shape & duration : duration 0.12 second or more . Bizarre , abnormal shape

P wave shape : visibility p wave depend time of PVC may absent or in front QRS

P-R interval : less than 0,12 second Each P followed by a QRSP: QRS ratio : 0 :1 , 1 :1

kemo 2009

2- Ventricular Tachycardia( V-tach.)It three or more PVC in arow A whole strip with PVCs.No P waves.If there is no pulse, it is lethalAlways check the Pulse and BP

kemo 2009

Ventricular Tachycardia( V-tach.)

Ventricle & a trial rate : ventricle rate 100 – 200beats /m

QRS shape & duration : duration 0.12 second or more .

P wave shape : very difficult to detect P-R interval : very irregular if see p wave

Each P followed by a QRSP: QRS ratio : more QRS then p wave

kemo 2009

Ventricular Tachycardia( V-tach.) Treatment lidocaineSynchronized cardioversion

kemo 2009

3- ventricular FibrillationNo P waves, No QRS, only electrical activity present.

Lethal, always check Pulse and BP

kemo 2009

ventricular FibrillationVentricle rate ; greater than 300 per mint

Ventricle rhythm : irregularQRS shape & duration irregular

kemo 2009

No electrical Activity( Asystole )

No QRS, no electrical activity, P waves may present.No heart rate ,pulse

kemo 2009

kemo 2009