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    Cardiac Arrhytmias

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    arvinth

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    Cardiac Arrhytmias

    Uploaded by

    arvinth
    0 views22 pages

    Original Title

    CARDIAC ARRHYTMIAS

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    0 views22 pages

    Cardiac Arrhytmias

    Uploaded by

    arvinth

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 22

    CARDIAC

    ARRHYTMIAS
    TYPES
    TACHYARRHYTMIAS-HR>100/min
    Sinus tachycardia
    Atrial flutter
    Atrial fibrillation
    Supraventriculr tachycardia
    Ventricularfibrillation
    BRADYARRHYTMIAS-HR<60/min
    Sinus bradycardia
    Sick sinus syndrome
    Heart block
    CAUSES OF TACHYARRHYTMIAS
    Coronary artery disease
    Valvular heart disease
    Sino atrial disease
    Hypertension
    Hyperthyroidism
    Alcohol
    Cardiacmyopahty
    Idiopathic
    ATRIAL FLUTTER
    Large RE-ENTRY circuit with in right atrium
    RATE-300/min(2:1,3:1,4:1 AV block)
    ECG - “FLUTTER WAVES”
    ATRIAL FIBRILLATION
    Sustained cardiac arrhytmia due to multiple
    interacting re-entry circuits looping around atria
    Ectopic-Pul.V,diseased atrial tissue
    Precipitated by large atrium
    Unco-ordinated and ineffective atrial contraction with
    irregular ventricular activation “irregularly irregular
    pulse”
    TYPES:Paroxysmal,Persisitent
    ECG-Irregular QRS complex,no P wave
    MANAGEMENT
    Clinical history
    ECG
    ECHO
    TFT
    TREATMENT
    PAROXYSMAL-beta blockers
    Propafenone/flecainide
    RADIO FREQUENCY ABLATION
    ATRIAL PACING(structural disease)
    PERSISTENT ATRIAL FIBRILLATION
    RHYTM CONTROL
    Structural damage-ELECTRICAL CARDIOVERSION
    If not,intravenous flecainide(2mg/kg 30min)
    RATE CONTROL
    Digoxin
    Beta blockers
    Calcium antagonist
    SUPRAVENTRICULAR-
    TACHYCARDIA
    AV nodal re-entry tachycardia(AVNRT)
    Re-entry in right atrium and AVN
    Normal heart
    Regular tachycardia:140-220/min
    ECG-Normal
    TREATMENT-Beta blockers
    i.v. adenosine
    DC cardioversion
    Catheter ablation
    AVRT and WPW syndrome
     ACCESSORY PATHWAY:Abnormal conducting tissue
    between atria and ventricles similar to purkinji fibres.
     CONCEALED ACCESSORY PATHWAY
    -from ventricles to atria
    -normal sinus rhytm
    MANIFEST ACCESORY PATHWAY
    -conduction via AVN and accessory path.
    ECG-short PR interval and DELTA WAVES
    WOLF-PARKINSON-WHITE SYNDROME
    TREATMENT
    -i.v. adenosine
    DC Cardioversion
    Prophylaxis for future attack-
    amiodarone
    VENTRICULLAR FIBRILLATION

     Unco-ordinated contraction of ventricles of the


    heart,making them to quiver rather than contract
    properly.
     Pathophysiology:hypoxia and re-entry
     Pulse-Absent pulse or feeble
     TREATMENT
    CPR
    DE-FIBRILLATION
    ACE-Inhibitor,Amiodarone,Beta-blocker
    BRADY-ARRHYTMIAS
    CAUSES:
    Advanced age
    Hypothyroid
    Hypoglycemia
    Hypothermia
    Drugs-clonidine,verapamil
    Sleep apnoea
    Infection-Rheumatic fever,Diptheria
    SYMPTOMS
    Syncope
    Palpitation
    Shortnes of breath
    Chest pain
    Hypotension
    SINUS BRADY-CARDIA
    HR<60 beats/min
    Mostly asymptomatic-no treatment
    Stmptomatic-i.v.Atropine 0.6-1.2mg
    SICK SINUS SYNDROME
    Collection of heart rhytm disorder ,includes
    Sinus brady–cardia
    Sinus arrest
    Atrial tachycardia
    Bradycardia-Tachycardia
    PATHOLOGY
    FIBROSIS,DEGEN.CHANGES,ISCHAEMIA
    TREATMENT
    No symptom-no treatment
    Bradycardia-Permanent pacemaker
    Tachycardia-Radiofrequency ablation

    COMPLICATION
    Angina
    Heartfailure
    Syncope
    HEART BLOCK
     Unusually slow heart beat due to slowing or blocking
    of electrical conducting system of heart
     Influenced by autonomic nervous system
     TYPES
     First degree heart block
     Second degree heart block
     Complete heart block
     Stokes-Adams Attack
    FIRST DEGREE HEART BLOCK
    AV conduction delay
    PR interval>0.20 secs
    Mostly asymptomatic
    No Treatment required
    SECOND DEGREE HEART BLOCK
    Some impulses from atria fail to conduct to ventricles
    DROPPED BEATS present.
    MOBITZ Type-I:Progressive lengthening of successive
    PR interval
    MOBITZ Type-II:PR interval constant
    Some P waves not conducted
    Risk of asystole
    COMPLETE HEART BLOCK
    None of electrical impulse will reach ventricles
    resulting in generation of some impulses on their
    own(slower)
    Atrial and ventricular contractions become
    independent.
    STOKE-ADAMS ATTACK
    Ventricular ASYSTOLE complicating mobitz type-
    II/Complete heart block
    Recurrent Syncope/Convulsions/Death like
    appearance
    Flush+ ,epilepsy resolved
    MANAGEMENT
     Second degree,/complete Heart block WITHOUT
    ASYSTOLE:
    Atropine 0.6mg i.v.,if not effective TEMPORARY
    PACEMAKER
    Resolves in 7-10 days
    WITH ASYSTOLE:
    i.v. Atropine 3mg/i.v Isoprenaline(2mg in 500ml 5%
    dextrose) to maintain circulation until
    TEMPORARY PACING done.
    CHRONIC:Permanent Pacemaker

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