Aritmia for Paramedic

Aritmia

Ahmad Handayani

Aritmia.

Merupakan keadaan dimana terdapat irama jantung yang tidak memenuhi kriteria irama yang normal (sinus ritme)

Faktor Pencetus

Underlying cardiac disease- Penyakit jantung koroner- Penyakit jantung katup- Penyakit jantung hipertensi- Penyakit jantung bawaan- Pre excitation (short of PR interval)- Long QT (congenital or acquired)

Faktor pencetus

Obat-Obatan- anti-aritmia- sympathomimetic.- B2 agonis, cocaine, anti depresants

(tricyclic), Aminophylline, caffeine.

- alcohol.

Faktor Pencetus

Metabolic abnormalities.- Electrolyte (low K, Na, Ca, Mg )- Hypoximia, Hypercarbia. - Acidosis

0 Endocrine abnormalities

-Thyrotoxicosis, Phaeochrocytoma.

Faktor pencetus

Miscellaneous.- Febrile illness- Emotional stress- Smoking- Fatigue.

Arrhytmia

Tachyarrhythmia (rate >100 x/min)

Bradyarrhytmia(rate < 60 X/min)

• QRS sempit (<0.12 ms)

• QRS lebar (>0.12 ms)

• AV blok derajat 1, 2 & 3• RBBB & LBBB

Diagnostic Tachyarrhytmia

Lebar gel. QRS

Keteraturan gel. QRS

P wave ??

QRS complex Teratur / tidak teratur ?

QRS complexSempit / lebar ?

P wave ?

Hubungan antara P and QRS ?

QRS sempit : Supraventricular origin

QRS sempit

Irama Teratur

Atrial Flutter

Irama Tidak teratur

QRS Lebar : Ventricular origin

VES (Ventricular extrasystole)-

VES couplet

VT-ventricular tachycardia

AF-atrial fibrillation, course P wave , RR interval irregular

ATRIAL FLUTTER

SVTRR interval regular, P or T wave not identified

Atrial Fibrilasi

VT , wide qrs , fixed axis

VF, ventricular fibrillation, changed axis

VT

VT

VF

Bradyarrhytmia(rate < 60 x/min)

Failure of impulse formation

Sinus Bradycardia Sick Sinus Syndrome

AV conduction abnormalities

1st and 2nd AV Block Total AV Block BBB (Bundle Branch

Block)

LBBBLBBB

VF