1. CARDIAC ARRHYTHMIAS ORIGINATING IN THE VENTRICLES Commonly
caused by an acute myocardial infarction or myocardial ischaemia
Other causes include cardiac surgery, valvular disease, left
ventricular failure, cardiomyopathy, ventricular aneurysm,
myocarditis, electrolyte and pH derangements, hypoxaemia,
hypoglycaemia 2. VENTRICULAR ECTOPICS (VE) Image:
www.skills4nurses.com QRS rate: determined by the underlying rhythm
QRS width: VE will be wide and bizarre with chaniging amplitude,
morphology and deflection. Morphology differs from that of the QRS
complexes associated with underlying rhythm. ST segment usually
slopes in a direction opposite to the QRS deflection; Pwaves:
usually none associated with VEs. Not possible to determine the
relationship between P waves and VEs. 3. VENTRICULAR ECTOPICS (VE)
different types Uniform or unifocal VES: VEs of the same morphology
Image: www.skills4nurses.com Multiform: 2 or more VEs of distinctly
of different morphology Image: www.skills4nurses.com R on T : When
VE lands on T wave Ventricular bigeminy: VE after every sinus beat
Ventricular trigeminy: VE after every second beat Couplets: pairs
of VE Salvos: three or more consecutive VEs. 4. Ventricular
Tachycardia (VT) If there are 3 or more successive ventricular
ectopics at a rate >120/min, it is classed as VT. Sustained VT
lasting more than 30 seconds Non-sustained VT less than 30 seconds.
QRS width wide and bizarre Unconscious VT is a shockable rhythm
Monomorphic VT Image: floarnurse-mike.blogspot.com 5. TORSADES DE
POINTES It is a form of ventricular tachycardia Name refers to
twisting around point So rhythm looks like a twisted ribbon. Wave
like pattern to QRS complex. Magnesium is the treatment of choice.
6. Ventricular Fibrillation No recognisable QRS complex Chaotic
waveform Low amplitude waveforms Disorganised undulation about the
baseline Very fatal as the patient becomes pulseless and
unconscious due to lack of cardiac output VF is a shockable rhythm
and requires immediate defibrillation Image:
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