Type Name What is it? ECG – Rhythm Strip Supraventric ular arrythmias: SVT Atrial Flutter “Shockable rhythm” An atrial contraction rate of over 250-300 bpm. Rapid and regular form of atrial tachycardia. Atria depolarize in an organised circular movement caused by a re-entrant circuit of excitation i.e. it goes straight back into the atria instead of the impulses just travelling to the ventricles. Usually paroxysmal – sometimes persistent. Patients presenting with paroxysms of atrial flutter often have normal hearts, whereas patients with chronic atrial flutter usually have underlying heart disease. Chronic atrial flutter eventually converts to chronic atrial fibrillation. “sawtooth pattern” of ECG esp. in Lead II Clinical Features: Palpitations, Chest Pain , Dyspnoea 125-160bpm Episodes can last from seconds to years Signs of heart failure (raised JVP, peripheral oedema etc) Do U&Es, TFTs and Echocardiography. Ischaemic heart disease, hyperthyroidism , cardiomyopathy and rheumatic heart disease can all cause it but sometimes, no cause is found Arial Fibrillation This is an atrial rhythm which is ineffective, chaotic and irregular, usually of around 300-600 bpm. Paroxysmal - Lasting less than 48 hour - Often recurrent Persistent - An episode of AF ECG Interpretation: No P waves Irregular QRS complexes (some may be normal)
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Type Name What is it? ECG – Rhythm StripSupraventricular arrythmias:
SVT
Atrial Flutter
“Shockable rhythm”
An atrial contraction rate of over 250-300 bpm. Rapid and regular form of atrial tachycardia.Atria depolarize in an organised circular movement caused by a re-entrant circuit of excitation i.e. it goes straight back into the atria instead of the impulses just travelling to the ventricles. Usually paroxysmal – sometimes persistent. Patients presenting with paroxysms of atrial flutter often have normal hearts, whereas patients with chronic atrial flutter usually have underlying heart disease. Chronic atrial flutter eventually converts to chronic atrial fibrillation.
“sawtooth pattern” of ECG esp. in Lead II
Clinical Features:Palpitations, Chest Pain , Dyspnoea 125-160bpm Episodes can last from seconds to yearsSigns of heart failure (raised JVP, peripheral oedema etc)Do U&Es, TFTs and Echocardiography.Ischaemic heart disease, hyperthyroidism, cardiomyopathy and rheumatic heart disease can all cause it but sometimes, no cause is found
Arial Fibrillation This is an atrial rhythm which is ineffective, chaotic and irregular, usually of around 300-600 bpm.Paroxysmal - Lasting less than 48 hour - Often recurrentPersistent - An episode of AF lasting greater than 48 hours, which can still be cardioverted to NSR. Unlikely to spontaneously revert to NSRPermanent - Inability of pharmacologic or non-pharmacologic methods to restore NSRLone (idiopathic) AF: Absence of any heart disease and no evidence of ventricular dysfunction. A diagnosis of exclusion. Could be genetic (~30% have family history). Significant stroke rate if > 75 years of age.
FBC, U&Es, TFTs, CXR, Echocardigraphy.
ECG Interpretation:No P waves Irregular QRS complexes (some may be normal)Transient flutter waves in V1Irregularly irregular heart rate Symptoms:Asymptomatic. Palpitations, Chest pain, Pre-syncope (dizziness), Dyspnea, Syncope, Sweatiness, Fatigue. Symptoms often worse at the onset of AF. Sudden cardiac death. Worsening pre-existing condition: angina, CHF
Re-entry supraventricular tachycardia
An arrhythmia caused by a second connection between atria and ventricles, in addition to the normal conduction system. There are two types: AVRNT (Atrio-Ventricular Node Re-entry Tachycardia) - the second connection is closely related to the AV
Rate of 130-250. Narrow QRS complex (except in bundle branch block), P waves are: inverted, masked by QRS complex (AVNRT) or occur halfway between complexes (AVRT), one P wave per QRS complex.
AVRT (Atrio-Ventricular Re-entry Tachycardia) - the second connection is not related to the AV node.node.
Wolff-Parkinson-White syndrome
Usually
WPW is caused by the presence of an abnormal accessory electrical conduction pathway between the atria and
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