Cardiac Rhythms Flashcards
What are the different types of cardiac rhythms?
Normal Sinus Rhythm
Arrhythmias
Asystole
Atrial Fibrillation
Name 2 different types of Arrhythmias
Ventricular Tachycardia (VT)
Ventricular Fibrillation (VF)
What is Ventricular Tachycardia (VT)?
Ventricular Tachycardia (VT) is characterised by an absence of P waves as the ventricles have taken over - QRS complex is wide and fast
There is initially a pulse, but VT can progress onto no palpable pulse (no cardiac output) = cardiac arrest (needs defibrillation)
This is a life-threatening rhythm
What is Ventricular Fibrillation (VF)?
Ventricular fibrillation (VF) is characterised by rapid disorganised contraction of the ventricles = life-threatening rhythm - needs defibrillating immediately!!
No discernible atrial or ventricular activity
No palpable pulse (no cardiac output) or respirations = cardiac arrest
VF is the most common arrhythmia in patients with cardiac arrest - can be because of myocardial infarction (MI)
What is Asystole?
Easiest rhythm to memorise
Complete absence of electrical activity - straight line on the monitor
No QRS complexes - no cardiac output
Cessation of the heart’s functioning
What is Atrial Fibrillation (AF)?
Atrial Fibrillation (AF) - completely disorganised atrial electrical activity
Impulses arise from the SA node and other sites in the atria
Conduction through the AV node is irregular and usually fast
There are no P waves and it is irregular
Instead of a P wave - it has uneven fibrillary lines (F waves) before the QRS complex
What are some Atrial Fibrillation Risk Factors?
Older age
Male gender
Obesity
Hypertension
Excessive alcohol intake
Heart Failure
What are some signs and symptoms of Atrial Fibrillation?
SOB
Fatigue
Palpitations
Chest pain
Haemodynamic instability (abnormal or unstable blood pressure)
What is the treatment for Atrial Fibrillation?
Depends on the cause, severity of symptoms and the pattern
Get the rate down – Beta Blockers
Control the rhythm – medication or cardioversion
Anticoagulation due to the risk of thromboembolism
What is a 12 lead ECG?
A diagnostic tool used to help identify pathological changes associated with Acute coronary syndromes (ACS) such as a myocardial infarction (MI)
Detects the heart’s electrical activity through electrodes attached to the skin and relays them as waveforms for interpretation on graph paper
10 physical leads to attach to the patient showing 12 different views of the heart
Where do the ECG leads go?
On the 4th intercostal space
Name the landmarks for each ECG lead
V1 should go on the right side of the sternum, where the sternum meets the rib
V2 should go on the left side of the sternum, where the sternum meets the rib
V4 goes on the mid-clavicular line on the 5th intercostal space
V3 goes in the middle of V2 and V4
V5 goes horizontally to V4 on the anterior axillary line which is furthest to the front of the side of the chest wall
V6 goes in the mid axillary line which is on the side, vertical to the armpit
One electrode on each arm
Leg electrodes go somewhere down on the calves or thighs which depends on what kind of access you have to the patient’s lower extremities
