Arrhythmias Any change in the normal sequence of the electrical impulses from the sinus node (SA) to the ventricles can cause arrhythmia
P-wave: contraction of the atria • QRS-complex: contraction of the ventricles • T-wave: recovery of the ventricles
ECG in PSG • Mostly only 1 channel • Recognition of heartrhythm disturbances • Not a diagnostic tool for other heartpathologies s.a. signs of ischaemia
Tachy-arrhythmia (too fast: > 100 bpm)Brady-arrhyhthmia(too slow: < 60 bpm)
Atrial arrhythmia An atrial arrhythmia is an arrhythmia caused by • a dysfunction of the sinus node or • the development of another atrial pacemaker within the heart tissue that takes over the rhythm of the sinus node
Sinus Tachykardia A condition in which the heart rate is faster than 100 beats per minute because the sinus node is sending out electrical impulses at a rate faster than usual
Atrial flutter The electrical signals come from the atria at a fast but even rate. When the signals from the atria are coming at a faster rate than the ventricles can respond to, the ECG pattern develops a "sawtooth" pattern, showing two or more flutter waves between each QRS complex.
Ventricular arrhythmia A ventricular arrhythmia is an arrhythmia caused by • a dysfunction of the sinus node • an interruption in the conduction pathways • the development of another pacemaker
Prolonged pr-interval (>200 msec) Atrial ventricular AV Block 1st degree
Atrial ventricular AV Block2nd degree • Wenckebach. Progressive prolongation PR interval until a p-wave is blocked • Mobitz Type II: pr-interval constant, evt. shorter after a p-wave block
Atrial ventricular AV Block3d degree • No atrial impulses reach the ventricles • Possibly lifethreatening if the subsidiary pacing in the ventricles is not sufficiant
Ventricular tachycardia !! Life threatening !!
Ventricular flutter !! Emergency !!
Ventricular fibrillation !! Emergency !!
Asystoly !! Emergency !!
CPR Cardio Pulmonary Resuscitation Newest guidelines
No circulation:No AED available Basic Life Support • 15 compressions on the chest • 2 breaths • Same rhythm, even if 2 reanimators
No circulationAED available • In case of fibrillation or ventricular tachycardia connect the patient to the AED , perform analysis • Without pulse: defibrillation • Repeat ABC • No result: restart BLS and defibrillation after 1 minute • No fibrillation: BLS