Ventricular

1. V-tachy
- QRS>120
- Three or more PVC
- Tachy rate
- Etiology- ischemia, infract
- Can become a-fib
- Tx: 1. Hemo unstable- cardioversion, 2. Stable- amio or lido

2. V-fib
- No coordinated ventricular depol
- No cardiac output
 3. Torsades
- Type of v tachy
- Seen with prolonged qt
- Seen with hypomag
- Treat underlying

Atrial

1. Supraventricular tacchy

A . Multifocal atrial tachy

- Ectopic foci, rate>100

- 3+ different looking p waves
- PR and RR intervals vary
- Etiology- lung disease+ theophylline use
 a. Wandering atrial pacemaker
- Like multifocal but less than 100bpm

b. Wolf Parkinson white

- Alternatve electrical pathway connecting atria and ventricles
- Bundle of kent causing earlier ventricular activation
- 1. Short pr
- 2. Wide qrs
- 3.delta wave
- Tx- ablation is def
- Stable- procainamide
- Unstable- cardiovert
 c. Paroxysmal atrial tachy
- P-waves look normal if there
- Qrs narrow

d. Atrial flutter
- Atrial rate of 250
- Saw tooth appearance
- Can be 2:1, 3:1, or 4:1
- Normal rhythm
- Tx by slowing av conduction

e. A- fib
- Atria fired at vary rapid rate
- No p wave
- Ventricular depol at irregular intervals: R-R vary

Premature beats

1. Atrial premature beat (APC)

- Ectopi focus in atrium
- QRS is normal
- Irregular

2. Atrial bigeminy
- Each sinus beat is followed by atrial premature beat
 3. Ventricular premature beat (PVC)
- Wide qrs
- Irregular

Escape beats

1. Junctional escape

- Av node fires after pause

- QRS normal
- P waves absent
Ventricular escape

- Same except QRS wider

Blocks

1. First degree block

- PR>200msec

2. Second degree

a. Mobitz 1 (wenckebach)
- Progresive lengthening of pr until there is dropped beat

-
b. Mobitz II
- PR is prolonged but no lengthening
- Dropped beat
- Can become 3rd degree
 c. 3rd degree block
- Atrial and ventricle beat independently
- P and QRS not associated
- Tx with pacemaker