Arrhythmias

Name: Emmanueal A

RA. No: RA1921014010043

Course: Bsc. Cardiac care technology.

Year: Final year 7th semester

Topic: Arrhythmias
Content

• Definition

• Classification

• Pathophysiology

• Complication

• Diagnosis

• Clinical management

• Medical management
Definition:
• Arrhythmia are deviation from normal
heartbeat pattern.

• They include abnormalities of impulse

formation such as heart rate, rhythm, site
of impulse origin and conduction
disturbance

• Which disrupt the normal sequence of atrial

and ventricular activation.

• Arrhythmias may cause sudden death,

syncope, heart failure, dizziness,
palpitations.
Classification:
• Tachyarrhythmia

a ) Atrial

° Atrial flutter

° Atrial fibrillation
 b) Ventricle
° Ventricular fibrillation
° Ventricular flutter

Atrial
Atrial flutter
• Atrial flutter (AFL) is a common abnormal heart rhythm that starts in the atrial
chambers of the heart.

• When it first occurs, it is usually associated with a fast heart rate and is classified as a
type of supraventricular tachycardia with sawtooth pattern.

Signs and symptoms:

 • Palpitations
• Chest pain
• Tachycardia
• Shortness of breath
• Swelling in your feet and legs

Diagnosis:
ECG in case of Atrial flutter.
o Narrow complete tachycardia.
o Regular atrial activity at 300 beats per minute
o Flutter wave (Saw -tooth pattern) best seen in leads ll, lll,
aVF.
o Flutter wave in V1 may resemble P wave
o Loss of the isoelectric baseline.

Treatment:
 o Calcium channel blockers and beta
adrenergic blockers to slow your heart rate
o Blood thinning medicine to help prevent
stroke.
o Electrical cardioversion to stop atrial flutter.
o Cather ablation to stop atrial flutter.
Atrial Fibrillation:
o Atrial fibrillation (A-fib) is an irregular and often very rapid
heart rhythm (arrhythmia) that can lead to blood clots in the
heart.
o Rapid , irregular rhythm increasing the risk of stroke, MI and
thrombosis.

Diagnosis
ECG in case of Atrial Fibrillation.
 o P wave absent
o Absent an irregularly irregular qrs complex
o Rhythm : Irregular
o Heart rate: 90 bpm
Sign and symptoms

• Chest pain

• Dizziness

• Fatigue

• Reduced ability to exercise

• Shortness of breath

• Weakness

Treatment:

Treatment for atrial fibrillation depends on how long you've had A-fib, your
symptoms and the underlying cause of the heartbeat problem. The goals of treatment
are to:

• Reset the heart rhythm

• Control the heart rate

• Prevent blood clots that can lead to stroke

Atrial fibrillation treatment may involve:

 • Medications

• Therapy to reset the heart rhythm (cardioversion)

• Surgery or catheter procedures

Medication:

• Beta blockers. These medications can help slow the heart rate at rest and
during activity.

• Calcium channel blockers. These medicines control the heart rate but may need
to be avoided by those who have heart failure or low blood pressure.

• Digoxin. This medication may control the heart rate at rest, but not as well during
activity. Most people need additional or alternative medications, such as calcium
channel blockers or beta blockers.

• b) Ventricle
° Ventricular fibrillation
• Ventricular fibrillation (V-fib or VF) is an abnormal heart rhythm in
which the ventricles of the heart quiver.
• It is due to disorganized electrical activity.
• Ventricular fibrillation results in cardiac arrest with loss of
consciousness and no pulse.

Diagnosis
• ECG in case of ventricle fibrillation
No wave pattern found.
No P wave found .
Signs and symptoms
•Dizziness
 • Palpitations (skipping, fluttering or pounding in the chest)
• Fatigue.
• Chest pressure or pain.
• Shortness of breath.
• Fainting .

Treatment:
• Cardiopulmonary resuscitation (CPR). CPR mimics the pumping motion of the heart. It
keeps blood flowing through the body
• Then start CPR by pushing hard and fast on the person's chest — about 100 to 120
compressions a minute.
• Let the chest rise completely between compressions. Continue CPR until an automated
external defibrillator (AED) is available or emergency medical help arrives.
• Defibrillation. This treatment is also called cardioversion. An automated external
defibrillator (AED) delivers shocks through the chest wall to the heart.
• t can help restore a regular heart rhythm.

Surgery:

• Implantable cardioverter-defibrillator (ICD). An ICD is a battery-powered unit that's

implanted under the skin near the collarbone — similar to a pacemaker.
The ICD continuously monitors the heart rhythm. If the device detects an episode of
ventricular fibrillation, it sends shocks to stop it and reset the heart's rhythm.
• Cardiac ablation. This procedure uses heat or cold energy to create tiny scars in the
heart to block the irregular heart signals that cause ventricular fibrillation. It's most often
done using thin, flexible tubes called catheters inserted through the veins or arteries. It
may also be done during heart surgery.
 • Coronary angioplasty and stent placement. If ventricular fibrillation is caused
by a heart attack, this procedure may reduce the risk of future episodes of
ventricular fibrillation.

The health care provider inserts a long, thin tube (catheter) through an
artery, usually in the groin, to a blocked artery in the heart. A balloon on the
tip of the catheter briefly inflates to widen the artery. This restores blood flow
to the heart. A metal mesh stent may be placed into the artery to help it stay
open.

Ventricle flutter:
Ventricular flutter is an arrhythmia, more specifically a tachycardia affecting
the ventricles with a rate over 250-350 beats/min, and one of the most indiscernible.

It is characterized on the ECG by a sinusoidal waveform without clear definition of

the QRS and T waves.

Diagnosis
Ecg in case of ventricle flutter
Rate – 250- 350
ECG looks identical when turned upside down.
Signs and symptom
•Chest pain
• Rapid heartbeat (tachycardia)
• Dizziness
• Nausea
• Shortness of breath
• Loss of consciousness.

Treatment:
• Medications
• Implantable cardioverter-defibrillator (ICD)
• Coronary angioplasty and stent placement.
• Coronary bypass surgery.