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Impulses originate
regularly at a frequency
SAN
of 60-100 beat/ min
AVN
SA node AV node
Bundle of His
Purkinje fibres
ECG
Normal PR interval? 0.12s to 0.2 s (3 to 5 small
square)
Normal QRS complex? <0.12s (< 3 small
squares)
Cardiac Arrhythmias
Long-term management
Ablation of an accessory pathway.
Verapamil, diltiazem & -blockers - effective in 60-80% of
patients.
The Wolf Parkinson White Syndrome (WPW)
An abnormal band of atrial tissue connects the atria
and ventricles and can electrically bypass the normal
pathways of conduction; a re-entry circuit can develop
causing paroxysms of tachycardia.
ECG:
- Short PR interval
- Delta wave - upstroke of QRS complex
Drug treatment - flecainamide, amiodarone or
disopyramide.
Digoxin & verapamil are contraindicated - enhance
antegrade conduction through the AP by increasing
the refractory period in the AV node
Treatment - transvenous catheter radiofrequency
ablation
Broad complex tachy
VF
A condition in which many electrical signals are sent from the ventricles at
a very fast and erratic rate. As a result, the ventricles are unable to fill with
blood and pump.
It may cause sudden cardiac death. Basic and advanced cardiac life
support is needed