Professional Documents
Culture Documents
Randa Al-Harizy
Prof.
Prof.of
ofInternal
InternalMedicine
Medicine
Impulse conduction
Impulses originate
regularly at a frequency
SAN
of 60-100 beat/ min
AVN
mv 20 Phase 1 Cardiac Action
0
Potential
Phase 2
Depolarization
)Plateau Phase(
20-
40-
Phase 0 Phase 3
60-
80- Phase 4
Resting membrane
Potential
-100 +++++Na
+
Na
Na caca
++
++
Na
Na
Na ca++
K+
m
+
Na +
K ca++ ATPase
h Na
KKK
+ +
K
+ ++
mv 20 Phase 1 Cardiac Action
0
Potential
Phase 2
Depolarization
)Plateau Phase(
20-
40- Phase 4
Phase 3 only in(
60- Phase 0 pacemaker
cells
80- Phase 4
R.M.P
+
Na
Na
Na
-100 ++
++
Na
Na caca
++
ca++
++
+
Na
K+
m
+
Na +
K ca++ ATPase
h Na
KKK
+ +
K
+ ++
Cardiac Arrhythmias
::Mechanisms
Mechanismsof
ofbradicardias
bradicardias
Sinus
Sinusbradycardia
bradycardiaisisaaresult
resultof
ofabnormally
abnormallyslow
slow
automaticity
automaticitywhile
whilebradycardia
bradycardiadueduetotoAV
AVblock
blockisiscaused
caused
by
byabnormal
abnormalconduction
conductionwithin
withinthe
theAV
AVnode
nodeor
orthe
thedistal
distal
.AV
.AVconduction
conductionsystem
system
::Mechanisms
Mechanismsgenerating
generatingtachycardias
tachycardiasinclude
include
.Accelerated automaticity--
.Acceleratedautomaticity
Triggered activity--
Triggeredactivity
Re-entry
Re-entry(or
(orcircus movements)--
circusmovements)
ACCELERATED AUYOMATICITY
Normal
Re-enterant
Tachycardia
Atrial Arrhythmias
Sinus arrhythmia:
Sinus tachycardia
• Pharmacological therapy.
• Cardioversion.
• Pacemaker therapy.
• Surgical therapy e.g. aneurysmal excision.
• Interventional therapy “ablation”.
Classification of Anti-Arrhythmic Drugs
:Class IV
Ca ++ channel blockers
-
-
:Class II
Phase 2
Beta blockers
)Plateau Phase(
-
:Class I Phase 1
.Na + channel blockers
-
Phase 3