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Cardiovascular System 2: Arrhythmias 1&2
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A detailed description on different types of arrhythmias and how they affect the shape of an ECG with particular reference to QRS complex and P:QRS ratio.
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ARRHYTHMIAS 1 & 2When diagnosing arrhythmias:
Look at QRS – is it broad or narrow?
Look at P wave in relation to QRS complex.
Normal Sinus Rhythm: P:QRS ratio is a 1:1 ratio.
Calculate Heart Rate on an ECG: 300/no. of squares between 2 QRS complexes’.
TACHYARRHYTHMIAS
If irregular rhythm – then it is atrial fibrillation.
If regular rhythm – with narrow QRS (atrial flutter or super ventricular tachycardia) or broad
QRS (ventricular tachycardia).
If they have tachyarrhythmia’s then they’ll have palpitations.
Hyperthyroidism can cause atrial fibrillation.
Hypothyroidism can cause bradycardia.
Anaemia – increase risk of arrhythmia.
Sinus Tachycardia
Regular narrow QRS.
P waves visible and normal P:QRS ratio (1:1).
80-120 bpm.
Ectopic Beats
Missed beats and thumps.
Usually benign.
Supraventricular Tachycardia
Rapid more than 100 bpm.
AV node re-entry.
Regular narrow QRS complex.
Can be terminated with valsalver maneuver or with adenosine.
AV Node Re-entry Tachycardia
Have 2 pathways through the AV node.
An ectopic atrial beat comes and blocks the fast pathway and conducts slow
pathway instead.
Therefore, get re-entry down slow pathway and back up the fast pathway
repeatedly. So you get atria and ventricles contracting at the same time.
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