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ECG Dysrhythmias

Updated March 2006: D. Tucker, RPh, BCPS

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Ov

erv

iew

ECG waveforms

Normal sinus rhythm Asystole

Bradycardia

Ventricular fibrillation Ventricular tachycardia

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ECG Rhythm Strip

Electrocardiogram or ECG is used to

measure the activity of the heart

ECG is used to represent the conduction of

electrical impulses from the atria to the

ventricles

ECG is used to characterize rhythms and

conduction abnormalities of the heart

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ECG Wav

eforms

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Normal Sinus Rhythm

Normal impulse conduction through the

heart

Normal sinus rhythm (NSR) is the standard

against which all other rhythms are

compared

NRS contains no ectopic or aberrant beats

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ECG Rhythms

Normal sinus rhythm

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ECG Rhythms

Asystole

Bradycardia

Ventricular

fibrillation

Ventriculartachycardia

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Asystole Asystole is a cardiac standstill, i.e., flatline

Asystole is the absence of electrical activityin the venticles

Asystole usually results from a prolongedperiod of cardiac arrest without

resuscitation Asystole usually means the patients life has

ended

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ECG Rhythms

Ventricular asystole

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Bradycardia Bradycardia is when the heart is < 60 beats/minute

or when the heart rate is slower than expected

Sinus bradycardia usually occurs as a response to

a reduced demand for blood flow

Signs and symptoms might include:

Chest pain, shortness of breath Hypotension, pulmonary edema, congestive heart

failure

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ECG Rhythms

Sinus bradycardia

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Ventricular Fibrillation

Ventricular fibrillation (VF) occurs as aresult of electrical impulses coming from

multiple ectopic pacemaker in the ventricles

VF results in no cardiac output as a result ofproducing no effective ventricular

contractions With VF the ventricular muscle quivers

instead of contracting

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ECG Rhythms

Ventricular fibrillation

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Ventricular Tachycardia

Ventricular tachycardia (VT) is a result of 3or more ventricular contractions occur

earlier than expected resulting in aventricular rate of >10 beats/minute

VT usually preceeds VF

Causes of VT include myocardial ischemia,heart failure, drug toxicity fromprocainamide, quinidine, or cocaine

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ECG Rhythms

Ventricular tachycardia

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ECG Rhythms

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