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Cardiac Arrythmias and Rhythm Interpretation

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Jacob Stanley

on 18 February 2017

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Transcript of Cardiac Arrythmias and Rhythm Interpretation

Cardiac Arrythmias and Rhythm Interpretation
Supraventricular Arrythmias
Ventricular Arrythmias, LBBB and RBBB
AV Nodal Blocks
Aims of the Session
To outline the various Cardiac Arrythmias:

Supraventricular Arrythmias
Ventricular Arrythmias
AV Nodal Blocks

Look at example ECG's in small groups. Interpret the rhythm's and discuss.
Supraventricular Arrythmias
Ventricular Arrythmias
First degree block
Second Degree Heart Block's
Third Degree Heart Block
By Jake Stanley
Supraventricular Arrythmia's
Ventricular Arrythmias
Right Bundle Branch Block

Usually a sign of Ischaemic Heart Disease
Patient will often be Asymptomatic
RBBB ECG diagnostic criteria:

Broad QRS Complex (>120ms)
RSR Pattern V1-V3
Wide Slurred S Wave in in the Lateral Leads
LBBB is considered more significant than RBBB.


If we see a new or presumed new LBBB in the presence of chest pain, is this significant?

LBBB ECG Diagnostic Criteria are:

Broad QRS Complex (>120ms)
Dominant S Wave in V1
Broad Monophasic R Wave in V5, V6
Often a normal variant, first degree block is the term used to describe the prolongation of the PR Interval.

The diagnostic criteria are a PR interval of >200ms (5 small squares)

Second Degree Heart Block: Mobitz 1 (Wenckeback)
This disorder is caused by a diseased
AV node
This causes the PR interval to increase with each beat, until a beat is "dropped".
Second Degree Heart Block: Mobitz 2
In this instance, the PR interval remains the same.

One beat will "drop" inbetween groups of conducted beats.

This can be done in a 3:2, 4:3, 5:4 fashion.
Can lead to complete heart block.
Caused by a complete absence of AV conduction.

Often referred to as AV disassociation.

Maintained by a junctional or ventricular escape rhythm.

Require insertion of permanent pacemaker.

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