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ECG Made Easy,Ch. 6

Ventricular Rhythms

QuestionAnswer
Torsades de pointes (TdP) is a type of monomorphic ventricular tachycardia. False
Transcutaneous pacing is the treatment of choice for pulseless ventricular tachycardia or ventricular fibrillation. False
Absence of electrical activity on the cardiac monitor. Asystole
The result of an electrical impulse from a supraventricular site discharging at the same time as an ectopic site in the ventricles. Fusion beat
Two sequential PVCs Pair or couplet
Premature ventricular beats that look alike in the same lead and begin from the same anatomic site. Uniform premature ventricular complexes
Chaotic rhythm associated with no breathing or pulse. Ventricular fibrillation
Pattern in which every other beat is an ectopic beat. Bigeminy
Essentially regular ventricular rhythm with a ventricular rate of 20 to 40 beats/min Idioventricular rhythm
Name given a PVC falling on the T wave of the preceding beat. R on T phenomenon
Clinical situation in which organized electrical activity (other than VT) is observed on the cardiac monitor, but there is an absence of mechanical contraction of the myocardial fibers. Pulseless electrical activity
Essentially regular ventricular rhythm with a ventricular rate of 41 to 100 beats/min Accelerated Idioventricular rhythm
Explain the difference between a PVC and a ventricular escape beat. A PVC is premature and occurs before the next expected sinus beat. A ventricular escape beat is late, occurring after the next expected sinus beat.
List four (4) common causes of premature ventricular complexes. 1. Normal variant 2. Hypoxia 3. Stress/anxiety 4. Exercise 5. Digitalis toxicity 6. Acid-base imbalance 7. Myocardial ischemia
List four (4) more common causes of premature ventricular complexes. 8. Electrolyte imbalance (hypokalemia, hypocalcemia, hypercalcemia, hypomagnesemia) 9. CHF 10. Increased sympathetic tone 11. Acute MI 12. Stimulants (alcohol, caffeine, tobacco) 13. Meds (sympathomimetics, cyclic antidepressants, phenothiazines)
How do coarse and fine ventricular fibrillation differ? Coarse ventricular fibrillation (VF) is 3 mm or more in amplitude. Fine VF is less than 3 mm in amplitude.
What is the name given to polymorphic VT that occurs in the presence of a long QT interval? Torsades de pointes
List three (3) potential sites of origin of ectopic beats. 1. the atria (PACs) 2. the AV junction (PJCs) 3. the ventricles (PVCs)
List three (3) reasons why the ventricles may assume responsibility for pacing the Five Hs Hypovolemia Hypoxia Hypothermia Hypokalemia/Hyperkalemia Hydrogen ion (acidosis) heart. 1. SA node fails to discharge 2. SA node impulse generated but blocked as exits 3. Rate of discharge of SA node is slower than that of the ventricles 4. Irritable site in either ventricle produces an early beat or rapid rhythm
List five (5) possible causes of Asystole or pulseless electrical activity. 5 Hs Hypovolemia Hypoxia Hypothermia Hypokalemia/Hyperkalemia Hydrogen ion (acidosis)
List five (5) possible causes of Asystole or pulseless electrical activity. 5 Ts Tamponade, cardiac Tension pneumothorax Thrombosis: lungs (massive pulmonary embolism) Thrombosis: heart (acute coronary syndromes) Tablets/toxins: drug overdose
How would you differentiate a junctional escape rhythm at 40 beats/min from a ventricular escape rhythm at the same rate? The junctional escape rhythm will have a narrow QRS complex; the ventricular escape rhythm will have a wide QRS complex.
Created by: djoyo14
 

 



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