Tachyarrythmia ecg

ECG, tachycardia, SVT, VT, VF, palpitation

1. TACHYARRYTHMIA MADE EASY ECG

2. > 90/min = tachycardia > 150/min = tachyarrythmia . If > 150/min less likely sinus tacycardia

3. ALS Management Stable Pharmacological treatment. Unstable Syncronize cardioversion . What is stable? No alter mental status No chest pain No sudden shortness of breath No low BP No cold peripheries .

4. Tachyarrythmia SVT Atrial Flutter Fast Atrial fibrillation Wolf-Parkinson- White (WPW) Ventricular tachycardia Torsades de Pointes Ventricular fibrillation How to interpret? 2 rules: Broad/Narrow QRS? Regular or irregular rhythm?

5. How to calculate rate in tachycardia ECG? CANNOT USE 300/small box formula. 30 small box = 15 cm = 6 second Steps: Count R wave in 30 small box or in 15 cm. X 10 = rate per minute

6. R wave = 15 Rate = R wave x 10 = 150/min

7. SVT Tachy Narrow QRS complexes Regular rhythm No P wave

8. Atrial flutter Atrial rate > 200/min R wave rate < 90/min Saw-toothed appearance

9. Fast Atrial Fibrillation Tachy Narrow QRS complex. Irregular QRS complex No P wave

10. Ventricular tachycardia Tachy Broad QRS complex Regular QRS compex No P No T

11. Ventricular Fibrillation Tachy Broad QRS complex Irregular QRS compex No P No T

12. Torsades De Pointes polymorphic ventricular tachycardia occurring in the context of QT prolongation it has a characteristic morphology in which the QRS complexes “twist” around the isoelectric line . Next rhythm  VF Rx- IV Mg SO4

13. Wolf Parkinson White (WPW)   short PR slurred upstroke in the QRS complex Delta wave

14. Contraindication : Adenosine Beta blockers , C alcium channel blockers ( diltiazem , verapamil)