| ID | 72 |
|---|---|
| Name | CARDIAC ARRHYTHMIA |
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| Introduction | Arrhythmia: An arrhythmia may be defined as an abnormality of the rate, rhythm or conduction or site of origine of cardiac impulse due to disturbance in electrical activity of the heart. An arrhythmia may be asymptomatic or symptomatic (such as palpitation, syncope, heart failure), or sometimes it may cause sudden death. Cardiac arrhythmias may be paroxysmal or continuous. There are two main categories of arrhythmias- a. Bradycardia- where the heart rate is slow (<60/min). b. Tachycardia- where the heart rate is fast (>100/min). Arrhythmias are potentiated or even initiated by the following conditions- 1. Pain and anxiety 2. Fever 3. Exercise 4. Hypoxia 5. Acidosis 6. Hypo- or hyperkalaemia 7. Hypo- or hypercalcaemia 8. Hypomagnasaemia 9. Sick cell syndrome |
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| Classification | Classification of arrhythmia: Abnormality in rate & rhvthm: Cardiac arrhythmias may be supraventricular (such as sinus, atrial or junctional) or ventricular in origine. Supraventricular arrhythmias: A Sinus rhythm (S-A nodal) 1. Sinus arrhythmia. 2. Sinus tachycardia. 3. Sinus bradycardia. B. Atrial tachyarrhythmias 1. Atrial premature beat/atrial ectopics. 2. Paroxysmal atrial tachycardia. 3. Atrial fibrillation, 4. Atrial flutter. 5. Multifocal atrial tachycardia. C. A-VJunctional tachyarrhythmias: 1. Paroxysmal supraventricular tachycardia a. Intra AV nodal reentry tachycardia (AVNRT)- most common. b. Atrioventricular reentry tachycardia (AVRT)- less common. - (in this, reentry is due to an accessory atrioventricular pathway of an abnormal band of atrial tissue bypassing AV node- known as Wolff Parkinson-White synd-rome). 2. Nonparoxysmal Junctional tachycardia D. Ventricular tachyarrhythmias: 1. Ventricular ectopics (extrasystole or premature beat). 2. Ventricular tachycardia. a. Acute ventricular tachycardia b. Chronic recurrent ventricular tachycardia c. Torsades De Pointes tachycardia 3. Ventricular fibrillation 4. Accelerated idioventricular rhythm Abnormality in conduction 1. Sick sinus syndrome this includes- a. Sinus arrest b. S.A nodal block (or sinoatrial exit block) 2. Atrioventricular block (Heart block) 3. Atrioventricular dissociation 4. Intraventricular conduction defects including bundle branch block. |
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