144 2C

Front 1

14. VENTRICULAR TACHYCARDIA (V-Tach)
• see this a lot in TV
• a very irritable focus in ventricle is sending out ___ rate. Remember that the usual rate for ventricle sending out impulse

is _-____.
• Can compare to sinus ______because it comes from ventricle
• No impulse – no atrial contraction – no cardiac output from atria
• This is an unstable rhythm

Back 1

14. VENTRICULAR TACHYCARDIA (V-Tach)
• see this a lot in TV
• a very irritable focus in ventricle is sending out high rate. Remember that the usual rate for ventricle sending out impulse

is 20-40.
• Can compare to sinus tachycardia because it comes from ventricle
• No impulse – no atrial contraction – no cardiac output from atria
• This is an unstable rhythm

Front 2

14. VENTRICULAR TACHYCARDIA (V-Tach)
• see this a lot in TV
• a very irritable focus in ventricle is sending out high rate. Remember that the usual rate for ventricle sending out impulse

is 20-40.
• Can compare to sinus tachycardia because it comes from ventricle
• No impulse – no _____________ – no cardiac output from
___
• This is an ___ rhythm

Back 2

14. VENTRICULAR TACHYCARDIA (V-Tach)
• see this a lot in TV
• a very irritable focus in ventricle is sending out high rate. Remember that the usual rate for ventricle sending out impulse

is 20-40.
• Can compare to sinus tachycardia because it comes from ventricle
• No impulse – no atrial contraction – no cardiac output from atria
• This is an unstable rhythm

Front 3

14. VENTRICULAR TACHYCARDIA (V-Tach)
Diagnostic characteristics:
1. Heart rate: usually between __ - ____
2. ____ interval: Rhythm: usually _______ - 3 or more consecutive PVCs
3. QRS complex:
• wide, bizarre,
• abrupt onset, termination
4. Nonsustained ( < 30 sec) vs. Sustained ( > 30sec)

Back 3

Diagnostic characteristics:
1. Heart rate: usually between 100 - 250
2. R-R interval: Rhythm: usually regular - 3 or more consecutive PVCs
3. QRS complex:
• wide, bizarre,
• abrupt onset, termination
4. Nonsustained ( < 30 sec) vs. Sustained ( > 30sec)

Front 4

14. VENTRICULAR TACHYCARDIA (V-Tach)
Diagnostic characteristics:
1. Heart rate: usually between 100 - 250
2. R-R interval: Rhythm: usually regular - 3 or more consecutive PVCs
3. QRS complex:
• ____, bizarre,
• abrupt __, _____
4. ___ ( < 30 sec) vs. ________ ( > 30sec)

Back 4

14. VENTRICULAR TACHYCARDIA (V-Tach)
Diagnostic characteristics:
1. Heart rate: usually between 100 - 250
2. R-R interval: Rhythm: usually regular - 3 or more consecutive PVCs
3. QRS complex:
• wide, bizarre,
• abrupt onset, termination
4. Nonsustained ( < 30 sec) vs. Sustained ( > 30sec)

Front 5

14. VENTRICULAR TACHYCARDIA (V-Tach)
Causes:
1. Acute ______________ or infarction
2. C__________
3. E____________  check potassiums
4. M__________ of the endocardium
5. Drug induced: digoxin, quinidine, procainamide

Back 5

14. VENTRICULAR TACHYCARDIA (V-Tach)
Causes:
1. Acute myocardial ischemia or infarction
2. Cardiomyopathy
3. Electrolyte abnormalities  check potassiums
4. Mechanical stimulation of the endocardium
5. Drug induced: digoxin, quinidine, procainamide

Front 6

14. VENTRICULAR TACHYCARDIA (V-Tach)
Causes:
1. Acute myocardial ischemia or infarction
2. Cardiomyopathy
3. Electrolyte abnormalities  check potassiums
4. Mechanical stimulation of the endocardium
5. Drug induced: ______, _____, ________

Back 6

14. VENTRICULAR TACHYCARDIA (V-Tach)
Causes:
1. Acute myocardial ischemia or infarction
2. Cardiomyopathy
3. Electrolyte abnormalities  check potassiums
4. Mechanical stimulation of the endocardium
5. Drug induced: digoxin, quinidine, procainamide

Front 7

14. VENTRICULAR TACHYCARDIA (V-Tach)
Clinical significance: significant because of the ____________. May be fatal.
Treatment:
1. Drug tx: ______, _______, ________ (anti-arrhythmics)
2. Defibrillation/Cardioversion – don’t sync the cardioversion for V-Tach
treat the same as V-fib if it’s unstable, so we D-fib unstable V-Tach

Back 7

14. VENTRICULAR TACHYCARDIA (V-Tach)
Clinical significance: significant because of the decreased CO. May be fatal.
Treatment:
1. Drug tx: lidocaine, pronestyl, bretylium (anti-arrhythmics)
2. Defibrillation/Cardioversion – don’t sync the cardioversion for V-Tach
treat the same as V-fib if it’s unstable, so we D-fib unstable V-Tach

Front 8

14. VENTRICULAR TACHYCARDIA (V-Tach)
Clinical significance: significant because of the decreased CO. May be fatal.
Treatment:
1. Drug tx: lidocaine, pronestyl, bretylium (anti-arrhythmics)
2. _________ – don’t sync the cardioversion for V-Tach
treat the same as V-fib if it’s ________, so we D-fib _______ V-Tach

Back 8

14. VENTRICULAR TACHYCARDIA (V-Tach)
Clinical significance: significant because of the decreased CO. May be fatal.
Treatment:
1. Drug tx: lidocaine, pronestyl, bretylium (anti-arrhythmics)
2. Defibrillation/Cardioversion – don’t sync the cardioversion for V-Tach
treat the same as V-fib if it’s unstable, so we D-fib unstable V-Tach

Front 9

15. VENTRICULAR FIBRILLATION (V-Fib)/FLUTTER
• the other rhythm incompatible with life – common in TV/movies
• bizarre – can’t find any ____ waves, ____waves
• ______
• patient may notice if you _______________, so they may manipulate you this way

Back 9

15. VENTRICULAR FIBRILLATION (V-Fib)/FLUTTER
• the other rhythm incompatible with life – common in TV/movies
• bizarre – can’t find any P waves, R waves
• can’t measure a heart rate. Looks like something squiggly
• patient may notice if you run into room when you play with leads, so they may manipulate you this way

Front 10

15. VENTRICULAR

FIBRILLATION (V-Fib)/FLUTTER
• if this is for real, patient won’t _________
• imagine the heart is just like _______
• if you see bypass surgery, they put heart into a _________
• no __________
• for V-fib, treatment is D-fib

Back 10

15. VENTRICULAR FIBRILLATION (V-Fib)/FLUTTER
• if this is for real, patient won’t be able to talk to you
• imagine the heart is just like jello – just quivering
• if you see bypass surgery, they put heart into a chilled rhythm so that it kind of sits there, barely moving – shaking
• no cardiac output
• for V-fib, treatment is D-fib

Front 11

15. VENTRICULAR FIBRILLATION (V-Fib)/FLUTTER
• if this is for real, patient won’t be able to talk to you
• imagine the heart is just like jello – just quivering
• if you see bypass surgery, they put heart into a chilled rhythm so that it kind of sits there, barely moving – shaking
• no cardiac output
• for V-fib, treatment is ___

Back 11

15. VENTRICULAR FIBRILLATION (V-Fib)/FLUTTER
• if this is for real, patient won’t be able to talk to you
• imagine the heart is just like jello – just quivering
• if you see bypass surgery, they put heart into a chilled rhythm so that it kind of sits there, barely moving – shaking
• no cardiac output
• for V-fib, treatment is D-fib

Front 12

15. VENTRICULAR FIBRILLATION (V-Fib)/FLUTTER
Diagnostic characteristics:
1. No identifiable _____________- completely bizarre, chaotic & irregular deflections from incomplete ventricular depolarization
2. composed of ____________: Course vs. Fine v-fib

Back 12

Diagnostic characteristics:
1. No identifiable ECG waveform - completely bizarre, chaotic & irregular deflections from incomplete ventricular depolarization
2. composed of fibrillatory waves: Course vs. Fine v-fib

Front 13

15. VENTRICULAR FIBRILLATION (V-Fib)/FLUTTER
Causes:
1. __________
2. __________
3. _________
4. R on T phenomenon
5. sustained V-tach
6. Failure to synchronized during cardioversion

Back 13

15. VENTRICULAR FIBRILLATION (V-Fib)/FLUTTER
Causes:
1. CAD/Acute myocardial infarction I ischemia
2. cardiomyopathy
3. Digoxin toxicity
4. R on T phenomenon
5. sustained V-tach
6. Failure to synchronized during cardioversion

Front 14

15. VENTRICULAR FIBRILLATION (V-Fib)/FLUTTER
Causes:
1. CAD/Acute myocardial infarction I ischemia
2. cardiomyopathy
3. Digoxin toxicity
4. _________ phenomenon
5. sustained _______
6. Failure to __________

Back 14

15. VENTRICULAR FIBRILLATION (V-Fib)/FLUTTER
Causes:
1. CAD/Acute myocardial infarction I ischemia
2. cardiomyopathy
3. Digoxin toxicity
4. R on T phenomenon
5. sustained V-tach
6. Failure to synchronized during cardioversion

Front 15

15. VENTRICULAR FIBRILLATION (V-Fib)/FLUTTER
Clinical significance: Fatal if left untreated
Treatment:
1. _______! _________! _______!
2. ______
3. Drug tx: _______, __________ (lidocaine, etc.)
4. I___

Back 15

15. VENTRICULAR FIBRILLATION (V-Fib)/FLUTTER

Front 16

VENTRICULAR ASYSTOLE/CARDIAC STANDSTILL
• Very hard to __________
• See this with _______
• May see them ___ in practice just in case there’s a weak signal

Back 16

VENTRICULAR ASYSTOLE/CARDIAC STANDSTILL
• Very hard to bring patient pack – this is the worst of the worst
• See this with advanced cardiac disease
• May see them D-fib in practice just in case there’s a weak signal

Front 17

VENTRICULAR ASYSTOLE/CARDIAC STANDSTILL
Diagnostic characteristics:
1. Absence ________

Back 17

Diagnostic characteristics:
1. Absence of all electrical activity

Front 18

VENTRICULAR ASYSTOLE/CARDIAC STANDSTILL
Causes:
1. advanced _______
2. Acute ____
3. final arrhythmia following _____, ______, ventricular _______

Back 18

Causes:
1. advanced cardiac disease
2. Acute MI
3. final arrhythmia following V-tach, V-fib, ventricular escape rhythm

Front 19

VENTRICULAR ASYSTOLE/CARDIAC STANDSTILL
Treatment:
1. _____
2. _______
3. _______

Back 19

Treatment:
1. CPR
2. Drug therapy
3. Pacemaker