Cardiac Arrhythmias

CARDIAC ARRHYTHMIAS

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Определение Cardiac arrhythmias is a term that denotes a disturbances of the heart rhythm and conduction, such as beating too fast (tachycardia), too slow (bradycardia), or irregularly.

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Классификация Main types of bradyarrhythmia:

Sick sinus syndrome Heart block (atrio-ventricular block) Bundle block branch

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Классификация Variants of tachyarrhythmia: Supraventricular tachycardia Atrial fibrillation Ventricular tachycardia Ventricular fibrillation Supraventricular and ventricular premature beats 4

Pathogenesis of arrhythmias: suppression of automaticity

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Pathogenesis of arrhythmias: triggered activity

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Pathogenesis of arrhythmias: re-entry

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Symptoms of cardiac arrhythmia: • • • • • • • •

Fast or slow heart beat (palpitation) Skipping beats Dizziness Chest pain Shortness of breath Paleness Sweating Cardiac arrest 8

Diagnose of arrhythmia  ECG  Ambulatory cardiac (Holter) monitoring (24 hours)  Echocardiogram  Electrophysiological study (EPS)  Coronary angiography 9

Clinical variants of atrial fibrillation Acute AF is new-onset AF lasting < 48 h. Paroxysmal AF is recurrent AF that typically lasts < 48 h and that converts spontaneously to normal sinus rhythm

Persistent AF lasts > 1 wk and requires treatment to convert to normal sinus rhythm

Permanent AF cannot be converted to sinus rhythm 10

ECG symptoms of atrial fibrillation

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Principles of atrial fibrillation treatment

 ventricular rate control  rhythm control  prevention of thromboembolism

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ECG symptoms of atrial flutter

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ECG symptoms of supraventricular premature beats

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ECG symptoms of reentrant supraventricular tachycardia

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ECG symptoms of ventricular premature beats

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ECG symptoms of ventricular tachycardia

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ECG symptoms of atrioventricular block

First-degree AV block

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ECG symptoms of atrioventricular block

Mobitz type I 2nd-degree AV block

Mobitz type II 2nd-degree AV block 19

ECG symptoms of atrioventricular block

High-grade 2nd-degree AV block

Third-degree AV block 20