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{{Infobox_Disease |
__NOTOC__
  Name          = Cardiac arrhythmia |
{| class="infobox" style="float:right;"
  Image          = EKG_VF.jpg|
|-
  Caption        = Ventricular Fibrillation or V-Fib, an example of cardiac arrhythmia. |
| [[File:Siren.gif|30px|link=Arrhythmia resident survival guide]]|| <br> || <br>
  DiseasesDB    = 15206 |
| [[Arrhythmia resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
  ICD10          = {{ICD10|I|47||i|30}} - {{ICD10|I|49||i|30}} |
|}
  ICD9          = {{ICD9|427}} |
{{CMG}}; {{AE}} {{Rim}}
  ICDO          = |
  OMIM          = |
  MedlinePlus    = 001101 |
  eMedicineSubj  = |
  eMedicineTopic = |
  MeshID        = D001145 |
}}
{{Cardiac arrhythmia}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}


==[[Cardiac arrhythmia overview|Overview]]==
==Overview==
Cardiac arrhythmia is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the [[heart]]. The [[heart beat]] may be too fast or too slow, and may be regular or irregular. A heart beat that is too fast is called [[tachycardia]] and a heartbeat that is too slow is called [[bradycardia]]. Although many arrhythmias are not life-threatening, some can cause [[cardiac arrest]].


== Faster and slower arrythmias ==
==Classification of Cardiac Arrhythmia==  
In an adult, a heart rate faster than 100 beats/minute is considered [[tachycardia]]. This number varies with age, as the heartbeat of a younger person is naturally faster than that of an older person's. During exercise the sinus node increases its rate of electrical activity to accelerate the heart rate. Such normal fast rate that develops is called sinus tachycardia. In contrast, arrhythmias that are due to fast, abnormal electrical activity can cause tachycardias that are dangerous. If the [[left ventricle|ventricles]] of the heart experience one of these tachycardias for a long period of time, there can be deleterious effects. Individuals may sense a tachycardia as a pounding sensation of the heart, known as [[palpitation]]s. If a tachycardia lowers blood pressure it may cause lightheadedness or dizziness, or even [[fainting]] (syncope). If the tachycardia is too fast, the pump function of the heart is impeded, and rarely may lead to [[cardiac arrest|sudden death]].
{{familytree/start |summary=Arrhythmia}}
{{familytree | | | | | | | | | | | | | | A01 | | | A01='''Arrhythmia'''}}
{{familytree | | | | | |,|-|-|-|-|-|-|-|-|+|-|-|-|-|-|-|-|-|.| | | | | }}
{{familytree | | | | | B01 | | | | | | | B02 | | | | | | | B03 | B01= '''[[Bradyarrhythmia]]'''| B02= '''Arrhythmia <br> with normal heart rate'''| B03= '''[[Tachyarrhythmia]]''' }}
{{familytree | | | | | |!| | | | |,|-|-|-|+|-|-|-|.| | | | |!| | | | | }}
{{familytree | | | | | |!| | | | B04 | | B05 | | B06 | | | |!| | | | | B04= '''<u>The origin of the impulse:</u><br>Atria'''| B05= '''<u>The origin of the impulse:</u><br>AV junction'''| B06= '''<u>The origin of the impulse:</u><br> Ventricles'''}}
{{familytree | | | | | |!| | | | |!| | | |!| | | |!| | | | |!| | | | | }}
{{familytree | | | | | |!| | | | B07 | | B08 | | B09 | | | |!| | | | |B07= [[Sinus arrhythmia]] <br> [[Atrial bigeminy]]| B08=[[Accelerated junctional rhythm]] <br> [[Junctional bigeminy]]| B09= [[Accelerated idioventricular rhythm]] <br> [[Ventricular bigeminy]] }}
{{familytree | | | | | |!| | | | | | | | | | | | | | | | | |!| | | | | }}
{{familytree | |,|-|-|-|+|-|-|-|.| | | | | | | | |,|-|-|-|-|^|-|-|-|.| }}
{{familytree | C01 | | C02 | | C03 | | | | | | | C04 | | | | | | | C05 | | C01= '''<u>The origin of the impulse:</u><br>Atria'''| C02= '''<u>The origin of the impulse:</u><br>AV junction'''| C03= '''<u>The origin of the impulse:</u><br> Ventricles'''|C04= '''[[SVT|Narrow complex tachycardia (SVT)]]'''| C05= '''[[Wide complex tachycardia]]''' }}
{{familytree | |!| | | |!| | | |!| | | | |,|-|-|-|^|-|.| | | | |,|-|+|-|.| |}}
{{familytree | D01 | | D02 | | D03 | | | D04 | | | | D05 | | | D06 |!| D07 |D01= '''Normal variant:'''<br>[[Respiratory sinus arrhythmia]]<br> <br>'''[[Sinus node dysfunction]]:'''<br>[[Sinus bradycardia]]<br> [[Sinoatrial block]] <br> [[Sinus arrest]] <br> [[Sick sinus syndrome]]<br><br> '''Abnormality in the atria:'''<br>[[Low atrial focus bradycardia]]<br> [[Atrial bigeminy]] <br><br> '''[[AV block|AV node dysfunction]]:'''<br>[[First Degree AV Block|First degree AV block]] <br> [[Second Degree AV Block|Second degree AV block]] <br> [[Complete or Third-Degree AV Block|Complete or third-degree AV block]]|D02= [[Junctional bradycardia|Junctional escape rhythm]] <br> [[Junctional bigeminy]]| D03=[[Isorhythmic A-V dissociation]] <br> [[Slow VT]] ([[idioventricular rhythm]])<br>[[Ventricular escape rhythm]]<br> [[Escape capture bigeminy]]|D04= '''<u>The origin of the impulse:</u><br>Atria'''| D05= '''<u>The origin of the impulse:</u><br>AV junction'''| D06= '''<u>The origin of the impulse:</u><br>Atria or AV junction'''| D07= '''<u>The origin of the impulse:</u><br> Ventricles''' }}
{{familytree | | | | | | | | | | | | |,|-|^|-|.| | | |!| | | | |!| |!| |!| }}
{{familytree | | | | | | | | | | | | E01 | | E02 | | E03 | | | E04 |!| E05 |E01= [[Atrial fibrillation]] <br> [[Atrial flutter]] <br> [[Ectopic Atrial Rhythm|Ectopic atrial rhythm]] <br> [[Multifocal Atrial Tachycardia (MAT)|Multifocal atrial tachycardia (MAT)]] <br> [[Paroxysmal Atrial Tachycardia (PAT) with Block|Paroxysmal atrial tachycardia (PAT) with block]] <br> [[Premature Atrial Contractions (PACs)|Premature atrial contractions (PAC)]] <br> [[Sinus Tachycardia|Sinus tachycardia]] <br> [[Wandering atrial pacemaker]]<br> [[Sick sinus syndrome]]| E02= [[AVNRT]] <br><br> [[AVRT]] ([[accessory pathway]]):<br>- [[Wolff-Parkinson-White syndrome|Wolff-Parkinson-White syndrome (WPW)]]<br>- [[Lown-Ganong-Levine syndrome|Lown-Ganong-Levine syndrome (LGL)]]|E03=[[Accelerated junctional rhythm]] <br> [[Junctional ectopic tachycardia]]| E04= '''[[Wide complex tachycardias|SVTAC]]'''<br>'''([[Wide complex tachycardias|SVT with aberrant conduction]]):<br><br>'''[[Left Bundle Branch Block|Left bundle branch block]] <br> [[LAHB|Left anterior hemi-block]] <br> [[Left posterior fascicular block electrocardiogram|Lefo posterior hemi-block]] <br> [[Right Bundle Branch Block|Right bundle branch block]] <br> [[Trifascicular block]]| E05= [[Ventricular tachycardia]] <br> [[Ventricular fibrillation electrocardiogram|Ventricular fibrillation]] <br> [[Ventricular Parasystole|Ventricular parasystole]] <br> [[Ventricular bigeminy]]}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |,|-|-|^|-|-|.| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | F01 | | | | F02 | F01=  '''<u>The origin of the impulse:</u><br>Atria, AV junction or ventricles<br><br> Presence of an [[accessory pathway]]'''| F02= '''<u>The origin of the impulse:</u><br>Pacemaker'''}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | G01 | | | | G02 | G01= '''[[Accessory pathway]]'''<br><br>[[Wolff-Parkinson-White syndrome|Wolff-Parkinson-White syndrome (WPW)]]<br>[[Lown-Ganong-Levine syndrome|Lown-Ganong-Levine syndrome (LGL)]]| G02= '''[[Paced rhythm]]'''<br><br>[[Pacemaker-mediated tachycardia]] <br> [[Runaway pacemaker syndrome]]<br> [[Sensor induced tachycardia]]}}
{{familytree/end}}


Most tachycardias are not dangerous. Anything that increases adrenaline or its effects on the heart will increase the heart rate and potentially cause palpitations or tachycardias. Causes include stress, ingested or injected substances (ie: [[caffeine]], [[amphetamines]], [[ethanol|alcohol]]&mdash;see [[Holiday heart syndrome]]), and an overactive thyroid gland ([[hyperthyroidism]]). Individuals who have a tachycardia are often advised to limit or remove exposure to any causative agent. However, these causative agents are not the only contributors to tachycardias and their prevalence has not been evaluated statistically.
==Cardiac Arrhythmias in Alphabetical Order==
{{col-begin|width=80%}}
{{col-break|width=33%}}
*[[Accelerated idioventricular rhythm]]


A slow rhythm, known as [[bradycardia]] (less than 60 beats/min), is usually not life threatening, but may cause symptoms. It may be caused by reversible causes (low oxygen, electrolyte abnormalities), or be more permanent (heart block). When it causes symptoms implantation of a permanent [[artificial pacemaker|pacemaker]] may be needed. Either dysrhythmia requires medical attention to evaluate the risks associated with the arrhythmia.
*[[Accessory pathway]]


== Fibrillation ==
*[[Andersen–Tawil syndrome]]


A serious variety of arrhythmia is known as [[Ventricular fibrillation|fibrillation]]. The muscle cells of the heart normally function together, creating a single contraction when stimulated. Fibrillation occurs when the [[heart]] [[muscle]] begins a quivering motion due to a disunity in contractile cell function. Fibrillation can affect the atrium ([[atrial fibrillation]]) or the ventricle ([[ventricular fibrillation]]); ventricular fibrillation is imminently life-threatening.
*[[Artificial pacemaker]]
 
*[[Atrial fibrillation]]
 
*[[Atrial flutter]]
 
*[[Atrial tachycardia]]
 
*[[AV nodal reentrant tachycardia]]
 
*[[AV reentrant tachycardia]]


''Atrial fibrillation'' is the quivering, chaotic motion in the upper chambers of the heart, known as the [[Atrium (heart)|atria]]. Atrial fibrillation is often due to serious underlying medical conditions, and should be evaluated by a [[physician]]. It is not typically a medical emergency.
*[[Bradycardia]]


''Ventricular fibrillation'' occurs in the [[ventricle (heart)|ventricles]] (lower chambers) of the heart; it is always a medical emergency. If left untreated, [[ventricular fibrillation]] (VF, or V-fib) can lead to death within minutes. When a heart goes into V-fib, effective pumping of the blood stops. V-fib is considered a form of [[cardiac arrest]], and an individual suffering from it will not survive unless [[cardiopulmonary resuscitation]] (CPR) and [[defibrillation]] are provided immediately.
*[[Broad complex tachycardia]]


CPR can prolong the survival of the [[brain]] in the lack of a normal pulse, but defibrillation is the intervention which is most likely to restore a more healthy heart rhythm. It does this by applying an electric shock to the heart, after which sometimes the heart will revert to a rhythm that can once again pump blood.
*[[Bundle of His]]


Almost every person goes into ventricular fibrillation in the last few minutes of life as the heart muscle reacts to diminished oxygen or general blood flow, trauma, irritants, or depression of electrical impulses themselves from the brain.
*[[Bundle of Kent]]


== Differential Diagnosis ==
*[[Cardiac arrhythmia following heart transplantation]]


=== AV Reentry Tachycardia with Preexcitation Complex ===
*[[Ectopic atrial rhythm]]


* Congenital
*[[First degree AV block]]
* [[Drug]]s
* Emotional excitation
* Heavy exercise


=== AV Node Reentry Tachycardia Without Preexcitation ===
*[[Focal atrial tachycardia]]


* [[Ddx:Cardiomyopathy|Cardiomyopathy]]
*[[Heart transplantation associated arrhythmias]]
* Congenital
* [[Hyperthyroidism]]
* [[Mitral valve prolapse]]


By analogy, imagine a room full of people all given these instructions: "If you see anyone starting to stand up, then stand up for three seconds and sit back down." If the people are quick enough to respond, the first person to stand will trigger a single wave which will then die out; but if there are stragglers on one side of the room, people who have already sat down will see them and start a second wave, and so on.
*[[Idioventricular rhythm]]
{{col-break|width=33%}}


==Diagnosis==
*[[Isorhythmic A-V Dissociation]]


Cardiac dysrhythmias are often first detected by simple but nonspecific means: [[auscultation]] of the heartbeat with a [[stethoscope]], or feeling for peripheral [[pulse]]s. These cannot usually diagnose specific dysrhythmias, but can give a general indication of the heart rate and whether it is regular or irregular. Not all the electrical impulses of the heart produce audible or palpable beats; in many cardiac arrhythmias, the premature or abnormal beats do not produce an effective pumping action and are experienced as "skipped" beats.
*[[Junctional bradycardia]]


The simplest ''specific'' diagnostic test for assessment of heart rhythm is the [[electrocardiogram]] (abbreviated '''ECG''' or '''EKG'''). A [[Holter monitor]] is an EKG recorded over a 24-hour period, to detect dysrhythmias that may happen briefly and unpredictably throughout the day.
*[[Junctional tachycardia]]


==SADS==
*[[Left anterior hemiblock]]


'''SADS''', or '''sudden arrhythmia death syndrome''', is a term used to describe sudden [[death]] due to [[cardiac arrest]] brought on by an arrhythmia. The most common cause of sudden death in the US is coronary artery disease. Approximately 300,000 people die suddenly of this cause every year in the US.
*[[Left bundle branch block]]


Sudden Arrhythmia Death Syndrome (SADS) can also occur from other causes. Also, there are many inherited conditions and heart diseases that can affect young people that can cause sudden death. Many of these victims have no symptoms before dying suddenly. 
*[[Left posterior fascicular block]]


Causes of SADS in young people are [[long QT syndrome]], [[Brugada syndrome]], [[Catecholaminergic polymorphic ventricular tachycardia]] and [[hypertrophic cardiomyopathy]] and [[arrhythmogenic right ventricular dysplasia]] ("arrythmia"-causing, "right ventricle"-involving, pre-cancerous malformation).
*[[Low atrial focus tachycardia]]


==List of common cardiac arrhythmias==
*[[Lown-Ganong-Levine syndrome]]


*Atrial Rhythms
*[[Mahaim fibers]]
**[[Premature atrial contraction|Premature Atrial Contractions (PACs)]]
**[[Wandering pacemaker|Wandering Atrial Pacemaker]]
**[[Multifocal atrial tachycardia]]
**[[Supraventricular tachycardia|Supraventricular tachycardia (SVT)]]
**[[Atrial flutter]]
**[[Atrial fibrillation|Atrial fibrillation (Afib)]]
*Ventricular Rhythms
**[[Premature ventricular contraction|Premature Ventricular Contractions (PVC)]]
**[[Accelerated idioventricular rhythm]]
**[[Ventricular tachycardia]]
**[[Ventricular fibrillation]]
**[[Polymorphic ventricular tachycardia]]
*Atrial Ventricular Arrythmias
**[[AV nodal reentrant tachycardia]]
**[[AV reentrant tachycardia]]
***[[Wolff-Parkinson-White syndrome]]
***[[Lown-Ganong-Levine syndrome]]
*Junctional Arrhythmias
**[[Junctional rhythm]]
**[[Junctional tachycardia]]
**Premature junctional complex
*Heart Blocks, also known as [[atrioventricular node|AV]] blocks
**[[First degree heart block]], also known as PR prolongation
**[[Second degree heart block]]
***[[Type 1 Second degree heart block]], also known as [[Mobitz I]] or [[Wenckebach]]
***[[Type 2 Second degree heart block]], also known as [[Mobitz II]]
**[[Third degree heart block]], also known as [[complete heart block]]


== Antiarrhythmic therapies==
*[[Multifocal atrial tachycardia]]


There are many classes of antiarrhythmic medications and many individual drugs within these classes. See the article on '''[[antiarrhythmic agents]]'''.
*[[Pacemaker mediated tachycardia]]


Dysrhythmias may also be treated electrically. [[Cardioversion]] is the application of electrical current across the chest wall to the heart and it is used for treatment of supraventricular or pulsed ventricular tachycardia. [[Defibrillation]] differs in that it is used for ventricular fibrillation and pulseless ventricular tachycardia, and more electricity is delivered with defibrillation than with cardioversion. In cardioversion, the recipient is either sedated or lightly [[anesthesia|anesthetized]] for the procedure. In defibrillation, the recipient has lost consciousness so there is no need for sedation. 
*[[Paroxysmal Atrial Tachycardia (PAT) with Block]]


Electrical treatment of dysrhythmia includes [[cardiac pacing]]. Temporary pacing may be done for very slow heartbeats, or [[bradycardia]], from [[drug overdose]] or [[myocardial infarction]]. A [[artificial pacemaker|pacemaker]] may be placed in situations where the bradycardia is not expected to recover.
*[[Paroxysmal supraventricular tachycardia]]


Atrial fibrillation can also be treated through a procedure, e.g. pulmonary vein isolation. This is performed by a cardiologist who specializes in electrophysiology and is done [[percutaneously]] with [[catheters]]. Alternatively, a maze procedure can be performed through [[cardiothoracic surgery]].
*[[Premature atrial contraction]]


===Fatty acids===
*[[Right bundle branch block]]


[[Fatty acids]] play an important role in the life and death of cardiac cells because they are essential fuels for mechanical and electrical activities of the heart.<ref>{{cite web | title=External blockade...by polyunsaturated fatty acids | url=http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=43279&pageindex=1#page | format= | publisher=pubmed}}Retrieved on 18 January 2007 </ref><ref>{{cite web | title=Antiarrythmic effects of omega-3 fatty acids | url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16919517&query_hl=87&itool=pubmed_DocSum | format= | publisher=pubmed}}Retrieved on 18 January 2007</ref> <ref>{{cite web | title=Alpha-linolenic acid, cardiovascular disease and sudden death | url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17086218&query_hl=3&itool=pubmed_DocSum | format= | publisher=pubmed}}Retrieved on 18 January 2007</ref> <ref>{{cite web | title=Omega-3 and health | url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17091903&query_hl=3&itool=pubmed_DocSum | format= | publisher=pubmed}}</ref> Retrieved on 18 January 2007
*[[Runaway pacemaker syndrome]]


==References==
*[[Second degree AV block]]
{{reflist|2}}
 
*[[Sensor induced tachycardia]]
 
*[[Sick sinus syndrome]]
{{col-break|width=33%}}
 
*[[Sinoatrial nodal reentry tachycardia]]
 
*[[Sinus arrhythmia]]
 
*[[Sinus bradycardia]]
 
*[[Sinus tachycardia]]
 
*[[Slow VT]]
 
*[[Supraventricular tachycardia]]
 
*[[SVT with aberrancy]]
 
*[[Tachycardia]]
 
*[[Tachycardia bradycardia syndrome]]
 
*[[Third degree AV block]]
 
*[[Trifascicular block]]
 
*[[Ventricular escape]]
 
*[[Ventricular fibrillation]]
 
*[[Ventricular parasystole]]
 
*[[Ventricular tachycardia]]
 
*[[Wandering atrial pacemaker]]
 
*[[Wide complex tachycardias]]
 
*[[Wolff-Parkinson-White syndrome]]
{{col-end}}
<font color="white">{{Smallcaps|{{PAGENAME}} developed by WikiDoc.org}}</font>
 
===Causes===
 
===Drug Side Effect===
* [[Agalsidase beta]]
* [[Bromocriptine]]
* [[Calcium gluconate]].
* [[Caspofungin acetate]].
* [[Cefotaxime sodium]].
* [[Clomifene]].
* [[Crizotinib]].
* [[Cyclobenzaprine]].
* [[Cyclophosphamide]].
* [[Dipivefrine]]
* [[Doxorubicin Hydrochloride]].
* [[Gadoterate]]
* [[Granisetron]]
*[[Idarubicin hydrochloride]]
* [[Idursulfase]]
* [[interferon alfacon-1]]
* [[Tretinoin]].
* [[Meprobamate]]
* [[Metaproterenol]]
* [[Muromonab-CD3]]
*[[Nabilone]]
* [[Nalmefene]].
*[[Omacetaxine]]
*[[Oprelvekin]]
*[[Oxaprozin]]
* [[Oxytocin]].
* [[Pegylated interferon alfa-2b]]
* [[Pentamidine]]
* [[Pilocarpine]]
* [[Prednisolone]].
* [[Rubidium Rb 82]]
*[[Sargramostim]]
* [[Sorafenib]].
* [[Sodium phenylbutyrate]]
*  Laxatives like [[sodium sulfate, potassium sulfate and magnesium sulfate]].
*[[Teniposide]]
* [[Valdecoxib]],


==Related Chapters==
====Contraindicated medications====
*[[Clinical cardiac electrophysiology]]
*[[Antiarrhythmic agents]]
*[[Artificial pacemaker]]
*[[Electrical conduction system of the heart]]
*[[Implantable cardioverter-defibrillator]].


{{Electrocardiography}}
{{MedCondContrAbs|MedCond = Cardiac arrhythmia|Cyclobenzaprine|Metaproterenol|Sumatriptan}}


[[de:Herzrhythmusstörung]]
==References==
[[es:Trastornos del ritmo cardíaco]]
{{Reflist|2}}
[[fr:Troubles de la conduction cardiaque]]
[[ko:부정맥]]
[[hr:Aritmija]]
[[it:Aritmia]]
[[he:הפרעת קצב]]
[[nl:Hartritmestoornis]]
[[new:कार्डियाक अरिदमिया]]
[[ja:不整脈]]
[[no:Arytmi]]
[[pl:Zaburzenia rytmu serca]]
[[pt:Arritmia cardíaca]]
[[ru:Аритмия]]
[[fi:Rytmihäiriö]]
[[sv:Arytmier]]
[[vi:Rối loạn nhịp tim]]
[[tr:Aritmi]]
[[uk:Аритмії серця]]
[[zh:心律失常]]


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Latest revision as of 19:28, 23 August 2021
Resident
Survival
Guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]

Overview

Cardiac arrhythmia is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heart beat may be too fast or too slow, and may be regular or irregular. A heart beat that is too fast is called tachycardia and a heartbeat that is too slow is called bradycardia. Although many arrhythmias are not life-threatening, some can cause cardiac arrest.

Classification of Cardiac Arrhythmia

 
 
 
 
 
 
 
 
 
 
 
 
 
Arrhythmia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Bradyarrhythmia
 
 
 
 
 
 
Arrhythmia
with normal heart rate
 
 
 
 
 
 
Tachyarrhythmia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The origin of the impulse:
Atria
 
The origin of the impulse:
AV junction
 
The origin of the impulse:
Ventricles
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sinus arrhythmia
Atrial bigeminy
 
Accelerated junctional rhythm
Junctional bigeminy
 
Accelerated idioventricular rhythm
Ventricular bigeminy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The origin of the impulse:
Atria
 
The origin of the impulse:
AV junction
 
The origin of the impulse:
Ventricles
 
 
 
 
 
 
Narrow complex tachycardia (SVT)
 
 
 
 
 
 
Wide complex tachycardia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Normal variant:
Respiratory sinus arrhythmia

Sinus node dysfunction:
Sinus bradycardia
Sinoatrial block
Sinus arrest
Sick sinus syndrome

Abnormality in the atria:
Low atrial focus bradycardia
Atrial bigeminy

AV node dysfunction:
First degree AV block
Second degree AV block
Complete or third-degree AV block
 
Junctional escape rhythm
Junctional bigeminy
 
Isorhythmic A-V dissociation
Slow VT (idioventricular rhythm)
Ventricular escape rhythm
Escape capture bigeminy
 
 
The origin of the impulse:
Atria
 
 
 
The origin of the impulse:
AV junction
 
 
The origin of the impulse:
Atria or AV junction
 
 
The origin of the impulse:
Ventricles
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Atrial fibrillation
Atrial flutter
Ectopic atrial rhythm
Multifocal atrial tachycardia (MAT)
Paroxysmal atrial tachycardia (PAT) with block
Premature atrial contractions (PAC)
Sinus tachycardia
Wandering atrial pacemaker
Sick sinus syndrome
 
AVNRT

AVRT (accessory pathway):
- Wolff-Parkinson-White syndrome (WPW)
- Lown-Ganong-Levine syndrome (LGL)
 
Accelerated junctional rhythm
Junctional ectopic tachycardia
 
 
SVTAC
(SVT with aberrant conduction):

Left bundle branch block
Left anterior hemi-block
Lefo posterior hemi-block
Right bundle branch block
Trifascicular block
 
 
Ventricular tachycardia
Ventricular fibrillation
Ventricular parasystole
Ventricular bigeminy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The origin of the impulse:
Atria, AV junction or ventricles

Presence of an accessory pathway
 
 
 
The origin of the impulse:
Pacemaker
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Accessory pathway

Wolff-Parkinson-White syndrome (WPW)
Lown-Ganong-Levine syndrome (LGL)
 
 
 
Paced rhythm

Pacemaker-mediated tachycardia
Runaway pacemaker syndrome
Sensor induced tachycardia

Cardiac Arrhythmias in Alphabetical Order

Cardiac arrhythmia developed by WikiDoc.org

Causes

Drug Side Effect

Contraindicated medications

Cardiac arrhythmia is considered an absolute contraindication to the use of the following medications:

References


Template:WikiDoc Sources CME Category::Cardiology

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