Cardiac arrhythmia: Difference between revisions

	Cardiac arrhythmia;
	Ventricular Fibrillation or V-Fib, an example of cardiac arrhythmia.
ICD-10	I47 - I49
ICD-9	427
DiseasesDB	15206
MedlinePlus	001101
MeSH	D001145

VisualWikitext

Revision as of 15:53, 23 August 2012

Template:Cardiac arrhythmia Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Fibrillation

A serious variety of arrhythmia is known as 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.

Atrial fibrillation is the quivering, chaotic motion in the upper chambers of the heart, known as the 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.

Ventricular fibrillation occurs in the 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.

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.

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.

SADS

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.

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.

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).

List of common cardiac arrhythmias

Atrial Rhythms
Ventricular Rhythms
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 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

References

Related Chapters

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@@ Line 68: / Line 68: @@
 ***[[Type 2 Second degree heart block]], also known as [[Mobitz II]]
 **[[Third degree heart block]], also known as [[complete heart block]]
-== Antiarrhythmic therapies==
-There are many classes of antiarrhythmic medications and many individual drugs within these classes. See the article on '''[[antiarrhythmic agents]]'''.
-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.
-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.
-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]].
-===Fatty acids===
-[[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
 ==References==

v t e Electrocardiography
Overview	History of the EKG • EKG interpretation basics • Normal sinus rhythm
EKG Complexes	P wave • QRS complex • ST Segment • T wave • T wave alternans • Tombstone T wave • U wave Osborn wave • H wave • K wave • Delta wave NSSTW changes
EKG Intervals	PR Interval • QRS Interval • ST Interval • QT Interval
Conduction System & Bradycardia	Cardiac pacemaker • SA node • AV node• Bundle of His • Purkinje fibers • Sinus bradycardia • First Degree AV Block • Second Degree AV Block • Complete or Third-Degree AV Block • Concealed conduction • AV Junctional Rhythms • LBBB • LAHB • LPHB • RBBB • Trifascicular block
Atrial Arrhythmias	Sinus tachycardia • Premature Atrial Contractions (PACs) • Ectopic Atrial Rhythm • Paroxysmal Atrial Tachycardia (PAT) • Paroxysmal Atrial Tachycardia (PAT) with Block • Multifocal Atrial Tachycardia (MAT) • Atrial Flutter • Atrial Fibrillation • Wandering atrial pacemaker
Ventricular Arrhythmias	Differential Diagnosis of Tachycardia with a Wide QRS Complex • Accelerated Idioventricular Rhythm • Ventricular Parasystole • Premature Ventricular Contractions (PVCs) • Ventricular tachycardia • Ventricular Fibrillation • Sudden cardiac death
EKG Abnormalities in Disease States	Hypertrophy & Dilatation • Right atrial enlargement • Left atrial enlargement • Biatrial enlargement • Left Ventricular Hypertrophy • Right Ventricular Hypertrophy • Biventricular Hypertrophy • Acute myocardial infarction • NSTEMI • STEMI • Tombstone ST elevation • Right ventricular myocardial infarction • Atrial infarction Pre-excitation Syndromes • Wolff-Parkinson-White Syndrome • Lown Ganong Levine Syndrome • Mahaim Type Preexcitation Cardiomyopathies • Arrhythmogenic Right Ventricular Dysplasia • Dilated Cardiomyopathy • Hypertrophic Cardiomyopathy Drug Effects on the EKG • Adenosine • β-blockers • Digitalis • Quinidine • Procainamide • Disopyramide • Lidocaine • Tocainide and Mexiletine • Phenytoin • Encainide, Flecainide and Propafenone • Amiodarone • Bretylium • Ca Channel Blockers • Phenothiazines • Tricyclic Antidepressants • Lithium Congenital Heart Disease • Dextrocardia • Atrial Septal Defect • Ventricular Septal Defect • Tetralogy of Fallot • Conjoined Twins or Siamese Twins • Congenital heart block Electrolyte Disturbances • Hyperkalemia • Hypokalemia • Hypercalcemia • Hypocalcemia • Nonspecific Changes Other Heart Diseases • Pericarditis • Myocarditis • Tamponade • Heart Transplantation • Sick Sinus Syndrome • Long QT Syndrome Inherited Disease • Brugada Syndrome Systemic Diseases • CNS Disease • Cardiac Tumors Heart Transplantation • EKG Changes in patient with Heart Transplantation Exogenous Effects • Hypothermia • Chest Trauma • Insect Bites • Electric Injuries
Technical Issues and Potential Errors in Interpretation	Artifacts • Lead Placement Errors • The EKG in a Patient with a Pacemaker • EKG in athletes