Ventricular Rhythms

Overview

• Introduction to ventricular rhythms with training resources and quizzes available on EKG interpretation.
• Ventricles can take over pacemaking role, observable in EKG tracings.
• Various types of ventricular rhythms are outlined.

Types of Ventricular Rhythms

Accelerated Idioventricular Rhythm

• Three or more ventricular escape beats in sequence.
• Heart rate: 50-100 bpm.
• QRS complex: Wide (≥0.12 sec).

Asystole

• No cardiac electrical activity or output.
• Immediate action required.

Idioventricular Rhythm

• Slow rhythm (<50 bpm).
• Indicates ventricles are producing escape beats.

Premature Ventricular Complex (PVC)

• Occurs when ventricular site generates impulse before next regular sinus beat.
• QRS complex: Wide (≥0.12 sec), can be bizarre.
• Absence of P wave.

Variants of PVC

• Bigeminy: PVC follows every normal beat.
• Trigeminy: PVC follows every two normal beats.
• Quadrigeminy: PVC follows every three normal beats.

Ventricular Fibrillation

• Originates in ventricles, chaotic with no normal EKG waves.
• Emergency condition; no observed heart rate.

Ventricular Tachycardia

• Sequence of three PVCs in a row.
• Heart rate: 120-200 bpm.
• Variants:
  • Monomorphic: Originates in one ventricle with wide QRS (>100 bpm).
  • Polymorphic: Varying QRS shapes/sizes; long QT interval indicates Torsade de Pointes.

Torsade de Pointes

• Special form of ventricular tachycardia.
• QRS complexes vary in shape and amplitude, winding around the baseline.

Training and Resources

• Ventricular Rhythms Training Module focuses on morphologic features and qualifying criteria.
• Includes interactive Q&A for better understanding.
• EKG Rhythm Tests available for practice, tailored to learning needs.

Authors and Reviewers

• EKG heart rhythm modules by Thomas O'Brien.
• Medical review by Dr. Jonathan Keroes, MD, Dr. Pedro Azevedo, MD, Cardiology.
• Last updated on 11/8/2021.

Sources

• Electrocardiography for Healthcare Professionals, 5th Edition by Kathryn Booth and Thomas O'Brien
• Rapid Interpretation of EKG's, 6th Edition by Dale Dublin
• 12 Lead EKG for Nurses by Aaron Reed
• The Virtual Cardiac Patient by Jonathan Keroes, David Lieberman

External References: Wikipedia, PracticalClinicalSkills.com, Free Dictionary

Disclaimer: Information for professional medical education only. For medical care, contact your doctor.

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