ARRHYTHMIA
Improper beating of the heart, whether irregular, too fast or too slow.
Four criteria
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
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HR- (60-100)
Impulse originate from SA node
Normal conduction path
Normal velocity
It means any changes in normal rhythm of heart.
Types of Arrhythmia
I) According to location:- 1) supra ventricular arrhythmia
 SA nodal (sinus arrhythmia)
 Junctional arrhythmia (AV NODAL)
 Atrial arrhythmia
2) Ventricular arrhythmia
 Mechanism of arrhythmia :
1) Increased automaticity
2) Triggering factor (smoking)
3) Reentry of impulse
II) Sinus bradycardia: - heart beat below 60 beat per min.
Rhythm stay normal
R-R interval long.
Cause: athletic, hypotension, β blocker, hypothermia, uremia.
III) Sinus tachycardia: - heart rate more then 100
Cause: adrenergic stimulation (pain), hypovolemic, vasodilation, fever, myocarditis, exercise
and vagolytic drugs
Management: appropriate cause, O2 therapy, ECG monitoring, cardiac monitoring
RAGHAV SHARMA (RJ) NURSING TUTOR
R-R interval short.
IV) Sick sinus paws (Brady techy arrhythmia):- rhythm is irregular, sinus pause, sudden rate
changes.
V) Atrial flutter: - heart rate may up to 250-300-350
Flutter present in abnormal P wave
In between QRS complex more than 3 flutter present.
ECG show saw tooth shape / fish tooth appearance.
VI) Atrial fibrillation: - most common arrhythmia involving atria.
Heart rate up to 300.
It occurs due to rapid filling of impulse from SA node to different atrial area.
P wave absent.
Management: O2 therapy, anticoagulant to prevent clot formation.
VII) Ventricular fibrillation: - sever abnormal heart rhythm.
Life threatening, no visible QRS complex.
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Rhythm is unorganized.
Management: - defibrillation, adm. O2 therapy, CPR
VIII) Ventricular tachycardia: - no QRS visible.
Management: (1) stable pt. with VT: - pulse present and no sign of decrease cardiac output.
O2 therapy
Antiarrhythmic drug › lidocaine
(2) Unstable pt. with VT: - pulse present and sign of decrease CO.
O2 therapy
Cough CPR
(3) Pulseless VT: - no pulse and sign of decrease CO
Defibrillation, CPR.
(IX) Supra ventricular tachycardia: - SVT is any tachycardia rhythm originating above the
ventricular tissue atrial and ventricular rate = 150- 250 bpm.
Regular rhythm P is usually not discernable (no fix).
(X) Premature ventricular completes (PVC’s) :- ventricle contract before time.
(XI) Asystole:- no P, QRS, T wave.
RAGHAV SHARMA (RJ) NURSING TUTOR
RAGHAV SHARMA (RJ) NURSING TUTOR