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Premature Ventricular Complex (PVC) Unifocal Multifocal Couplets Bigeminy Ventricular Parasystole Fusion Complexes Ventricular escape rhythm Accelerated idioventricular rhythm Ventricular tachycardia
Non-sustained Monomorphic VT Polymorphic VT Torsades de pointes
Ventricular fibrillation
Ventricular Couplet
Ventricular parasystole
Ectopic ventricular pacemaker activates concurrently with the basic rhythm Ventricular impulse independent of basic rhythm
ECG characteristics:
Ventricular parasystole
Fusion/Capture complex
Ventricular impulse discharges at the time the atrial rhythm arrives at the ventricles Ventricle depolarized by two activation fronts and a fusion beat is produced Morphology intermediate between atrial rhythm complex and ventricular complex Seen in all types of ventricular arrhythmias Occur more commonly with ventricular parasystoles
Fusion/Capture complex
The underlying setting is of a recent inferior wall M.I. The AIVR gradually sets in and later self-terminates
Nonsustained
lasts 30 seconds or less
ECG characteristics supporting VT: Abnormal wide QRS with secondary ST-T changes, at least three ventricular complexes in succession Ventricular rate > 100 BPM Rhythm is regular or slightly irregular Abrupt onset and termination AV dissociation is often present Capture beats may occur Fusion beats may occur
Bidirectional VT
Patient had aconite toxicity from homeopathic medication
Polymorphic VT
Causes
Acute ischemia Dysmetabolic state especially low serum K+ levels
Ventricular rate
Abnormal wide QRS with secondary ST-T changes, at least three ventricular complexes in succession Ventricular rate between 200-250 bpm Irregular Rhythm Two or more cycles of QRS complexes with alternating polarity TdP: QT prolongation in basic rhythm with typical morphology of polymorphic VT
Polymorphic VT
During a stress test .
Torsades refers to an ornamental motive imitating twisted hairs or threads as seen on classical architectural columns, andpointes refers to points or peaks
A circular detachable hair band that could be twisted to demonstrate how the points of the teeth and the intermediary gap simulated the pointed side and the broad side, respectively, of the asymmetrical electrocardiographic waves that formed the TdP
Torsades de pointes
Cardiac arrest
Ventricular Fibrillation Cardiac arrest 80%
Flat
Asystole 20% P waves
Ventricular fibrillation
Polymorphic VT - VF
Termination by DC shock
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