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    Basic Medical Algorithmic Approach To Arrhythmias

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    Jee Junpyo
    This document provides an overview of algorithms for classifying different types of arrhythmias based on characteristics like heart rate, regularity of rhythm, and presence of P waves. It outlines flowcharts for categorizing irregular rhythms, rhythms with pauses, early beats, regular rhythms with normal and abnormal heart rates, and narrow and wide complex tachycardias. The document concludes with general management guidelines for tachyarrhythmias and bradyarrhythmias depending on whether they are symptomatic or asymptomatic.

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    Basic Medical Algorithmic Approach To Arrhythmias

    Uploaded by

    Jee Junpyo
    47 views17 pages
    This document provides an overview of algorithms for classifying different types of arrhythmias based on characteristics like heart rate, regularity of rhythm, and presence of P waves. It outlines flowcharts for categorizing irregular rhythms, rhythms with pauses, early beats, regular rhythms with normal and abnormal heart rates, and narrow and wide complex tachycardias. The document concludes with general management guidelines for tachyarrhythmias and bradyarrhythmias depending on whether they are symptomatic or asymptomatic.

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    6. Basic Medical Algorithmic Approach to Arrhythmias

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    This document provides an overview of algorithms for classifying different types of arrhythmias based on characteristics like heart rate, regularity of rhythm, and presence of P waves. It outlines flowcharts for categorizing irregular rhythms, rhythms with pauses, early beats, regular rhythms with normal and abnormal heart rates, and narrow and wide complex tachycardias. The document concludes with general management guidelines for tachyarrhythmias and bradyarrhythmias depending on whether they are symptomatic or asymptomatic.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    47 views17 pages

    Basic Medical Algorithmic Approach To Arrhythmias

    Uploaded by

    Jee Junpyo
    This document provides an overview of algorithms for classifying different types of arrhythmias based on characteristics like heart rate, regularity of rhythm, and presence of P waves. It outlines flowcharts for categorizing irregular rhythms, rhythms with pauses, early beats, regular rhythms with normal and abnormal heart rates, and narrow and wide complex tachycardias. The document concludes with general management guidelines for tachyarrhythmias and bradyarrhythmias depending on whether they are symptomatic or asymptomatic.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 17

    ALGORITHMS FOR THE

    CLASSIFICATION OF ARRHYTHMIAS

    Antonio L. Dans, MD, FPCP

    UP-PGH Section of Cardiology


    CLASSIFICATION OF ARRHYTHMIAS

    Rhythm
    Irregularly Generally
    Regular
    irregular Regular
    Brady A B1/B2 C1/C2
    Rate

    Normal A B1/B2 D
    Tachy A B1/B2 E1/E2
    IRREG
    IRREG

    p-waves Y Y Sinus
    normal?
    ? arrhythmi
    N N a
    Saw Y A-flut w/ var
    tooth? conduction
    N
    Polymorphic
    p waves

    Y MFAT
    HR>100

    N
    HR<100 Wandering
    pacemaker

    Usually fib Atrial


    waves fibrillation

    Figure A - Chaotic Rhythms


    Pauses

    Pause 2nd
    Y Prior PRs Y
    after p? degree
    constant?
    AVB
    N N Mobitz I
    2nd
    Prior PRs
    degree
    prolongin
    AVB
    g
    Mobitz II
    Pause a Y Sinus
    Pause
    multiple of exit
    after QRS
    RRs? block
    N
    Sinus
    pause

    Figure B1 - Pauses
    Early
    Beats

    P or
    deformed Y PAC
    T prior?
    N
    Retro- Y
    grade p? * PNC

    N
    Absent P QRS > Y Probable
    wave 0.12s? PVC
    N
    Probable
    PNC

    * a retrograde p is a negative p
    wave seen shortly before,
    during, or immediately after a Figure B2 - Early Beats
    QRS
    Regular Figure C1 - Bradycardias
    HR<60

    Normal Sinus
    Definite p Y Y
    conducted bradycardia
    waves?
    P’s ?
    N N
    Fig C2 Retro-
    Idionodal
    grade p Y
    rhythm
    waves?
    N
    Flut Y A-Flut with
    waves? block
    N
    Independent 3rd degree
    P and QRS AVB

    UP-PGH Section of Cardiology


    Figure C2 - Bradycardias
    Fig C1

    No p
    waves

    FibN AF
    Y with
    waves
    ? AVB
    N
    QRS Idiovent or
    Flat Y idionodal
    >0.12ms?
    baseline rhythm
    N
    Idionodal
    rhythm

    UP-PGH Section of Cardiology


    Regular
    HR=60 Figure D - Regular Rhythm, Normal HR
    to 100

    indepen-
    Definite p Y Y 3rd degree
    dent p & AVB
    waves?
    QRS?
    N N
    Fig C2 PR< Y Delta Y WPW
    0.12s wave? syndrome
    N N
    LGL
    syndrome

    PR> 0.20s Y 1st degree


    AVB
    N
    Normal AV QRS > Y BBB
    conducito 0.12s
    n N
    Normal
    Ventricular
    Conduction
    UP-PGH Section of Cardiology
    Narrow Figure E1 - Narrow QRS Tachycardia
    QRS tachy

    p-waves Y Normal p Y Sinus


    ? waves? tachycardia
    N N
    Saw Y Atrial
    tooth? flutter
    N
    Abnormal p
    <300/min

    P before Y Atrial
    QRS tachycardia
    N
    P after Y AVNRT
    QRS
    N
    SVT P between AVRT
    (generic) QRS
    Wide
    QRS tachy

    Conduc- Y SVT (see


    ted P’s ? Fig E1)
    N
    Capture Y
    beats?
    N
    Fusion Y
    beats?
    N
    AV Y VT
    dissoc
    N
    Suspect
    PSVT

    Figure E2 - Wide QRS Tachycardia


    Tachy-
    arrhythmia

    Symptom- Y
    atic?
    N
    search for
    underlying
    disease

    Y
    present?

    N
    High need to
    Y
    grade treat;
    VA? refer.
    N
    no need
    to treat;
    reassure.
    Management of Tachyarrhythmias
    UP-PGH Section of Cardiology
    Brady-
    arrhythmia

    Symptom- Y
    atic?
    N
    observe
    response
    to exercise

    no need to
    adequate? Y
    treat;
    reassure.
    N
    need to
    treat; refer.

    Management of Bradyarrhythmias
    UP-PGH Section of Cardiology
    END OF
    LECTURE

    THANK
    YOU!

    ANY
    Y ANSWER
    QUESTIONS
    IF ABLE
    ?
    N

    GOOD-
    BYE1

    UP-PGH Section of Cardiology


    Thank You!

    UP-PGH Section of Cardiology


    Identify the rhythm abnormality.
    1) Atrial flutter 3) 3º AV block
    2) atrial fibrillation 4) atrial tachycardia

    UP-PGH Section of Cardiology


    Identify the rhythm abnormality.
    1) Atrial tchycardia 3) PSVT
    2) Junctional tachycardia 4) AVNRT

    UP-PGH Section of Cardiology


    Identify the rhythm abnormality.
    1) Atrial fibrillation 3) PAT
    2) MAT 4) atrial flutter

    UP-PGH Section of Cardiology

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