Bradycardia Atrial bradycardia Sinus bradycardia

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Description

Medical Mgmt.

Nursing Mgmt.

60 per minute. Rhythm: Regular. P waves: Upright, consistent, and normal in morphology and duration. P-R Interval: Between 0.120.20 seconds in duration. QRS Complex: Less than 0.12 seconds in width, and consistent in morphology.

Rate: Less than

Intraveno us access, supplemental oxygen, and cardiac monitoring In symptomat ic patients, intravenous atropine may be used. In rare cases, transcutaneo us pacing may need to be initiated in the field.

Control your cholesterol and blood pressure.

Eat a lowfat, low-salt diet.

.
Get regular exercise. Your doctor can tell you what level of exercise is safe for you.

Stop smoking.

Atrioventricular nodal bradycardi a

This usually appear on an EKG with a normal QRS complex accompanied with an inverted P wave either before, during, or after the QRS complex.

Discontinuing

any medications that slow the heart rate Diagnosis and treatment of any underlying conditions Intravenous (IV) atropine this medication may be used to temporarily increase heart rate
Artificial

Limit alcohol.

Ventricular bradycardi a

a heart rate of less than 50 beats a minute a wide QRS complex with heart rates between 20 and 40 beats a minute. Those above the His bundle, also known as junctional, will typically range between 40 and 60 bpm with a narrow QRS complex. AV block maybe ruled out with an EKG indicating

pacemaker this device may be either temporarily or permanently implanted under the skin in the chest wall. Treatment often consist of the administration of atropine Artificial cardiac pacing may be recommended

Take your medicines as prescribed.

See your doctor for regular follow-up care.

People who get pacemakers need to be careful around strong

"a 1:1 relationship between P waves and QRS complexes."

Infantile bradycardi a

a heart rate of less than 100 beats per minute

Medications (theophylline or caffeine) can be used to treat these spells in babies if necessary. NICU standard practice is to electronically monitor the heart and lungs for this reason.

magnetic or electrical fields, such as MRI machines or magnetic wands used at airports. If you get a pacemaker, your doctor will give you information about the type you have and what precautions to take.

Tachycardia

Specific Type of Diseases Sinus Tachycardia

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Description
The discharge rate from the sinus node is increased as a result of vagal inhibition or sympathetic stimulation. The sinus rate is greater than 100 beats/min - Heart rate is greater than 100 beats /min and the rhythm is regular. The p wave is normal, precedes each QRS complex, and has a normal contour and fixed interval. The PR interval is normal, and the QRS complex has a normal contour

Medical management
*Beta blockers inhibit these normal epinephrinemediated sympathetic actions, but have minimal effect on resting subjects. That is, they reduce the effect of excitement/physical exertion on heart rate and force of contraction, dilation of blood vessels and opening of bronchi, and also reduce tremor and breakdown of glycogen -The antiarrhythmic effects of beta blockers arise from sympathetic nervous system blockade resulting in depression of sinus node function and atrioventricular node conduction, and prolonged atrial refractory periods. Sotalol, in particular, has additional antiarrhythmic properties and prolongs action potential duration through potassium channel blockade.

Nursing Management
>Administer medication as prescribed, noting response and watching for side effects and toxicity. Clarify with physician parameters for withholding medications. Maintain optimal fluid balance. For patients with decreased preload, administer fluid challenge as prescribed, closely monitoring effects.

PAROXYSMA L ATRIAL TACHYCARD IA

>A period of veryPREVENTION >Administer rapid and regular medication as episodes heart beats that>Frequent prescribed, begins and endsare usually cause fornoting response abruptly. The heartmedication. In rareand watching for rate is usuallycases, the doctor mayside effects and a between 160 andrecommend Clarify procedure calledtoxicity. 200 beats per with physician ablation, minute. Thiscatheter parameters for condition is alsowhich will remove (or withholding known asablate) the precise area of the heartmedications. paroxysmal responsible for supraventricular triggering the fastMaintain optimal tachycardia. fluid balance. For heart rate. patients with In a catheter ablationdecreased >The termprocedure, the doctorpreload, paroxysmal meanswill place a specialadminister fluid that the eventcatheter against thechallenge as begins suddenly,area of the heartprescribed, without warningresponsible for theclosely and ends abruptly.problem. Radiomonitoring Atrial tachycardiafrequency energy is effects. means that thethen passed to the tip upper chambers ofof the catheter, so that the heart areit heats up and beating abnormallydestroys the target>Maintain fast. Paroxysmalarea. Catheter ablationadequate atrial tachycardiais considered a non-ventilation and can occur withoutsurgical technique. perfusion, as in any heart disease the following: being present. It is usually more -Place patient in annoying than semi- to highTreatment dangerous. Fowlers position >Causes andThe doctor may suggest that during an -Place in supine symptoms episode of paroxysmal position. atrial tachycardia the >Paroxysmal atrialfollowing practice may -Administer tachycardia mayhelp. Briefly hold the humidified be caused bynose and mouth oxygen as several differentclosed and breathe ordered things. The fastout, or by bearing >Maintain rate may bedown, as though physical and triggered by astraining at a bowel premature atrialmovement. The doctor emotional rest beat that sends anmay try to stop the

impulse along anepisode by gently >Explain abnormal electricalmassaging an area in symptoms and path to thethe neck called the interventions for ventricles. Othercarotid sinus. decreased causes stem from cardiac output anxiety, stimulants,If these conservative related to overactive thyroid,measures do not work, etiological and in somean injection of the drug factors women, the onsetverapamil or of menstruation. adenosine should stop the episode quickly. Though seldom >Explain drug In rare cases, the life-threatening, regimen, paroxysmal atrialdrugs do not work and purpose, dose, electrical shock tachycardia and side effects produces annoying(cardioversion) may be symptoms whichnecessary, particularly can includeif serious symptoms lightheadedness, are also present with >Explain chest pain,the tachycardia. progressive palpitations, activity schedule anxiety, sweating, and signs of and shortness of overexertion breath.

>Explain diet restrictions (fluid, sodium).

Type of dysrhyth mia Ventricula r tachycard ia

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Description

Medical management

Nursing management Treatment is indicated if arythmia is symptoma tic. Interventio ns are oxygen administra tion, initiating standing protocol orders. Notify the MD if this is a new arrhythmia . Determine underlying causes and treat. The patient may have a pulse. If he or she does, administer the prescribed medication . Start oxygen, obtain vital signs. If the patient is pulse-less, start the code process with serial defibrillati on and CPR per hospital protocol. Obtain vital signs, treat with prescribed medication per

Ventricular tachycardia (Vtach or VT) is a tachycardia, or fast heart rhythm, that originates in one of the ventricles of the heart. This is a potentially lifethreatening arrhythmia because it may lead to ventricular fibrillation and sudden death. Summary of ECG criteria

electrical

Cardioversion / Defibrillation

It is usually possible to terminate a VT episode with a direct current shock across the heart. This is ideally synchronised to the patient's heartbeat. As this is quite uncomfortable, shocks should be delivered only to an unconscious or sedated patient. Amiodarone MOA: Amiodarone is a class III antiarrhythmic agent which inhibits stimulation, prolongs action potential and refractory period in myocardial tissues. It also decreases AV conduction and sinus node function. Sinus rate is reduced by 15-20%, PR and QT intervals are increased. Amiodarone can cause marked sinus bradycardia or sinus arrest and heart block. In acute IV doses, amiodarone may exert a mild negative inotropic effect. Procainamide MOA: Procainamide

There are no normallooking QRS complexes. Rate: Greater than 100 beats/minu te and usually not faster than 200 beats/minu te. Rhythm: Usually regular but may be irregular. P waves: In rapid VT the P waves are usually not recognizabl e. At slower ventricular rates, P waves may be recognized and may represent normal