Recognizing heartrhythm disturbances in psg
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Recognizing heartrhythm disturbances in PSG. Ann Ryckx. Arrhythmias. Any change in the normal sequence of the electrical impulses from the sinus node (SA) to the ventricles can cause arrhythmia. P-wave: contraction of the atria QRS -complex : contraction of the ventricles

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Recognizing heartrhythm disturbances in PSG

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Recognizing heartrhythm disturbances in psg

Recognizing heartrhythm disturbances in PSG

Ann Ryckx


Arrhythmias

Arrhythmias

Any change in the normal sequence of the electrical impulses from the sinus node (SA) to the ventricles can cause arrhythmia


Recognizing heartrhythm disturbances in psg

  • P-wave: contraction of the atria

  • QRS-complex: contraction of the ventricles

  • T-wave: recovery of the ventricles


Ecg in psg

ECG in PSG

  • Mostly only 1 channel

  • Recognition of heartrhythm disturbances

  • Not a diagnostic tool for other heartpathologies s.a. signs of ischaemia


Tachy arrhythmia too fast 100 bpm brady arrhyhthmia too slow 60 bpm

Tachy-arrhythmia (too fast: > 100 bpm)Brady-arrhyhthmia(too slow: < 60 bpm)


Atrial arrhythmia

Atrial arrhythmia

An atrial arrhythmia is an arrhythmia caused by

  • a dysfunction of the sinus node or

  • the development of another atrial pacemaker within the heart tissue that takes over the rhythm of the sinus node


Sinus tachykardia

Sinus Tachykardia

A condition in which the heart rate is faster than 100 beats per minute because the sinus node is sending out electrical impulses at a rate faster than usual


Supraventricular tachycardia paroxysmal atrial tachycardia

Supraventricular tachycardia = paroxysmal atrial tachycardia


Af atrial fibrillation

AF: Atrial fibrillation


Atrial flutter

Atrial flutter

The electrical signals come from the atria at a fast but even rate.

When the signals from the atria are coming at a faster rate than the ventricles can respond to, the ECG pattern develops a "sawtooth" pattern, showing two or more flutter waves between each QRS complex.


Atrial extra systoly premature beat

Atrial extra systoly = premature beat


Ventricular arrhythmia

Ventricular arrhythmia

A ventricular arrhythmia is an arrhythmia caused by

  • a dysfunction of the sinus node

  • an interruption in the conduction pathways

  • the development of another pacemaker


Atrial ventricular block av block

Atrial ventricular BlockAV Block


Atrial ventricular av block 1 st degree

Prolonged pr-interval

(>200 msec)

Atrial ventricular AV Block 1st degree


Atrial ventricular av block 2 nd degree

Atrial ventricular AV Block2nd degree

  • Wenckebach. Progressive prolongation PR interval until a p-wave is blocked

  • Mobitz Type II: pr-interval constant, evt. shorter after a p-wave block


Atrial ventricular av block 3 d degree

Atrial ventricular AV Block3d degree

  • No atrial impulses reach the ventricles

  • Possibly lifethreatening if the subsidiary pacing in the ventricles is not sufficiant


Ventricular tachycardia

Ventricular tachycardia

!! Life threatening !!


Pv c p remature ventricular complexe

PVC:Premature ventricular complexe


Bigeminy

Bigeminy


Trigeminy

Trigeminy


Multifocal pvc

Multifocal PVC


Ventricular tachycardia1

Ventricular tachycardia


Ventricular flutter

Ventricular flutter

!! Emergency !!


Ventricular fibrillation

Ventricular fibrillation

!! Emergency !!


Asystoly

Asystoly

!! Emergency !!


Cpr cardio pulmonary resuscitation

CPR Cardio Pulmonary Resuscitation

Newest guidelines


Step 1 check consciousness

Step 1: check consciousness


Step 2 call for help

Step 2: call for help


Abcd of basic life support

ABCD of basic life support


Check and free the upper airway

Check and free the upper airway


Hyperextension lift the chin

Hyperextension, lift the chin


Close the nose hyperextension

Close the nose, hyperextension


2 breaths deep and slow

2 breaths, deep and slow


Check the circulation carotis

Check the circulation: carotis


Automatic external defibrillation aed

Automatic External Defibrillation (AED)


No circulation no aed available

No circulation:No AED available

Basic Life Support

  • 15 compressions on the chest

  • 2 breaths

  • Same rhythm, even if 2 reanimators


Check for the lower ribs

Check for the lower ribs


Lower third of the sternum

Lower third of the sternum


Arms stretched 4 5 cm impression rhythm 100 min

Arms stretched, 4-5 cm impression, rhythm 100/min.


15 compressions 2 breaths

15 compressions / 2 breaths


No circulation aed available

No circulationAED available

  • In case of fibrillation or ventricular tachycardia connect the patient to the AED , perform analysis

  • Without pulse: defibrillation

  • Repeat ABC

  • No result: restart BLS and defibrillation after 1 minute

  • No fibrillation: BLS


Automatic external defibrillation aed1

Automatic External Defibrillation (AED)


Automatic external defibrillation aed2

Automatic External Defibrillation (AED)


Safetyposition after reanimation

Safetyposition after reanimation


Thanks

THANKS !!


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