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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Arrhythmias
Arrhythmias

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



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




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.



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 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






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










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






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






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