Ventricular arrhythmias

Ventricular (ventricular) arrhythmias usually occur due to ischemia (myocardial infarction, angina pectoris, chronic coronary insufficiency, myocardial aneurysm, angina vazosppastic), the cardiomiopaty, myocarditis, long QT - interval, mitral valve prolapse, physical exercise, right ventricular dysplasia artimogene and others., and can occur without clinically apparent disease.

Ventricular premature beats (ventricular premature beats, VES) on ECG - to be recognized by a wide QRS ompleksu, which is not preceded by P wave, and the result is abnormal and start the flow, and delayed ventricular depolarization. Origin and appearance may be different (multifokalneVES), compared to the previous normal PQRST may occur early during repolarization, the previous talasuT (R on T phenomenon). VES can occur in late diastole and be cause fusion complex or interpolated between two normally conducted sinus impulses. When you arise after each sinus impulses, it is a bigeminy, and after two pulses of trigeminiji. Two consecutive heather are a couple, three or more ventricular tachycardia.

Many patients do not feel the appearance of VES, while others were of the mind skipping the heart work harder or heart attacks. If there are no symptoms, no other individual VES clinical myocardial injury does not require medical treatment, and the injured myocardium, especially in the damaged left ventricle VES, VES in pairs, can be the sign of multifocal malignant ventricular arrhythmias and require treatment. In addition to treating the underlying disease, apply for beta blockers and antiarrhythmics I and III groups.

Ventricular tachycardia (ventricular tachycardia, VT) is defined as a series of three or more premature ventricular beats at a frequency between 100 and 250/min. It occurs due to the existence of the level of ectopic center chamber with fast-frequency pulses of creation. Presenting ventricular complexes that are bizarre with prolonged QRS and diskordinatnom final oscillation. As occurs in patients with significant myocardial damage, it can cause or worsen heart failure or cardiogenic shock. The most commonly manifested as palpitations (heart palpitations), weakness, dizziness, and dyspnea (shortness of breath).

Treatment of symptomatic forms is not required. In patients with acute myocardial infarction intraveska lidocaine and mexiletina is very effective. Treatment involves correction of attack precipitating factors, and medication from a drug of first choice is intravenous lidocaine, an alternative to beta-blockers, antiarrhythmics and groups. If the drugs do not have a quick effect elektrokatdioverzija the treatment of choice.

Chambers flutter (flutter ventriculorum) is due to the level of focus ektopičkog myocardium whose function is 250-300/min. It is characterized by QRS complexes is extended in the form of regular sine waves without the possibility of recognition of T wave. Chambers flutter leads to pronounced hemodynamic changes that are reflected in declining cardiac output. Flutter often goes into fibrillation chamber, because he needed urgent treatment, which consists of priomene elektrocardioversion.

Flickering of Commerce (fibrillatio ventriculorum) is chaotic activation myocardium resulting from the existence of ectopic focus in the heart muscle chambers with resultant circular motion at the level of Purkinje fibers. Fibrillation is the cessation of heart. They are registered in multiple, irregular, and different apmlitude duration, sinusoidal ripples.

Treatment is urgent, normal heart activity can be established defibrillation chamber (DC shock), the following procedure was cardiac massage and artificial respiration, followed by intravenous lidocaine and epinephrine, or both drugs together