Idioventricular Rhythms Click here for a preview Idioventricular rhythms IVR usually appear when the main pacemaker of the heart has slowed down or is non functional. Occasionally an accelerated idioventricular rhythm AIVR especially after successful thrombolysis of myocardial infarction, overrides the dominant pacemaker of the heart sinus rhythm. Accelerated idioventricular rhythm is a classical reperfusion arrhythmia while usually IVR occurs in complete heart block complete AV block. Continuous IVR decreases cardiac output due to the lack of atrial booster function and can cause syncope or near syncope. Treatment of IVR is aimed at increasing the heart rate to improve cardiac output and establishing sinus rhythm. Intravenous atropine can accelerate the sinus node to override the accelerated IVR.
Along with high quality CPR, emergency medicines and defibrillation are the only two interventions that are likely to restart the arrested heart. Defibrillation a powerful tool in the hands of the ACLS practitioner and it is important to know when to use defibrillation to reset the abnormal rhythm. Rhythms that are not amenable to shock include pulseless electrical activity PEA and asystole. In these cases, identifying primary causation, performing good CPR, and administering epinephrine are the only tools you have to resuscitate the patient. Shockable rhythms are rhythms that are caused by an aberration in the electrical conduction system of the heart. Kathawala, S.
Welcome to our asystole reference page that provides a definition and synopsis of EKG features. Links to our practice drills, quizzes, lessons and interactive guides can be found below. Asystole is a cardiac arrest rhythm with no discernible electrical activity on the EKG monitor.
Recognition of any of these killer ECG patterns should prompt expedited medical assessment and treatment. This patient presented to ED with pulmonary oedema after missing several dialysis sessions. The differential diagnosis for this patient with severe bradycardia and 1st degree AV block would include beta-blocker and calcium-channel blocker toxicity. Consideration should be given to empirical treatment with intravenous calcium whilst awaiting blood results e.