ekg presentation handout.pdf

PVCs are named based on 2 major characteristics: Site of Origin: PVCs Can occur as unifocal or multifocal. Unifocal PVCs originate from the same site and look identical. Multifocal PVCs originate from different locations, and therefore look different from one another. Visual indicators: Some possibl...

PVCs are named based on 2 major characteristics: Site of Origin: PVCs Can occur as unifocal or multifocal. Unifocal PVCs originate from the same site and look identical. Multifocal PVCs originate from different locations, and therefore look different from one another. Visual indicators: Some possible causes: *Broad QRS complex ≥120 milliseconds with abnormal morphology. Electrolyte abnormalities: Low Potassium, Low Magnesium or High Calcium. *Compensatory Pause. Other: Hyperthyroidism, hypertension, age, gender, poor cardiovascular markers. *Absence of P waves before the QRS complex. *Occurs earlier than expected for the next sinus impulse. Increase in SNS “fight or flight”: Epinephrine or norepinephrine activity on Beta Adrenergic receptors. Frequency of Occurrence: Bigeminy: PVC every 2 beats Trigeminy: PVC every 3 beats. Quadrigeminy: PVC every 4 beats. 3 beat Salvo (triplet): 3 consecutive PVCs. Non-sustained Ventricular Tachycardia (NSVT): 3 or more consecutive PVCs for less than 30 seconds. Ventricular Tachycardia AKA V-Tach: 3 or more consecutive PVCs for more than 30 seconds. *Irregular R-R or R-S Rhythm. Hypoxia: anemia, COPD, asthma, pneumonia, CHF, etc. Ninja Nerd. (2020, January 5). Rate and rhythm | Premature Ventricular Contraction (PVC) [Video]. YouTube. https://www.youtube.com/wa tch?v=2Z9StjA-U7Q Farzam, K., & Richards, J. R. (2023, August 8). Premature ventricular contraction. StatPearls - NCBI Bookshelf. https://www.ncbi.n lm.nih.gov/books/NBK532991/ Deflection can be helpful in determining origination area: For example, Negative deflection indicates that the electrical impulse is moving from positive toward negative. This suggests that the impulse is firing from the LEFT ventricle toward the RIGHT ventricle. Drugs/Alcohol: Illicit drugs, ADHD medications, alcohol, tobacco and caffeine. Infarcted tissue: Cardiomyopathy, Mitral Valve Prolapse, MI, any structural heart disease that alters conductions pathways due to tissue alteration. Treatments: Patients who experience asymptomatic or isolated PVCs rarely require treatment. Hypoxic patients should receive Oxygen. Electrolyte imbalances should be corrected. Drug toxicity and acute MI should be ruled out. If experiencing frequent or symptomatic PVCs etiology should be investigated. Medications include: antiarrhythmics, beta-blockers, and Ca channel blockers. If medications are unsuccessful, they may be candidates for radiofrequency catheter ablation.