Cardiac arrhythmia

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Resident
Survival
Guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]

Overview

Cardiac arrhythmia is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heart beat may be too fast or too slow, and may be regular or irregular. A heart beat that is too fast is called tachycardia and a heartbeat that is too slow is called bradycardia. Although many arrhythmias are not life-threatening, some can cause cardiac arrest.

Classification of Cardiac Arrhythmia

 
 
 
 
 
 
 
 
 
 
 
 
 
Arrhythmia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Bradyarrhythmia
 
 
 
 
 
 
Arrhythmia
with normal heart rate
 
 
 
 
 
 
Tachyarrhythmia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The origin of the impulse:
Atria
 
The origin of the impulse:
AV junction
 
The origin of the impulse:
Ventricles
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sinus arrhythmia
Atrial bigeminy
 
Accelerated junctional rhythm
Junctional bigeminy
 
Accelerated idioventricular rhythm
Ventricular bigeminy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The origin of the impulse:
Atria
 
The origin of the impulse:
AV junction
 
The origin of the impulse:
Ventricles
 
 
 
 
 
 
Narrow complex tachycardia (SVT)
 
 
 
 
 
 
Wide complex tachycardia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Normal variant:
Respiratory sinus arrhythmia

Sinus node dysfunction:
Sinus bradycardia
Sinoatrial block
Sinus arrest
Sick sinus syndrome

Abnormality in the atria:
Low atrial focus bradycardia
Atrial bigeminy

AV node dysfunction:
First degree AV block
Second degree AV block
Complete or third-degree AV block
 
Junctional escape rhythm
Junctional bigeminy
 
Isorhythmic A-V dissociation
Slow VT (idioventricular rhythm)
Ventricular escape rhythm
Escape capture bigeminy
 
 
The origin of the impulse:
Atria
 
 
 
The origin of the impulse:
AV junction
 
 
The origin of the impulse:
Atria or AV junction
 
 
The origin of the impulse:
Ventricles
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Atrial fibrillation
Atrial flutter
Ectopic atrial rhythm
Multifocal atrial tachycardia (MAT)
Paroxysmal atrial tachycardia (PAT) with block
Premature atrial contractions (PAC)
Sinus tachycardia
Wandering atrial pacemaker
Sick sinus syndrome
 
AVNRT

AVRT (accessory pathway):
- Wolff-Parkinson-White syndrome (WPW)
- Lown-Ganong-Levine syndrome (LGL)
 
Accelerated junctional rhythm
Junctional ectopic tachycardia
 
 
SVTAC
(SVT with aberrant conduction):

Left bundle branch block
Left anterior hemi-block
Lefo posterior hemi-block
Right bundle branch block
Trifascicular block
 
 
Ventricular tachycardia
Ventricular fibrillation
Ventricular parasystole
Ventricular bigeminy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The origin of the impulse:
Atria, AV junction or ventricles

Presence of an accessory pathway
 
 
 
The origin of the impulse:
Pacemaker
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Accessory pathway

Wolff-Parkinson-White syndrome (WPW)
Lown-Ganong-Levine syndrome (LGL)
 
 
 
Paced rhythm

Pacemaker-mediated tachycardia
Runaway pacemaker syndrome
Sensor induced tachycardia

Cardiac Arrhythmias in Alphabetical Order

Cardiac arrhythmia developed by WikiDoc.org

Causes

Drug Side Effect

Contraindicated medications

Cardiac arrhythmia is considered an absolute contraindication to the use of the following medications:

References


Template:WikiDoc Sources CME Category::Cardiology