Premature Ventricular Complex (PVC), Idioventricular Rhytm (IVR), Accelerated Idioventricular Rhytm (AIVR), Ventricular Tachicardia (VT),Ventricular Fibrilation (VFib), Agonal Rhytm
Sinus Rhytm with Premature Ventricular Complex (NSR with
PVC)
Premature ventricular complete (PVC) often represent
increased ventricular automaticaly or recentry phenomenon. The presence of PVC
may be benign but can indicated irritable ventricles. PVC’s arrive earlier than
expected and is usually widw (0,12 second or more). Note that the T wave often
points in an opposite direction from the QRS complex. A PVC every second
complex is called ventricular bigeminy...every 3rd-ventricular trigeminy.
Idioventricular Rhytm (IVR)
Idioventricular rhytm (IVR) occurs when the SA and AV nodes
are either NOT fiiring or firing slower
than the ventricular pacemaker rate. A common ventricular pacemaker rate is
20-40/minute, a rate that is often not sufficient to sustain an adequate
cardiac output
Accelerated Idioventricular Rhytm (AIVR)
Accelerated Idioventricular Rhytm (AIVR) is a ventricular
rhytm occuring at a rate between 41-100/minute – faster than typical pacemaker
rates expected of the ventricles (20-40/minute) and less than what is
considered a tachicardia (>100/minutes). Enhanced automaticity-possibly due
to hipoxia or abundant sympathetic stimulation - increases rate of ventricular electrical
impulses. Note that this rhytm is often unstable and can move quickly to either
asystole or ventricular tavhicardia (VT)
Ventricular Tachicardia (VT)
Ventricular Tachicardia (VT) often result in hemodynamic
compromise (due to minimal ventricular filling time and the absence of atrial
kick). What makes this rhytm more omnius is it tendency to transition into
ventricular fibrilation. Causes of VT include myocardial ischemia, a PVC
landing on a T wave (R-on-T), cardiac drug toxicity and electrolyte imbalance.
Non-sustained VT (a group of 3 or more PVCs) is a run of VT.
Ventricular Fibrilation (VFib)
Ventricular Fibrilation (Vfib) is a chaotic rhytm
originating in the ventricles, resulting in no cardiac output. Coarse Vfib is
noted when the amplitude (height) of the rhytm is equal to or more than 3 mm.
Fine Vfib is less than 3 mm in height and signifies less electrical energi
within the myocardium-less opportunity for a successful defibrilation.
Agonal Rhytm
Agonal Rhytm-typically an extreme ventricular bradycardia-is
considered an end stage cardiac rhytm with asystole quickly ensuing. The QRS complexes tend to be very wide and
flattened. The relative absence of cardiac output often results in a pulseless
patient.
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Sumber Pustaka: SkillStat Learning.Inc. 2005
