Cardiac Dysrhythmias Of Ventricular Origin
Ectopic Ventricular Dysrhythmias
Premature Ventricular Contractions
Characteristics Of PVC’s Are :
PVC’s May Appear Randomly
Bigeminy
Trigeminy
Quadrigeminy
Couplets
Triplets
Couplets Are Scary But Triplets Are Really Frightening
Multiform PVC’s
Rules Of Malignancy
From Least Severe To Most Severe
Appearance Of Multifocal PVC’s
RT On T Phenomenon
A Stimulus That Occurs Before Repolarization Is Finished Will Set Off A Disorganized Electrical Response To The Stimulus & May Set The Heart Up For A Malignant Ventricular Ectopy Like V-Tach Or V-Fib.
Exercise
Yes, You Can Exercise A Patient Having PVC’s. However, They Should Only Be Occasional Single Focus Single PVC’s.
If The Exercise Regimen Makes The Incidence Of PVC’s Occur More Often Or If The PVC’s Become More Malignant, Exercise Should Be Terminated.
A Person Should Not be Exercised When They Are Displaying Multiforme PVC’s Or Any PVC Rhythm (Bigeminy, etc.) Until Cleared By Their Cardiologist
The ACSM Guidelines
...or “Signs Of Poor Perfusion: Light Headedness, Confusion, Ataxia, Pallor, Cyanosis, Nausea, Or Cold & Clammy Skin” Then
Ventricular Tachycardia
Short Runs Of V-Tach Will Make The Patient Feel :
Sustained Runs OF V-Tach Will Render The Patient Unconscious Because The Cardiac Output Is So Negatively Effected As To Decrease Perfusion To The Brain & The Heart.
Ventricular Tachycardia Will Degenerate Quickly Into Ventricular Fibrillation
The Patient In V-Tach Must Be Supported With CPR Methods & Must Be Cardioverted Electrically Or Pharmacologically Out Of This Fatal Rhythm
Both V-Tach & V-Fib Are Absolute Medical Emergencies Requiring High Level Medical Management
Ventricular Fibrillation
V-Fib Is Characterized By :
The Patient Must Be Supported By CPR Methods & Must Be Electrically Cardioverted Out Of This Rhythm Or Death Ensues
Atrioventricular Blocks
First Degree AV Blocks
First Degree AV Block
Causes :
First Degree AV Block Does Appear In Healthy Individuals As Well As In Those With Ischemic Heart Disease
Also, The Rhythm Had To Have Been Present Before Exercise Started. If A Patient Is Normal On Their EKG Before Exercise & Degenerates Into First Degree AV Block, Exercise Must Stop !!
First Degree AV Block Is Generally Not Considered To Be A Highly Malignant Dysrhythmia
Second Degree AV Block Mobitz Type I Or A Wenckebach Block
Second Degree AV Block Or A Mobitz Type I AV Block Is Characterized By :
Mobitz Type I
Yes, Providing The Dysrhythmia Does Not Degenerate During Exercise.
A Problem Does Exist With A Mobitz Type I AV Block !!
Second Degree AV Block Mobitz Type II
Characteristics Are :
Mobitz Type II
Mobitz Type II AV Block Is A Dangerous Dysrhythmia Because Of The High Likelihood That It Will Convert To A Third Degree AV Block.
A Patient With A Mobitz Type II AV Block Is Going Eventually Convert To A Third Degree Block & Is A Candidate For A Surgically Implanted Pacemaker
Third Degree AV Block
The Atria Beat At Their Own Rate While The Ventricles Beat At Their Own Rate
The P Waves Appear & Are Not Connected To Any QRS Complex
3rd Degree AV Block
Most Patients In Third Degree AV Block Require The Implantation Of A Pacemaker.
Bundle Branch Blocks
Can you exercise a patient in RBBB ?
Left Bundle Branch Block
Can you exercise a person in LBBB ?
Email: David.Arnall@NAU.EDU , DAArnall@AOL.COM
Home Page: http://jan.ucc.nau.edu/~daa/heartlung/
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