ECG ASSESSMENT: AN INTRODUCTION FOR HEALTHCARE PROVIDERSST. GEORGE’S, UNIVERSITY OF LONDON

WEEK 2 TROUBLESHOOTING AND INTRODUCTION TO ECG

INTERPRETATION

VENTRICULAR ARRHYTHMIAS: AN INTRODUCTION

00:09 Ventricular arrhythmias-- an introduction. Ventricular arrhythmias is an umbrella term used to describe abnormal rhythms originating from the ventricles themselves. On the ECG, they're characterised by abnormally wide QRS complexes, fast heart rates, and typically, the absence of visible P waves. Examples include premature ventricular contractions, ventricular tachycardia, and ventricular fibrillation.

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00:43 Ventricular tachycardia arises when an area within the ventricles generates an impulse in a regular fashion and at a very fast rate. Because the impulses are derived from outside of the normal conduction pathway, they take longer to depolarise the ventricles, and therefore the QRS complexes are wider. The abnormal, rapid depolarizations can significantly impair the heart's ability to pump blood. So emergency treatment may be required, depending on the presentation.

01:20 On the ECG, you will see wide, bizarre-looking QRS complexes. The rate is fast and regular, and typically, no P waves are seen.

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01:36 Ventricular fibrillation arises when multiple areas within the ventricular muscle generate electrical impulses in a very rapid and random fashion. The chaotic activity leads to uncoordinated ventricular contraction, and a failure in the heart's ability to pump blood. Someone with this arrhythmia will therefore be unconscious with no pulse, and will require emergency advanced life support.

02:06 The chaotic ventricular activity is represented on the ECG as irregular waveforms with no discernible pattern.

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