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Inherent rate of the ventricles
20-40 bpm
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Premature Ventricular Complexes (PVCs)
- Originate from an irritable focus in the ventricles. Occur early, before the next expected beat in the rhythm.
- QRS is equal to or greater than (≥) 0.12 second
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Unifocal/UniformPVCs
Same shape in the same lead & originate from the same site (focus)
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Multifocal/MultiformPVCs
Different shapes in the same lead & usually originate from different sites (foci)
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Pairs or Couplets
2 sequential PVCs (in row)
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Runs(bursts or salvos)
3 or more sequential PVCs are called “ventricular tachycardia” (VT)
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Bigeminy
normal beats & premature beats occur alternately in repeating pattern
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R-on-T PVCs
When R wave of PVC falls on T wave of preceding beat (Vulnerable period)
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Ventricular Escape Beat
- Wide, bizarre ventricular beat that occurs after a pause in rhythm if supraventricular pacemakers fail to initiate an impulse.
- Appears late, after the next expected beat in underlying rhythm.
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Idioventricular Rhythm (IVR)
Three or more sequential ventricular escape beats occurring at a rate of 20 to 40 beats/min.
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Accelerated Idioventricular Rhythm (AIVR)
Rate of 40 - 100 bpm
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Ventricular Tachycardia (VT)
- •VT exists when 3 or more PVCs occur in a row at >100 bpm.
- Non-sustained VT: lasts < 30 seconds
- Sustained VT: lasts > 30 seconds
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Ventricular Fibrillation (VF)
Originates in the ventricles. No organized depolarization of the ventricles, so ventricular muscle quivers, & no effective contraction, no CO & no pulse.
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Asystole (Flat Line, Cardiac Standstill)
- Asystole is a total absence of ventricular electrical activity. No HR or rhythm, no pulse, & no CO.
- CONFIRM NO PULSE & TRUE ASYSTOLE. IMMEDIATE CPR.
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