A report on Arrhythmia

Ventricular fibrillation (VF) showing disorganized electrical activity producing a spiked tracing on an electrocardiogram (ECG)
Broad classification of arrhythmias according to region of heart required to sustain the rhythm
Normal sinus rhythm, with solid black arrows pointing to normal P waves representative of normal sinus node function, followed by a pause in sinus node activity (resulting in a transient loss of heartbeats). Note that the P wave that disrupts the pause (indicated by the dashed arrow) does not look like the previous (normal) P waves – this last P wave is arising from a different part of the atrium, representing an escape rhythm.

Too fast or too slow.

- Arrhythmia
Ventricular fibrillation (VF) showing disorganized electrical activity producing a spiked tracing on an electrocardiogram (ECG)

63 related topics with Alpha

Overall

ECG of a heart in normal sinus rhythm

Electrocardiography

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Process of producing an electrocardiogram , a recording of the heart's electrical activity.

Process of producing an electrocardiogram , a recording of the heart's electrical activity.

ECG of a heart in normal sinus rhythm
Normal 12-lead ECG
A 12-lead ECG of a 26-year-old male with an incomplete right bundle branch block (RBBB)
A patient undergoing an ECG
An EKG electrode
Proper placement of the limb electrodes. The limb electrodes can be far down on the limbs or close to the hips/shoulders as long as they are placed symmetrically.
Placement of the precordial electrodes
The limb leads and augmented limb leads (Wilson's central terminal is used as the negative pole for the latter in this representation)
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Diagram showing the contiguous leads in the same color in the standard 12-lead layout
QRS is upright in a lead when its axis is aligned with that lead's vector
Schematic representation of a normal ECG
Measuring time and voltage with ECG graph paper
Animation of a normal ECG wave
Formation of limb waveforms during a pulse
An early commercial ECG device (1911)
ECG from 1957
Use of real time monitoring of the heart in an intensive care unit in a German hospital (2015), the monitoring screen above the patient displaying an electrocardiogram and various values of parameters of the heart like heart rate and blood pressure
A 12-lead ECG of a 26-year-old male with an incomplete right bundle branch block (RBBB)

Symptoms such as shortness of breath, murmurs, fainting, seizures, funny turns, or arrhythmias including new onset palpitations or monitoring of known cardiac arrhythmias

Leads aVL and aVF of an electrocardiogram showing atrial fibrillation. There are irregular intervals between heart beats. No P waves are seen and there is an erratic baseline between QRS complexes. The heart rate is about 125 beats per minute.

Atrial fibrillation

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Leads aVL and aVF of an electrocardiogram showing atrial fibrillation. There are irregular intervals between heart beats. No P waves are seen and there is an erratic baseline between QRS complexes. The heart rate is about 125 beats per minute.
Normal rhythm tracing (top) Atrial fibrillation (bottom)
How a stroke can occur during atrial fibrillation
Non-modifiable risk factors (top left box) and modifiable risk factors (bottom left box) for atrial fibrillation. The main outcomes of atrial fibrillation are in the right box. BMI=Body Mass Index.
A 12-lead ECG showing atrial fibrillation at approximately 132 beats per minute
Diagram of normal sinus rhythm as seen on ECG. In atrial fibrillation the P waves, which represent depolarization of the top of the heart, are absent.
ECG of atrial fibrillation (top) and normal sinus rhythm (bottom). The purple arrow indicates a P wave, which is lost in atrial fibrillation.
3D Medical Animation still shot of Left Atrial Appendage Occlusion

Atrial fibrillation (AF or A-fib) is an abnormal heart rhythm (arrhythmia) characterized by rapid and irregular beating of the atrial chambers of the heart.

Artistic impression of a woman experiencing syncope, which may be accompanied by heart palpitations

Palpitations

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Further characterized by the hard, fast and/or irregular beatings of the heart.

Further characterized by the hard, fast and/or irregular beatings of the heart.

Artistic impression of a woman experiencing syncope, which may be accompanied by heart palpitations

Three common descriptions of palpitation are "flip-flopping" (or "stop and start"), often caused by premature contraction of the atrium or ventricle, with the perceived "stop" from the pause following the contraction, and the "start" from the subsequent forceful contraction; rapid "fluttering in the chest", with regular "fluttering" suggesting supraventricular or ventricular arrhythmias (including sinus tachycardia) and irregular "fluttering" suggesting atrial fibrillation, atrial flutter, or tachycardia with variable block; and "pounding in the neck" or neck pulsations, often due to cannon A waves in the jugular venous, pulsations that occur when the right atrium contracts against a closed tricuspid valve.

CPR being administered during a simulation of cardiac arrest

Cardiac arrest

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When the heart suddenly and unexpectedly stops beating.

When the heart suddenly and unexpectedly stops beating.

CPR being administered during a simulation of cardiac arrest
Conduction of the heart. Changes in this pattern can result from injury to the cardiac muscle and lead to non-conducted beats and ultimately cardiac arrest.
Ventricular fibrillation
Normal vs blocked coronary artery
Short axis view of the heart demonstrating wall thickening in left ventricular hypertrophy
EKG depiction of left ventricular hypertrophy
Medical personnel checking the carotid pulse of a patient
CPR training on a mannequin
An automated external defibrillator stored in a visible orange mural support
Lipid emulsion as used in cardiac arrest due to local anesthetic agents
Illustration of implantable cardioverter defibrillator (ICD)

Less common causes include major blood loss, lack of oxygen, very low potassium, electrical injury, heart failure, inherited heart arrhythmias and intense physical exercise.

A run of ventricular tachycardia as seen on a rhythm strip

Ventricular tachycardia

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Fast heart rate arising from the lower chambers of the heart.

Fast heart rate arising from the lower chambers of the heart.

A run of ventricular tachycardia as seen on a rhythm strip
Normal sinus top, ventricular tachycardia bottom
12 lead electrocardiogram showing a run of monomorphic ventricular tachycardia (VT)

In monomorphic ventricular tachycardia, the shape of each heart beat on the ECG looks the same because the impulse is either being generated from increased automaticity of a single point in either the left or the right ventricle, or due to a reentry circuit within the ventricle.

A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream.

Myocardial infarction

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A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle.

A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle.

A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream.
Cross section showing anterior left ventricle wall infarction
Diagram showing the blood supply to the heart by the two major blood vessels, the left and right coronary arteries (labelled LCA and RCA). A myocardial infarction (2) has occurred with blockage of a branch of the left coronary artery (1).
A 12-lead ECG showing an inferior STEMI due to reduced perfusion through the right coronary artery. Elevation of the ST segment can be seen in leads II, III and aVF.
ECG : AMI with ST elevation in V2-4
Inserting a stent to widen the artery.

An MI may cause heart failure, an irregular heartbeat, cardiogenic shock or cardiac arrest.

Lead II electrocardiogram strip showing PSVT with a heart rate of about 180.

Supraventricular tachycardia

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Umbrella term for fast heart rhythms arising from the upper part of the heart.

Umbrella term for fast heart rhythms arising from the upper part of the heart.

Lead II electrocardiogram strip showing PSVT with a heart rate of about 180.
Mechanisms of supraventricular tachycardias
Holter monitor-Imaging with start (red arrow) and end (blue arrow) of a SV-tachycardia with a pulse frequency of about 128/min.
A 12-lead ECG showing paroxysmal supraventricular tachycardia at about 180 beats per minute.
Atrial fibrillation: Red dots show atrial fibrillation activity.
Impulse arising in SA node, traversing atria to AV node, then entering ventricle. Rhythm originating at or above AV node constitutes SVT.
Atrial fibrillation: Irregular impulses reaching AV node, only some being transmitted.

They are generally due to one of two mechanisms: re-entry or increased automaticity.

A 1744 oil painting by Pietro Longhi called Fainting

Syncope (medicine)

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Loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery.

Loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery.

A 1744 oil painting by Pietro Longhi called Fainting
Syncope from bradycardia
ECG showing HOCM
Long QT syndrome
A short PR in Wolff–Parkinson–White syndrome
Type 2 Brugada ECG pattern

Heart related causes may include an abnormal heart rhythm, problems with the heart valves or heart muscle and blockages of blood vessels from a pulmonary embolism or aortic dissection among others.

Atrial flutter with varying A-V conduction (5:1 and 4:1)

Atrial flutter

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Atrial flutter with varying A-V conduction (5:1 and 4:1)
Type I atrial flutter, counterclockwise rotation with 3:1 and 4:1 AV nodal block.
Atrial flutter with a two to one block. Note the P waves hiding in the T waves in leads V1 and V2

Atrial flutter (AFL) is a common abnormal heart rhythm that starts in the atrial chambers of the heart.

A man with congestive heart failure and marked jugular venous distension. External jugular vein marked by an arrow.

Heart failure

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Set of manifestations caused by the failure of the heart's function as a pump supporting the blood flow through the body.

Set of manifestations caused by the failure of the heart's function as a pump supporting the blood flow through the body.

A man with congestive heart failure and marked jugular venous distension. External jugular vein marked by an arrow.
Signs and symptoms of severe heart failure
Severe peripheral pitting edema
Kerley B lines in acute cardiac decompensation. The short, horizontal lines can be found everywhere in the right lung.
Model of a normal heart (left); and a weakened heart, with over-stretched muscle and dilation of left ventricle (right); both during diastole
Chest radiograph of a lung with distinct Kerley B lines, as well as an enlarged heart (as shown by an increased cardiothoracic ratio, cephalization of pulmonary veins, and minor pleural effusion as seen for example in the right horizontal fissure. Yet, no obvious lung edema is seen. Overall, this indicates intermediate severity (stage II) heart failure.
Siderophages (one indicated by white arrow) and pulmonary congestion, indicating left congestive heart failure
Ultrasound showing severe systolic heart failure
Congestive heart failure with small bilateral effusions
Kerley B lines

This most commonly results from a concurrent illness (such as myocardial infarction (a heart attack) or pneumonia), abnormal heart rhythms, uncontrolled hypertension, or a person's failure to maintain a fluid restriction, diet, or medication.