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Aritmia
Gangguan irama jantung berupa segala jenis irama jantung selain IRAMA SINUS
Supraventrikular
QRS sempit seperti normal (kecuali beberapa hal: BBB, WPW,aberans)
Ventrikular
QRS lebar > 0,12 dt
Symptoms
Palpitations: nontachycardiac; rapid and regular; rapid and irregular (regularly irregular or irregularly irregular). Abrupt or accelerating onset and termination? Dyspnea
Chest discomfort
Syncope; nearly blacked out; syncope with spell Polyuria Cardiac arrest
Signs
Heart rate and pulses: regularity; amplitude; deficit Hypotension Hypoperfusion
TACHYCARDIA
V Tach
V Fibrillation
Aritmia Supraventrikular
Takikardi aritmia
SVT
Wolff-Parkinson-White syndrome
Aritmia Ventrikular
Takikardi aritmia
Ventrikel Takikardi N
100-250 x/mnt
Ventrikel Fibrilasi N
> 350 x/mnt
VENTRICULAR RHYTHMS
VES
Gambar A menunjukkan sinus takikardi dengan frequent uniform PVC dan B menunjukkan sinus takikardi dengan multiform PVC.
Torsade de pointes
Non-pharmacological
Surgical arrhythmias Catheter ablation Device : AICD
Assess rhythm
Check pulse +/VT/VF Attempt Defibrilation X3 Non-VT/VF
CPR 1 minute
VT/VF refractory to initial shock: epinephrine 1 mg iv every 3-5 minutes Consider buffers, pacing, antiarrhythmics Search for and correct reversible causes
CPR up to 3 minute
First-degree AV block Rhythm : Regular Rate : Usually normal P wave : Sinus P wave present; one P wave to each QRS PR : Prolonged ( greater than 0.20 seconds ) QRS : Normal
Second -degree AV block, Mobitz I Rhythm : Irregular Rate : Usually slow but can be normal P wave : Sinus P wave present; some not followed by QRS complexes PR : Progressively lengthens QRS : Normal
Second-degree AV block, Mobitz II Rhythm : Regular usually; can be irreguler if conduction ratios vary Rate : Usually slow P wave : Two, three, or four P waves before each QRS PR : PR interval of beat with QRS is constant; PR interval may be normal or prolonged QRS : Normal if block in His bundle; wide if block involves bundle branches
Third-degree AV block
Rhythm : Regular Rate : 40 60 if block in His bundle; 30 40 if block involves bundle branches P wave : Sinus P wave present; bear no relationship to QRS; can be found hidden in QRS complexes and T waves PR : Varies greatly QRS : Normal if block in His bundle; wide if block involves bundle branches
RBBB
0.04
LBBB
Gambaran asistol
BRADYCARDIA
Serious signs and symptoms? Due to bradycardia?
Atropine 0.5-1.0 mg
Transcutaneous pacing Dopamine 5-20 g/kg/min Epinephrine 2-10 g/min
Yes
No
VF VT VF
PEA
(Pulse less Electrical Activity)
Asystole
TH A N K YO U
VES
SVT
VES R on T
VT
VF