2. Kamlya balgoon 2009

3. Ventricular Rhythms General characteristics  Wide QRS.  NO P wave  Mostly very fast  Could be Lethal kemo 2009

4. Ventricular Rhythms  Premature Ventricular Contraction ( PVC )  Ventricular Tachycardia  ventricular Fibrillation ( V-tach.)  No electrical Activity ( Asystole ) kemo 2009

5. 1- Premature Ventricular Contraction ( PVC ) It impulse start ventricle before next normal sinus impulse Premature = comes early with bizarre shape. Most of the time accompany sinus rhythm. PVCs ( early, wide and bizarre) kemo 2009

6. PVCs … continued Multifocal ( different shape ) kemo 2009

7. Premature Ventricular Contraction ( PVC ) Unifocal kemo 2009

8. PVCs … continued 3- Couplets,tow in arow pair Couplets kemo 2009

9. PVCs … continued 4- Bigeminy every other beat is PVC kemo 2009

10. PVCs … continued 5- Trigeminy every third complex is PVC kemo 2009

11. Premature Ventricular Contraction ( PVC ) Ventricle & a trial rate : depend on rhythm Ventricle & a trial rhythm : irregular due to early QRS creating PR interval is shorter QRS shape & duration : duration 0.12 second or more. Bizarre, abnormal shape P wave shape : visibility p wave depend time of PVC may absent or in front QRS P-R interval : less than 0,12 second Each P followed by a QRS P: QRS ratio : 0 :1, 1 :1 kemo 2009

12. 2- Ventricular Tachycardia ( V-tach.)  It three or more PVC in arow  A whole strip with PVCs.  No P waves.  If there is no pulse, it is lethal  Always check the Pulse and BP kemo 2009

13. Ventricular Tachycardia ( V-tach.) Ventricle & a trial rate : ventricle rate 100 – 200beats /m QRS shape & duration : duration 0.12 second or more. P wave shape : very difficult to detect P-R interval : very irregular if see p wave Each P followed by a QRS P: QRS ratio : more QRS then p wave kemo 2009

14. Ventricular Tachycardia ( V-tach.) Treatment  lidocaine  Synchronized cardioversion kemo 2009

15. 3- ventricular Fibrillation No P waves, No QRS, only electrical activity present. Lethal, always check Pulse and BP kemo 2009

16. ventricular Fibrillation  Ventricle rate ; greater than 300 per mint  Ventricle rhythm : irregular  QRS shape & duration irregular kemo 2009

17. No electrical Activity ( Asystole ) No QRS, no electrical activity, P waves may present. No heart rate,pulse kemo 2009