Afib, Vtach, VFIB
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RebekahAfib, Vtach, VFIB
Uploaded by
RebekahAfib, Vtach, VFIB
Wednesday 18 September 2024 18:58
A Fib
• Contraction of atria is uncontrolled, rapid, irregular
• Absent p waves, narrow QRS
• Disorganised electrical activity that leads to irregular
conduction of electrical impulses to ventricles
○ Leads to
§ Irregularly irregular contractions
§ Tachycardia
§ HF due to poor filing of ventricles
§ Inc risk of stroke (tendency for blood to pool in
atria & form blood clots)
• Usually ASx but can present with palpitations, SOB, syncope
Irregularly irregular pulse can also be ventricular ectopic -
disappear when HR goes over a certain threshold (i.e. during
exercise)
Types of A Fib
• Valvular vs non valvular
○ Valvular - patients also had moderate/severe mitral
stenosis/mechanical heart valve
○ Non valvular - without valve pathology or with other
valve pathology (like mitral regur or aortic stenosis)
Most common causes
• SMITH
○ Sepsis, mitral valve pathology, ischaemia heart
disease, thyrotoxicosis, HTN
Treatment
• Rate & rhythm control NICE guidelines/ ZTF book
• Rate control
○ Beta blocker, calcium channel locker, digoxin
• Rhythm control
○ Cardioversion
• Rate control
○ Beta blocker, calcium channel locker, digoxin
• Rhythm control
○ Cardioversion
§ Can use amiodarone & flecainide or electrical
• Anticoagulation
VTACH
• Fast, regular heart rhythm originating from ventricles, usually >100 BPM
• Causes: ischaemic HD, electrolyte imbalances, HF, scar tissue post MI
• ECG
○ Wide QRS, regular
• Complications
○ Can lead to ventricular fibrillation & sudden cardiac death
• Treatment
○ Anti-arrthymatic (amiodarone), cardioversion, defib in unstable cases
VFIB
• Chaotic, disorganised electrical activity in the ventricles, leading to no
effective CO
• Causes: MI, electrolyte disturbances, severe heart disease
• ECG
○ Irregular, erratic waveforms
○ No P waves or QRS
• Complications
○ Cardiac arrest
• Causes: MI, electrolyte disturbances, severe heart disease
• ECG
○ Irregular, erratic waveforms
○ No P waves or QRS
• Complications
○ Cardiac arrest
○ Immediate death if untreated
• Treatment
○ Immediate defib, followed by CPR & addressing underlying cause