1. ARRHYTHMIA

2. Disturbance of cardiac rythumn

4. Anatomy of the conducting system

5. Arrhythmias Common Often benign Often intermittent causing diagnostic difficulty Sometimes can cause cardiac compromise

6. Cause of Arrhythmia Cardiac -MI,valvular heart disease,myocarditis,pericarditis, endocarditis Non cardiac- thyrotoxicosis,drugs,electrolyte imbalance

7. Features Often asymptomatic ex-AF Palpitation Syncope Hypotension cardiac faliure

8. classification Tachyarrythmias Bradyarrythmiass

10. Bradyarrythmias Sinus Bradycardia Heart block Sick sinus syndrome

11. Sinus bradycardia HR< 60 bpm Hypothyroidism Increased intracranial pressure Myocardial infarction Jaundice Athletes

13. Heart block 3 types The depolarization wave originating in the atrium is not conducted to the ventricle

14. Tachycardias Sinus tachycardia Atrial tachycardia-SVT/atrial flutter/atrial fibrillation Ventricular-VT/VF

15. Sinus tacycardias HR > 100bpm Anxiety Hyperthyroidism Myocardial infarction Heart failure

17. SINUS TACHYCARDIA Excessive discharge of SA node

18. Atrial tachyardia Cardiac rhythm originates from a site within the atrium other than the SA node Ex-AV node Types-SVT,Atrial flutter,atrial fibrillation

19. Atrial fibrillation Irregular atrial rhythm giving rise to an irregular ventricular rate Common in elderly Main risk is embolic stroke

21. causes Hypertension Heart failure Valvular heart disease MI Pneumonia hyperthyroidism

22. Treatment Find the cause and eliminate if possible Antiarrythmic drugs-rate control or rhythm control Anticoagulation cardioversion

23. Ventricuar VT VF

25. VF And pulseless VT are considered as forms of cardiac arrest Medical emergency Needs CPR

26. Ectopics What are atrial ectopics What are ventricular ectopics

27. Treatment of arrythmias Anti arrythmic drugs Name one drug used to treat bradyarrythmias Name 3 drugs used to treat tachyarrythmias

28. Non-drug therapy Cardioversion: For tachycardia especially hemodynamic unstable patient Radiofrequency catheter ablation (RFCA): For those tachycardia patients (SVT, VT, AF,) Artificial cardiac pacing: For bradycardia,

29. Thank you….