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Cardioverxion the presence of AV dissociation, one may also observe fusion beats which may result from the fusion of a P wave conducted to the ventricles.

QRS relativamente estrecho 0. In panel B the frontal QRS axis is further leftward a so called north-west axis. The purpose of this study was to further simplify the algorithm by omitting the complicated morphologic criteria and restricting the analysis to lead aVR.

cardioversion electrica sincronizada pdf creator

Sobre el proyecto SlidePlayer Condiciones de uso. Los botones se encuentran debajo. Idiopathic outflow tract tachycardias are usually exertion or stress related arrhythmias.

Figure 13 shows three patterns of idiopathic VT arising in or close to the outflow tract of slncronizada right ventricle.


Symptoms are primarily due to the elevated heart rate, associated heart disease, and the presence of left ventricular dysfunction [4,6,7]. The QRS complexes are not preceded by P waves. Al mismo tiempo, perfusion: When the rate is approximately beats per minute, atrial flutter with aberrant conduction should be considered, although this diagnosis should not be accepted without other supporting evidence.

As shown in fig 7, a VT origin in the apical part of the ventricle has a superior axis to the left of Patients are instructed to carry identification cards providing information about such devices, which can facilitate device interrogation. These notches might be P waves, or part of the QRS complexes themselves. During tachycardia the QRS is more narrow.


The origin of this QRS rhythm cardiovwrsion be known with certainty, and may be supraventricular with intraventricular aberration, junctional, or ventricular. Alta probabilidad de TV Solo puede explicarse: Unstable — This term refers to a patient with evidence of hemodynamic compromise, but who remains awake with a discernible pulse. If all precordial leads are predominantly positive, the differential diagnosis is an antidromic tachycardia using a left sided accessory eelctrica or a VT.

Puede existir y no ser obvia en ECG. The following findings are helpful in establishing the presence of Sincromizada dissociation. IM anteroseptal Miocardiopatia dilatada idiop.

The first criterion is the presence of a positive and dominant R wave in lead aVR, and the second is based on the vi: It is important in the differential diagnosis of various entities, in particular mild or subclinical forms of arrhythmogenic right ventricular cardiomyopathy. The QRS complex will be smaller when the VT has its origin in or close to the interventricular septum.


The most common type is shown in panel A. The left panel shows a VT arising in the apical area of the cardiovrsion ventricle resulting in negative concordancy of all precordial leads.

Desencadenadas con esfuerzo Bien toleradas. When in doubt, do not give verapamil or adenosine; procainamide should be used instead.

Left panel VT; right panel same patient during sinus rhythm. While the presence of AV dissociation largely establishes VT as the diagnosis, its absence is not as helpful for two reasons: The least common idiopathic left VT is the one shown in panel C.

Three types of idiopathic VT arising in or close to the outflow tract of the right elfctrica see text.

Fusion beats and capture beats are more commonly seen when the tachycardia rate is slower. Idiopathic outflow tract tachycardias are usually well tolerated, probably because of the preserved ventricular function. That area is difficult to reach by retrograde left ventricular catheterisation and when catheter ablation is considered an atrial transseptal catheterisation should be favoured.


The resulting QRS complex has a morphology intermediate between that of a sinus beat and a purely ventricular complex show ECG 9. One to one ventriculo-atrial conduction during VT. Figure 12 gives an example of QR complexes during VT in patients with an anterior panel A and an old inferior myocardial infarction panel B.

Muesca en descenso inicial del QRS neg.

cardioversion electrica sincronizada pdf creator

Give me the paddles! The prognosis is generally good, but these patients may be highly symptomatic. Ventricular bigeminy is present, likely originating from the same focus as the tachycardia. In the right panel ventricular activation starts in the left posterior area, resulting in positive concordancy of all precordial leads.

Sudden narrowing of a QRS complex during VT may also be the result of a premature ventricular depolarisation arising in the ventricle in which the tachycardia originates, or it may occur when retrograde conduction during VT produces a ventricular echo beat leading to fusion with the VT QRS complex.

Duration of the tachycardia — SVT is more likely if the tachycardia has recurred over a period of more than three years [6].

The insertion of the cardjoversion pathway in the free wall of the right ventricle results in sequential right to left ventricular activation and a wide QRS complex.