Extrasystole and blocks

Содержание

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Экстрасистолия

– a prematurely occurring beat of one of the chambers of the

Экстрасистолия – a prematurely occurring beat of one of the chambers of
heart that leads to momentary arrhythmia but leaves the fundamental rhythm unchanged

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Extrasystole is a special case of ectopic beats.
Ectopic beat is myocardial excitation

Extrasystole is a special case of ectopic beats. Ectopic beat is myocardial
of non-sinus origin.
Premature ectopic beat - extrasystole (active rhythm disturbances)
Late ectopic beat is a replacement complex that saves from asystole – escape beat (passive)

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400 мс

Atrial escape beat

Ventricular extrasystole

600 мс

400 мс Atrial escape beat Ventricular extrasystole 600 мс

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Supraventricular ES

Supraventricular ES

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Ventricular ES

300 мс

680 мс

Ventricular ES 300 мс 680 мс

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Compesatory pause

Preectopic interval

CP in SVES < 2RR CP in VES ≥

Compesatory pause Preectopic interval CP in SVES 1550 мс 1550 мс Postectopic
2RR

1550 мс

1550 мс

Postectopic interval

QRS< 100 ms, narrow

QRS > 120 ms, wide

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Ventricular ES

Classification (reference criteria):
The form
A source
Time of appearance
Amount
Allorhythmy
Prognostic value (clinical)

Ventricular ES Classification (reference criteria): The form A source Time of appearance

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The form (morphology)

The form (morphology)

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Time of appearance

Time of appearance

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Amount:
-single
paired

Amount: -single paired

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Allorhythmias

Bigeminy
trigeminy

Allorhythmias Bigeminy trigeminy

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Heart block

3 курс

Heart block 3 курс

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Heart blocks

Classification:
By localization:
Sinoatrial block
Intra and inter atrial
Atrioventricular block:
proximal (AVN)
distal (His Bundle)
Bundle

Heart blocks Classification: By localization: Sinoatrial block Intra and inter atrial Atrioventricular
branch block
By duration: transitory and permanent
By origin: Structural and autonomic

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Sinus node exit block occurs when the action potential initiated by the

Sinus node exit block occurs when the action potential initiated by the
sinoatrial node is suppressed or completely blocked before it leaves the SN and reaches the atrium - therefore, the SN block is an exit block

SN exit block

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SN exit blocks (SNEB)

SN exit blocks (SNEB)

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Замещающий АВ комплекс

Замещающий АВ комплекс

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AV blockade

Proximal, nodular (benign).
Distal, bundle (irreversible).
1. Transient (usually nodular): lower AMI, myocarditis,

AV blockade Proximal, nodular (benign). Distal, bundle (irreversible). 1. Transient (usually nodular):
drugs, hyper K+.
2. Persistent (often bundle): anterior AMI, idiopathic fibrosis.
Functional (usually nodal and up to II degree type 1) - vagotonic, in athletes.
Structural (AMI, myocarditis, cardiomyopathy).

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AV block I degree

AV block I degree

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AV block II degree 1 type

AV block II degree 1 type

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200 мс

AV block II degree 2 type

200 мс AV block II degree 2 type

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AV block II degree 2:1

1

2

AV block II degree 2:1 1 2

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AB block III degree (complete)

AB block III degree (complete)

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His bundle branch block

RHBBB

Sign of block: deformity of QRS
Completeness attribute: QRS width

His bundle branch block RHBBB Sign of block: deformity of QRS Completeness
>120 ms

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Causes of RBBB

Congenital heart disease
Coronary arteryt disease
PE
COPD
Pulmonary hypertension
Cardiomyopathies
Degenerative damage to the cardiac

Causes of RBBB Congenital heart disease Coronary arteryt disease PE COPD Pulmonary
conduction system (with aging)
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