Arrhythmia Classification

Arrhythmia Classification

Four methods:

1:  Site of impulse formation–sinus rhythm, atrial rhythms, junctional rhythms.
2:  Mechanism–tachy, brady, premature contractions.
3:  Conduction disorder–LBBB, RBBB, complete AV block.
4:  Seriousness or prognosis–minor, major, fatal.

(1) Minor–S tachy, S brady, PAC’s, PNC’s,  PAC (<6 / min.)

(2) Major–A fib, 1°, 2 °,3° block, PAC, PNC, PVC (>6/min.)

(3) Fatal–V fib, asystole.

Atrial Arrhythmia’s

1:  Supraventricular arrhythmia’s–arrhythmias whose impulse site is above the ventricles (atrial muscle or AV node).

2:  Premature atrial contractions (PAC or APC) –premature and characterized by presence of P wave before QRS.

3:  Paroxysmal atrial tachycardia (PAT) –runs of rapidly repeated premature atrial contractions–sudden onset; sudden stop; rate 50-150.

4:  Atrial flutter–main difference between PAT and atrial tachy is rate and duration rate (atrial ) 300-320.  Physiologic block at AV node doesn’t allow all atrial impulses through,

so ventricular rate may be in a ratio of 2:1 to 8:1 ( if 4:1 block, atrial rate 320, ventricular rate 80)–sawtooth baseline pattern.

5:   Atrial fibrillation–irregularily irregular, undulating baseline with variable ventricular response.  Lose atrial “kick” and embolization are problems.  Atrial rate 350-500.