Nursing Central: Ventricular Dysrhythmias

Ventricular Dysrhythmias

INTRODUCTION

DRG Category: 308

Mean LOS: 3.8 days

Description MEDICAL: Cardiac Arrhythmia and Conduction Disorders with CC

classification section:

A ventricular dysrhythmia is a disturbance in the normal rhythm of the electrical activity of the heart that arises in the ventricles (

). Types of ventricular dysrhythmias include premature ventricular contractions (PVCs), which can have one focus or can arise from multiple foci; ventricular tachycardia (VT), which can lead to ventricular fibrillation or sudden cardiac death; ventricular fibrillation (VF), which results in death if not treated immediately; and ventricular asystole (cardiac standstill), in which no cardiac output occurs and full cardiopulmonary arrest results (Table 1).

Types of Ventricular Dysrhythmias

TYPE	DESCRIPTION	CAUSE
• Premature ventricular contractions (PVCs)	• Early ectopic beats that arise from the ventricles • Atrial rate: Regular • Ventricular rate: Irregular • QRS complex; wide and distorted, usually longer than 0.14 sec • Occurrence: Singly, in pairs, or alternating with regular sinus beats	• Heart failure • Myocardial infarction • Cardiac trauma • Myocardial irritation from pacemaker or pulmonary artery catheter insertion • Hypercapnia, hypokalemia, or hypocalcemia • Medication toxicity (digitalis, aminophylline, tricyclic antidepressants, beta-adrenergic stimulants) • Caffeine, tobacco, or alcohol use; physiological and psychological stress
• Ventricular tachycardia (VT) • • •	• Three or more premature ventricular contractions in a row dissociated from the atrial contraction • P waves: In sustained ventricular tachycardia, none are identifiable; usually buried within aberrant, bizarre ventricular contractions • Ventricular rate: Usually 100–220 beats per minute • Ventricular rhythm: May start and stop suddenly	• Myocardial ischemia • Myocardial infarction • Rheumatic heart disease • Mitral valve prolapse • Heart failure • Cardiomyopathy • Electrolyte imbalances such as hypokalemia, hypomagnesemia, and hypercalcemia • Medication toxicities: Digitalis, procainamide, epinephrine, or quinidine
• Ventricular fibrillation (VF)	• Disorganized, ineffective contraction of the ventricle • P waves: None • QRS complex: None • Ventricular rhythm: Chaotic rhythm with a wavy baseline	• Medication toxicities: Digitalis, procainamide, epinephrine, or quinidine
• Ventricular asystole (cardiac standstill)	• Atrial rhythm: None • P, QRS, T waves: None • Ventricular rhythm: None	• Myocardial ischemia • Myocardial infarction • Valvular disease • Severe heart failure pH and electrolyte imbalances (severe acidosis, hypokalemia, or hyperkalemia in particular) • Electric shock • Pulmonary embolism • Cardiac rupture • Cardiac tamponade • Cocaine overdose

FIGURE.

Ventricular Dysrhythmias has been found in Diseases and Disorders

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