Ventricular ectopics
Last modified: 20 March 2022, 12:38:50 PM AEDT
Classification1 / 8
- unifocal / multifocal
- may occur in runs
- bigeminy, trigeminy, quadrigeminy
Epidemiology2 / 8
- Overview
- very common = 50% in 24 hour Holter monitors
- Incidence
- Prevalence
- Gender
Prognosis3 / 8
- isolated unifocal PVC do not represent any additional risk
- ⬆mortality = with IHD, VHD, CM
Aetiology / Causes / Risk Factors4 / 8
- normal variant
- anaesthesia
- standard arrhythmia causes
Pathophysiology5 / 8
- contraction from ectopic focus in VENTRICLE
Investigations6 / 8
- ECG
- wide QRS with abnormal (different) morphology to usual QRS
- pause after ectopic due to refractory period
Management7 / 8
- treat if
- haemodynamic disturbance
- associated with structural abnormality
- frequent = 5/min
- multifocal / polymorphic
- close to preceding T wave (risk of VF/VT)
- during vulnerable part of cardiac cycle = top of T wave = R on T phenomenon
- treat cause
- especially reversible = ⬇O2, ⬇pH, ⬇K, ⬇Mg, ischaemia
- anti-arrhythmics
- do not use drugs that cause DEVOLUTION to VT
- lidocaine
- amiodarone
Anaesthetic considerations8 / 8
- Pre-op
- Intra-op
- Post-op