1- Premature atrial:
– The premature born prematurely, the P wave is different morphology of the wave normal P;
– The following QRS complex is fine, except in case of branch block (organic or functional) or and preexcitation.
– ESA is followed by compensatory rest
– Sometimes when ESA occurs very early, it is blocked at the NAV that is still refractory period
2- Ventricular extrasystoles:
– They are not preceded by a P wave; they distort the QRS longer. Repolarization is reversed with a large negative T wave. Sometimes retrograde P wave.
– The ESV may arise either VD (with appearance left behind like a right bundle branch block) and vice versa.
– Severity criteria: polymorphism; coupling (ESV falling on top of T -> phenomenon R / T); Repeat (group 2, 3 …)
– Tachycardia burst is the existence of three or more successive ESV -> severity criterion.
– When ESV consistently follows a sinus complex is called bigeminy.
3- junctional tachycardia:
– Bouveret disease: palpitation at the beginning and end abruptly and polyuria crisis waning of palpitation.
– The breakthrough comes from the extrasystole and tachycardia that often interrupts another premature beat.
– Nodal reentry tachycardia or WPW syndrome.
– The treatment of the crisis is through vagal maneuvers (Valsalva maneuver). If ATP is used (Striadyne) or a calcium antagonist.
– Maintenance treatment: (if recurrent or disabling TJ); calcium channel blockers, beta-blockers or AA class Ic (if there is an accessory pathway).
4- Ventricular tachycardia:
– This is a wide complex tachycardia, defined by the succession of 3 ESV or more in the frequency is> 100 / min.
– There are three criteria to affirm the original ventricular tachycardia: capture complex fusion complex, atrioventricular dissociation.
– In case of poorly tolerated TV, the only treatment is the EEC
– If the TV is well tolerated and / or asymptomatic we can try a drug Cordarone cardioversion or lidocaine.
– Maintenance treatment: amiodarone, beta blockers (especially MI); the combination of both is often effective.
5- advanced Twist:
– Matches a macro-reentry interest to both ventricles, each time with a different point of emergence. Their initiation is done during an ESV while repolarization expanded with a prolonged QT interval.
– ECG the appearance is that of a sawtooth have rotated around its axis.
– Causes: Metabolic (hyponatremia, hypocalcemia) have drug (bradycardia therapy, AA class Ia); Long QT
– The main complication is the transformation into ventricular fibrillation
– TDP Access is treated with magnesium IV injection, the correction of hypokalaemia or accelerating the pace (isoprenaline or training electrosystolic probe).
– Treatment of recurrence: involves the standardization of a metabolic disorder, the elimination of an overload quinidine
