Ectopy
Premature impulse arising from cardiac conduction tissue:
- Atria
- AV junction
- His-Purkinje system
- Ventricle
- No preceding P-wave
- Wide-complex
- T-wave opposite polarity to QRS
- Compensatory pause
Temporary AV-dissociation leading to delay before the next conducted sinus beat. Absence of a pause is an interpolated ectopic, and occurs when the sinus rate is slow. - Also includes ventricular bigeminy or trigeminy
An ectopic, followed by one (or two) sinus beats.
Epidemiology and Risk Factors
Pathophysiology
Aetiology
Clinical Manifestations
Diagnostic Approach and DDx
Investigations
Management
Ventricular ectopics:
- Electrolyte correction
- K+ >4.5mmol/L
- Mg2+ >1mmol/L
Resuscitation:
Specific therapy:
- Pharmacological
- Physical
- Procedural
Supportive care:
Disposition:
Marginal and Ineffective Therapies
Ventricular ectopics:
- Antiarrythmic therapy ↑ mortality
Anaesthetic Considerations
Complications
Prognosis
Ventricular ectopics:
- Not associated with adverse outcome if asymptomatic unless:
- Exercise induced
- Occurring with acute MI
Precede VF or VT.
Key Studies
References
- Bersten, A. D., & Handy, J. M. (2018). Oh’s Intensive Care Manual. Elsevier Gezondheidszorg.