Ventricular Tachycardia

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Ventricular Tachycardia An dysrhythmia of the heart is an irregular heartbeat rhythm. Ventricular tachycardia is an dysrhythmia in which the lower chambers of the heart, the ventricles, beat unusually fast. The heart rate is measured with an electrocardiogram, or ECG. This is a machine that measures the electrical impulses from the patient's heart. This is displayed on a monitor or ECG graph paper. The boxes on the graph paper measure time. Five small boxes are equal to one large box. The large box represents two-tenths of a second. The atrial contraction is represented by the P wave. This is an upward, or positive wave of the line on the graph. The ventricular contraction is displayed by the QRS complex. The QRS complex is composed of three waves, the Q, R, and S waves. The Q wave is the first downward, or negative movement on the graph. The R wave is the positive movement following the Q wave. It rises above the starting point of the Q wave. The S wave is a negative movement following the R wave. The S wave returns the line to the original baseline. The T wave, the repolarization of the ventricle, is a positive wave of the line that ends one beat of the heart. The atrial repolarization is not represented on the graph. It is absorbed by the QRS complex, which is a stronger impulse. In a normal heart beat, there is one P wave for every QRS complex and T wave. The QRS complex is no larger than three small boxes on the graph paper. Every beat comes at the same interval as the other beats. During ventricular tachycardia, the P wave is not represented. The QRS complex is wide. The T wave is not present on the graph. The intervals between beats can be up to five times shorter than a normal rhyth... ... middle of paper ... .... When lidocaine and bretylium both fail to produce positive results, magnesium sulfate can be used. Magnesium sulfate is an antidysrhythmic, meaning that it establishes a normal heart rhythm. Magnesium sulfate can also cause hypotension, bradycardia, and circulatory collapse among other side effects. It is a last resort drug for ventricular tachycardia. Other medications, however, are indicated for an unusual form of ventricular tachycardia called Torsade de Pointes. Torsade de Pointes is the irregular rhythm of ventricular tachycardia, but it occurs in a pattern of small series of waves that increase to a greater magnitude, and then back in a repeating pattern. For Torsade de Pointes, the drug of choice is magnesium sulfate. It should be administered at a rate of one to two grams in one hundred milliliters of normal saline over one to two minutes.

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