Ventricular Fibrillation

This case study discusses the management of a 68 year old male who presented with chest palpitations secondary to rapid atrial fibrillation. Atrial fibrillation is a common cardiac arrhythmia with serious complications if not treated correctly. This essay will discuss the initial clinical presentation of the patient and examine the management and outcome of the interventions applied. The significance of atrial fibrillation including its pathophysiology and aetiology will also be discussed.

Patients who are suffering from cardiac arrests and neurologic outcomes have a high chance of needing cardiopulmonary resuscitation. Efficient use of both hands-only CPR versus breathing and hand use CPR may improve their survival chances and boost their neurologic outcomes when they undergo any form of an attack. The hands-only CPR versus breathing and hand use CPR training programs assist nurses, and the public on the treatment criteria to efficiently handle patients with cardiac arrests emergencies, resulting in an increase of the cardiac arrests survival rates for many patients across the world (Lamboy & Donohue, 2015).

What most distinguishes the role of the RN working in the context of a Cardiac specialty unit is the need for constant monitoring and rapid response. Where cardiac patients are concerned, the reduction of mortality will hinge largely on healthcare team response time and efficiency there within. According to National Institutes of Health (NIH), ""it is recognized that intensive observation, and immediate recognition of the patient's needs are essential. Institution of appropriate life-saving therapy must be done within an extremely short space of time." (NIH, p. 228) This informs the role of the RN as one of constant readiness and recognition. According to the NIH, this denotes that in most Cardiac Care contexts, the Registered Nurse will be expected to be versed and practiced in the performance of these life-saving techniques. Further, the NIH guidelines denote that the RN must be aware of the procedural and regulatory conditions by which they may administer said techniques, whether through the permission of a doctor or on the basis of standing procedural orders. In most instances, due to the time-sensitive nature of the administration of cardiac treatment, the latter prompting will apply.

Atrial fibrillation (AF) is the most common type of heart dysrhythmia which causes the irregular beating of the two atria in the heart. The cause of AF is multiple atrial ectopic foci firing randomly and chaotically. Atria rhythm can be completely disorganized at a rate of 350 to 600 times per minute by the multiple rapid impulses from numerous atrial foci, so the atria are in a quiver status; the ventricles beat with a rapid rate due to the rapid atrial impulses (Ignatavicius and Workman, 2013). The ventricular contraction rhythm can be 120 to 200 beats per minute. The ECG result shows a chaotic rhythm, no P waves, no atrial contractions, no atrial kick and irregular ventricular contractions. The rapid, irregular ventricular rate decreases

There are two common types of ectopic heartbeats, PVC -Premature ventricular contractions and PAC -Premature atrial contractions. First one, PVC can be found in both healthy and diseased hearts. “PVC is a premature beat (in the ventricle) that occurs earlier than the next expected beat. The normal (sometimes the P wave is not the same shape as other P waves) and these can be hard to pick out of a normal ECG. The identifying feature: The R-R interval between the PAC and the preceding beat is shorter than any of the other R-R intervals”

heart attacks, and strokes. Sometimes the heart beats so fast that it actually stops. Emergency

Project goal: Promotion of the cardiac chain of survival which includes early recognition and initiation of CPR and the delivery of an electrical shock to the heart within 3-5 minutes.

Without early intervention on average 360,000 people out of the hospital succumb to cardiac arrest. “ Cardiac arrest and sudden death account for 60 percent of all deaths from coronary artery disease”,(Bledsoe, Porter, & Cherry, 2011,2007,2004, p. 1229) [Click and drag to move] There are several causes of sudden cardiac arrest. Most are caused by ventricular fibrillation. “During ventricular fibrillation, the ventricles do not beat normally. Instead they quiver rapidly and irregularly.” When this occurs, the heart pumps very little and blood does not get circulated throughout the body. “ Most of the cases found with sudden cardiac death are related to undetected cardiovascular disease.("Sudden Cardiac Death," 2015, para. 2)Sudden cardiac arrest are immediate and drastic that includes sudden collapse, no pulse, not breathing, and loss of consciousness. “Four rhythms produce pulseless cardiac arrest: ventricular fibrillation, rapid ventricular tachycardia, pulseless electrical activity and asystole.”("Circulation ," 2005, p. IV-58)Other signs and symptoms that could occur prior to sudden cardiac arrest, include fatigue, fainting, blackouts, dizziness,

We recount a case in which the de Winter ECG pattern is identified immediately following ventricular fibrillation cardiac arrest. With non-specific ST changes on the initial ECG at presentation (Figure 1), and subsequently a transient complete normalization of these changes (Figure 2), the patient developed ventricular fibrillation requiring electrical defibrillation.

Electrocardiogram, ECG, is a test that measures the electrical activity of the heartbeat. Electrical impulse travels through the heart, with each beat, causing the heart muscle to squeeze and pump blood from the heart. These impulses can be measured and record through ten electrodes that attached to the chest, arms, and legs. There are six ECG segments/intervals that can relate directly to phases of cardiac conduction. The first is the PR interval, which represents the time the impulse takes to reach the ventricles from the SA node. The second is the PR segment, which represents the duration of the conduction from the AV Node to the bundle of His and to the bundle branches. The third is the QRS complex, which is the duration of ventricular

If a pulse cannot be felt, the patient is unresponsive, and respirations are absent or agonal then that patient might be undergoing cardiac arrest. The proper arrest algorithms for this situation is:

When a person suddenly goes into cardiac arrest, first responders need to start chest compressions right away in an attempt to keep the person alive.

Arrhythmias are categorized based on whether they affect the atria (two top chambers) or ventricles (two bottom chambers), and whether they quicken or slow the patient's heartbeat. These circumstances occur due to a disruption in the heart's electrical system. Normally, electrical impulses spread across the chambers in a uniform pattern, causing them to contract. Each impulse generates a single heartbeat. An arrhythmia interrupts these impulses, causing a change in the heart's rhythm.

Approximately 10% to 30% of patients with atrial flibrillation (AF) do not present structural heart disease or have a comorbidity such as hypertension. Atrial fibrillation is the most frequent arrhythmia in daily practice that occurs under diverse situations and its treatment should be based on the different scenarios of presentation. Severe population-based studies have found that AF is associated with greater morbidity and mortality and worse quality of life. It is the leading cause of arrhythmia-related hospitalizations with an important impact on medical costs.

I mistakenly listed a symptom of heart disease. An actual heart condition is cardiac arrest. This is a sudden loss of blood flow to the heart causing the heart to suddenly stop. When this occurs blood stops flowing to the brain and vital organs this condition can be very fatal if heart beat is not immediately restored to proper function. Some symptoms may include: sudden collapse, no pulse, loss of consciousness. A commonly give test for Sudden cardiac arrest is an electrocardiogram (ECG) this will help discover electrical activity of the heart. Treatment for this condition may include (CPR) cardiopulmonary resuscitation this procedure is done by compressing the chest which can help force air into the lungs, this may help an individual until