Preclinical Classification of Arrhythmias
An exact differentiation of the individual rhythm disorder is often not possible and not necessary in emergency therapy and preclinical therapy in a hurry. According to the recommendations of the AHA and the ERC, all cardiac arrhythmias can be divided into three rhythm categories that are groundbreaking for therapy.
- "Bradycardia
- Frequency less than 60/min.
- "Tachycardia with slim chamber complex
- Heart rate greater than 100/min * QRS width up to 0.10 sec
- Tachycardia with a broad ventricle complex
- Heart rate greater than 100/min * QRS width greater than 0.10 sec
A tachycardia with a broad ventricular complex is a ventricular tachycardia until proven otherwise. (Statistically, 80% of all tachycardias with a broad chamber complex have a VT. If there is a heart disease, the percentage is 95%).
The chamber complexes are wider than 100ms and the frequency is usually between 120 and 270 rpm. The QRS configuration is usually constant, which makes it easier to distinguish it from the Torsade de Pointes tachycardia.
With the addition of the present symptoms and the heart rate, the classification into an unstable or stable rhythm disorder also takes place, which essentially describes the hemodynamic impairment and in the case of an unstable rhythm disorder refers to the necessity of an electrical therapy (pacemaker for bradycardic heart rhythm disorders, cardioversion for tachycardic heart rhythm disorders).
- "Bradycardia
Unstable: Frequency less than 40/min.
Asystole in prehistory
AV Block II, Mobitz II
complete AV dissociation with wide chamber complex
cardiac insufficiency signs
Blood pressure syst. below 90 mmHg
Occurrence of ventricular rhythm disturbances (e.g. Torsade de Pointes)
Stabil: alle nicht instabilen Formen
- Tachykardie mit schlankem Kammerkomplex
Instabil: Herzfrequenz über 200/min. (ERC) bzw. über 180/min. (AHA)
Blutdruck syst. unter 90 mmHg
Angina pectoris
Herzinsuffizienzsymptome
Bewußtseinsstörung
Stabil: Alle nicht instabilen Formen
- Tachykardie mit breitem Kammerkomplex
Instabil: Herzfrequenz über 150/min. (ERC und AHA)
Blutdruck syst. unter 90 mmHg
Angina pectoris
Herzinsuffizienzsymptome
Bewußtseinsstörung
Stabil: Alle nicht instabilen Formen