Hemodynamics during Arrhythmias

Morton J. Kern, Thomas J. Donohue, Richard G. Bach

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Cardiac pressure waveforms are determined by the underlying cardiac rhythm. This chapter considers the right-heart hemodynamics with attention to the cardiac rhythm. It provides an example of how reliance on pressure waves of the pulmonary capillary wedge alone may be confusing, resulting in a misinterpretation of the cardiac events. Various arrhythmias can produce distorted pressure waveforms, which may be confused with benign physiologic events. The most commonly observed cardiac arrhythmia is a premature ventricular contraction (PVC). PVCs are often characterized by compensatory pauses and distorted QRS complexes. However, the QRS complex may not be easily distinguishable from a normal beat on physiologic monitors with reduced or poorquality electrocardiographic waveforms due to loose electrocardiographic leads. Such ECG tracings often require scrutiny of the associated pressure waves, since the electrocardiographic artifacts cause loss of the signal or a signal trigger for an audible beep in the laboratory of the regular rhythm.

Original languageEnglish
Title of host publicationHemodynamic Rounds
Subtitle of host publicationInterpretation of Cardiac Pathophysiology from Pressure Waveform Analysis: Fourth Edition
PublisherWiley Blackwell
Pages67-78
Number of pages12
ISBN (Electronic)9781119095651
ISBN (Print)9781119095613
DOIs
StatePublished - Feb 15 2018

Keywords

  • Cardiac arrhythmias
  • Cardiac rhythm
  • ECG tracings
  • Premature ventricular contraction
  • Pulmonary capillary wedge pressure
  • QRS complexes
  • Right-heart hemodynamics

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  • Cite this

    Kern, M. J., Donohue, T. J., & Bach, R. G. (2018). Hemodynamics during Arrhythmias. In Hemodynamic Rounds: Interpretation of Cardiac Pathophysiology from Pressure Waveform Analysis: Fourth Edition (pp. 67-78). Wiley Blackwell. https://doi.org/10.1002/9781119095651.ch5