Simultaneously recorded leads II and MCL1 rhythm strip obtained from a middle-aged adult with heart disease. Instead, correction of hypoxemia and hypomagnesemia controlled the patient's ventricular ectopy and eliminated the runs of VT. That said, the patient remained alert, asymptomatic and hemodynamically stable during the runergo, specific antiarrhythmic treatment was not needed. This rhythm is clearly VT, as judged by QRS widening with a very different QRS morphology from sinus-conducted beats, lack of premature P wave prior to the onset of the run, and post-ectopic pause following the run. The run is relatively slow and irregular at first (" warm-up" phenomenon), before speeding up to a more regular and rapid rate of 150/minute. An 11-beat run of NSVT (non-sustained ventricular tachycardia) follows. The treatment approach will obviously be different for hemodynamically significant VT, in which case antiarrhythmic agents (ie, amiodarone) and/or acute cardioversion are indicated.Īpplying these concepts to the rhythm in the Figure, the tracing begins with three beats of normal sinus rhythm. Potentially arrhythmia-inducing pharmacologic agents such as sympathomimetics, cocaine, amphetamines, and alcohol should be stopped. These may include heart failure, ischemia, hypotension from a variety of causes, hypoxemia, acid-base and/or electrolyte disturbance (especially hypokalemia and hypomag-nesemia). Clinically, what else is going on with the patient? A non-sustained ventricular rhythm that does not produce significant symptoms is preferentially treated by correction of underlying predisposing or exacerbating factors. Hemodynamic compromise is far less likely with AIVR, and such rhythms rarely require specific antiarrhythmic treatment.ģ. Realize that relatively slow ventricular rhythms (ie, less than 120/minute) represent AIVR (accelerated idioventricular rhythm) rather than true "VT". Is the run "real", and truly VT? What is the ventricular rate during the run, and is it sustained? Be sure that the rhythm is not rapidly-occurring artifact that may simulate VT. How is the patient during the run? Management decisions will vary greatly depending on whether the patient is symptomatic or not, and whether the patient is hemodynamically stable or about to go into cardiac arrest.Ģ. There are three principle issues to address when assessing a "run of VT (ventricular tachycardia)":ġ. When not immediately at the patient's bedside, what questions should you ask of the nurse who is caring for the patient? Apply this to assessment of the rhythm above. Hospital-based physicians (especially those who work night shifts) will often be called about "a run of VT". Despite this "run of VT", the patient remained alert, hemodynamically stable, and asymptomatic during tachycardia. Grauer is the sole proprietor of KG-EKG Press, and publisher of an ECG pocket brain book.įigure: Simultaneously recorded leads II and MCL1 rhythm strip obtained from a middle-aged adult with heart disease. > + !(*gDynamicEventInfo).builtin) = ChromeUtils.import("resource://gre/modules/Telemetr圜ontroller.jsm") Ĭonst IS_ANDROID = AppConstants.By Ken Grauer, MD, Professor, Department of Community Health and Family Medicine, University of Florida. ::: toolkit/components/telemetry/TelemetryEvent.cpp:482 One thing I'd like an explanation on, and one nit. The patch there can inform the missing changes in this patch as well of course let me know if you need more details about this madness!Ĭomment on attachment 89669945 - Enable recording events in artifact builds without rebuilding Firefox. We should take this for a manual test ride in addition to xpcshell testsįor context and technical background on the design, see bug 1425909 comment 12 (and next comments). We need the review from nfroydnj on the moz.build changes We need doc updates to mention that artifact builds support events (we also need to update the relevant MDN page) We need test coverage for the part above We should load it (as we do with the scalar JSON file) on local developer builds when Firefox starts The snapshotting logic is implemented (events can be seen in about:telemetry) The code that generates the JSON definitions out of the YAML file is pretty much there The registration code is in place (and doesn't crash anymore) Moving this to Jan-Erik, as he'll be pushing this to the finishing line.
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