Are P waves present and are they occurring regularly?.Is there an impulse formation or impulse conduction problem?.When examining the electrocardiogram (either from a frozen screen image on the monitor or a printed rhythm strip), the anesthetist should address these additional questions:.What is the patient’s heart rhythm? Is it regular or irregular?.What is the patient’s heart rate? Is it too slow (bradycardia), normal (sinus rhythm), or too fast (tachycardia)?.The following questions can help determine whether an abnormality is present on an ECG: There are other subsidiary pacemakers besides the SA node, such as the AV node, Purkinje fibers, and other myocardial cells, particularly the ventricular tissue, which can initiate impulse formation and form escape or premature beats.The normal electrical activity of the heart originates in the SA node (primary pacemaker), spreads through the atria to the AV node, travels to the bundle of His, and finally reaches the myocardial Purkinje fibers.Electrocardiographic diagnosis of cardiac arrhythmias based on electrical impulse formation and conduction This article addresses the recognition of specific abnormalities detected through anesthetic monitoring of dogs and cats as well as the therapeutic actions taken to correct them.įigure. If the appropriate action occurs too late, anesthetic injury or fatality may occur. Then, comprehensive monitoring of the patient’s progress is continued until the abnormality resolves. When an abnormality is detected in an anesthetized patient, correct interpretation is necessary in order to institute appropriate therapy.
It is important to realize that monitoring anesthesia is not a therapeutic action. Anesthetic monitoring provides an early warning of cardiorespiratory decompensation, allowing vital therapeutic intervention. Read the first two articles in the series, Anesthetic Monitoring: Your Questions Answered(January/February 2012) and Anesthetic Monitoring: Devices to Use & What the Results Mean (March/April 2012), at .Īn essential goal of monitoring is to prevent adverse events it is much easier to prevent an adverse event than to treat one.