Impulso ventricular prematuro | Blog de Medicina

arritmia

Son impulsos prematuros que nacen en los ventrículos. Pueden ser de origen extrasistólico (guarda relación con el impulso precedente por lo cual el período de acoplamiento suele ser fijo) o más raramente parasistólico (impulsos independientes del ritmo de base). Si se presentan tres o más seguidos se trata de una taquicardia ventricular (TV) y si duran más de 30 segundos hablamos de una TV sostenida.

En el ECG aparecen como complejos prematuros, anchos, con una morfología diferente al ritmo de base. La polaridad de la repolarización es contraria a la del QRS (T de polaridad opuesta y asimétrica). En el 70% de los casos no se propagan a la aurícula y, por tanto, no descargan el nudo sinusal, por lo que la pausa compensadora será completa (la distancia del QRS precedente al que sigue al complejo prematuro será dos veces la distancia de los complejos del ritmo de base).

En general, los complejos prematuros que se presentan en individuos sin cardiopatía de base se originan en el ventrículo derecho, por lo que tienen morfología de bloqueo de rama izquierda, suelen tener voltajes altos y no apreciarse muescas evidentes. Los complejos ventriculares prematuros con una duración < 160 ms y sin melladuras o con muescas de duración inferior a 40 ms suelen corresponder a individuos con una función ventricular normal o poco alterada, mientras que la presencia de muescas amplias (> 40 ms) suele traducir una disfunción ventricular
Via: blogmedicina.com

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