ELECTRICAL ALTERNANS

Course overview

ELECTRICAL ALTERNANS IS DEFINED AS ALTERNATING QRS AMPLITUDES IN ANY OR ALL LEADS ON AN ELECTROCARDIOGRAM (ECG) WITH NO ADDITIONAL EVIDENT CHANGES IN CONDUCTION PATHWAYS OF THE HEART. THIS RHYTHM IS TYPICALLY ASSOCIATED WITH PERICARDIAL EFFUSION FROM FLUID SURROUNDING THE HEART. HOWEVER, ELECTRICAL ALTERNANS IS ALSO ASSOCIATED WITH OTHER PATHOLOGIES INCLUDING BUT NOT LIMITED TO VENTRICULAR TACHYCARDIA, WOLFF-PARKINSON-WHITE (WPW), ACCELERATED IDIOVENTRICULAR RHYTHM, AND SUPRAVENTRICULAR TACHYCARDIA. RECOGNIZING THE VARIED PATHOLOGIES CAUSING THIS ECG FINDING IS KEY TO EVALUATION AND IF NECESSARY, SUCCESSFUL MANAGEMENT. THIS ACTIVITY DESCRIBES THE EVALUATION, DIAGNOSIS, AND MANAGEMENT OF ELECTRICAL ALTERNANS AND STRESSES THE ROLE OF TEAM-BASED INTERPROFESSIONAL CARE FOR AFFECTED PATIENTS.