. The ECG findings reveal that, (here is often a gross bradycardia.

is understood now, this syndrome is not uncommon Sick sinus syndrome ('SSS') i s characterized by some ECG changes and is due to some damage in the sinu atrial node (SAN) it may be symptom free. The ECG findings reveal that, (here is often a gross bradycardia. The P waves in ECG might be periodically missing Pace makers Pace makers have revolutionized the treatment of heart blocks. In heart block patients, pace makers are introduced with an aim to supply to the heart the proper stimuli. 50 that lack (due to block) of natural impure (coming from the SAN) will not result in cardiac standstill. A paces maker is an electronic device, placed suitably, (so that its tip is positioned in the right ventricle) which supplies stimuli to the heart Various types of pace makers are used but perhapsthe most popular type is'demand ventricular pace maker' In this type of instrument, (he naturally occurring impules do their job but if there be missed natural impulses, the pace maker detects them (= missing impulses) and supplies artiticial stimuli. FIBRILLATION Atrial fibrillation In thiscondition, the coordinated and effective contraction of the atria is lost. At any given instant. some pans of the atria are contracting while other pans are quiecent to that if looks like the movements of a warm (vermiform movements) Numerous independent action potentials develop in the atria, many of which are blocked at the AVN These impulses develop It irregular intervals. As a result the ventricles receive irregularly irregular impulses so that the outstanding: clinical feature is irregularly irregular pulse which is usually also very rapid. Persistent atrial fibrillation may lead to embolism and heart failure. Ventricular fibrillation. The same vermiform (worm like) movements may also develop in the ventricle leading to circulatory standstill. Ventricular fbrillation usually kill the patient instantaneously or rarely the patient develops Stokes Adams syndrome like condition and recovers without medical aid Medical aid consists of giving external electrical shock ("counter shock} or (if the instrument is not available) xylocaine may be injected SUMMARY & HIGHLIGHTS (i) In CVS shock, the cardiac output is not sufficient to meet the demands Nature's compensatory mechanisms consist mainly of neural (baroreceptor reflex etc), fluid shift and renin angiotensin mechanism. (ii) Heart failure may be seen as pump failure and the cardiac output Is insufficient to The need.