{"id":1852,"date":"2021-05-03T15:32:27","date_gmt":"2021-05-03T18:32:27","guid":{"rendered":"http:\/\/nave.vet.br\/?p=1852"},"modified":"2024-03-02T19:37:04","modified_gmt":"2024-03-02T22:37:04","slug":"ecg-na-anestesia","status":"publish","type":"post","link":"https:\/\/nave.vet.br\/en\/video-aulas\/ecg-na-anestesia\/","title":{"rendered":"ECG na ANESTESIA  \u2013 NAVE Ondas #4"},"content":{"rendered":"<div id=\"advads-738461890\" class=\"advads-antes-do-post advads-entity-placement\" style=\"margin-bottom: 30px;margin-left: auto;margin-right: auto;text-align: center;\"><div class=\"advads-antes-do-post advads-entity-placement\" style=\"text-align: center;\" id=\"advads-788671617\"><div id=\"advads-4060527058\"><a href=\"https:\/\/rb.gy\/brmhh3\" aria-label=\"WhatsApp Image 2024-04-11 at 10.31.52\"><img src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2024\/04\/WhatsApp-Image-2024-04-11-at-10.31.52.jpeg?fit=1000%2C137&#038;ssl=1\" alt=\"\"  srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2024\/04\/WhatsApp-Image-2024-04-11-at-10.31.52.jpeg?w=1000&ssl=1 1000w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2024\/04\/WhatsApp-Image-2024-04-11-at-10.31.52.jpeg?resize=300%2C41&ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2024\/04\/WhatsApp-Image-2024-04-11-at-10.31.52.jpeg?resize=768%2C105&ssl=1 768w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2024\/04\/WhatsApp-Image-2024-04-11-at-10.31.52.jpeg?resize=18%2C2&ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" width=\"1000\" height=\"137\"   \/><\/a><\/div><\/div><\/div>\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"\ud83d\udd34  ONDAS DE ECG NA ANESTESIA | NAVE Ondas #4\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/ij0sshM4iKI?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p>A eletrocardiografia, tamb\u00e9m conhecida como ECG, \u00e9 certamente a monitora\u00e7\u00e3o gr\u00e1fica mais antiga que temos. Ela surgiu no in\u00edcio do s\u00e9culo XX, enquanto que a avalia\u00e7\u00e3o da onda de <a href=\"http:\/\/nave.vet.br\/en\/video-aulas\/naveondas\/onda-de-pressao-arterial\/\" class=\"rank-math-link\">press\u00e3o arterial<\/a> foi iniciada na d\u00e9cada de 1920 e a <a href=\"http:\/\/nave.vet.br\/en\/video-aulas\/naveondas\/capnografia\/\" class=\"rank-math-link\">capnografia<\/a> e <a href=\"http:\/\/nave.vet.br\/en\/video-aulas\/naveondas\/oximetria-de-pulso\/\" class=\"rank-math-link\">oximetria<\/a> no in\u00edcio dos anos de 1970. O primeiro registro de tra\u00e7ado eletrocardiogr\u00e1fico data de 1902, obtido pelo fisiologista holand\u00eas Willem Einthoven. O aparelho pesava quase 300kg e, ainda que totalmente diferente dos modelos que temos hoje, j\u00e1 gerava um tra\u00e7ado de excelente qualidade.<\/p>\n\n\n\n<div class=\"wp-block-group is-layout-flow wp-block-group-is-layout-flow\">\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"357\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Captura-de-Tela-2021-05-03-a%CC%80s-12.24.44.png?resize=800%2C357\" alt=\"\" class=\"wp-image-1857\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Captura-de-Tela-2021-05-03-a%CC%80s-12.24.44.png?resize=1024%2C457&amp;ssl=1 1024w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Captura-de-Tela-2021-05-03-a%CC%80s-12.24.44.png?resize=300%2C134&amp;ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Captura-de-Tela-2021-05-03-a%CC%80s-12.24.44.png?resize=768%2C343&amp;ssl=1 768w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Captura-de-Tela-2021-05-03-a%CC%80s-12.24.44.png?resize=16%2C7&amp;ssl=1 16w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Captura-de-Tela-2021-05-03-a%CC%80s-12.24.44.png?w=1035&amp;ssl=1 1035w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<p>O ECG \u00e9, na verdade, uma composi\u00e7\u00e3o de v\u00e1rias ondas sequenciadas, que representam a atividade el\u00e9trica gerada pelo cora\u00e7\u00e3o em um batimento. Para entendermos como obter esse tra\u00e7ado, precisamos lembrar que o cora\u00e7\u00e3o \u00e9 um m\u00fasculo com condu\u00e7\u00e3o el\u00e9trica ritmada e, desde que esteja saud\u00e1vel, sempre vai gerar um primeiro est\u00edmulo em um determinado lugar, para a\u00ed ent\u00e3o propagar para outras partes do \u00f3rg\u00e3o. <\/p>\n\n\n\n<p>O est\u00edmulo inicial \u00e9 disparado no n\u00f3 sinoatrial, localizado no \u00e1trio direito. Ap\u00f3s isso, o est\u00edmulo segue em dire\u00e7\u00e3o ao n\u00f3 atrioventricular, que conduz o est\u00edmulo para os ventr\u00edculos, pelo feixe de Hiss, localizado no septo interventricular. Esse ent\u00e3o segue caminho, chegando at\u00e9 as fibras de Purkinje, formando as ondas do eletrocardiograma. <\/p><div id=\"advads-389269993\" class=\"advads-adsense-in-article advads-entity-placement\"><script async src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-9687921986569993\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display:block; text-align:center;\" data-ad-client=\"ca-pub-9687921986569993\" \ndata-ad-slot=\"1211285291\" \ndata-ad-layout=\"in-article\"\ndata-ad-format=\"fluid\"><\/ins>\n<script> \n(adsbygoogle = window.adsbygoogle || []).push({}); \n<\/script>\n<\/div>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"onda-de-ecg-padrao\">Onda de ECG Padr\u00e3o<\/h4>\n\n\n\n<p>Para obtermos as ondas de ECG na anestesia, geralmente utilizamos as deriva\u00e7\u00f5es bipolares de Einthoven, que s\u00e3o a DI (bra\u00e7o direito &#8211; bra\u00e7o esquerdo), DII (bra\u00e7o direito &#8211; perna esquerda) e DIII (bra\u00e7o esquerdo &#8211; perna esquerda). H\u00e1 outras deriva\u00e7\u00f5es, como a aVR, aVL, aVF e as precordiais, que tamb\u00e9m s\u00e3o importantes em uma avalia\u00e7\u00e3o mais detalhada do cora\u00e7\u00e3o. Por\u00e9m, a interpreta\u00e7\u00e3o do ECG durante a anestesia \u00e9 bem mais din\u00e2mica que na cl\u00ednica m\u00e9dica, isso porque fazemos uma leitura mais r\u00e1pida, sem medir tamanho de ondas e tentando correlacionar o tra\u00e7ado com os medicamentos utilizados ou acontecimentos durante a anestesia.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large is-resized\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"435\" height=\"411\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/ECG-wave.png?resize=435%2C411\" alt=\"\" class=\"wp-image-1895\" style=\"width:371px;height:350px\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/ECG-wave.png?w=435&amp;ssl=1 435w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/ECG-wave.png?resize=300%2C283&amp;ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/ECG-wave.png?resize=13%2C12&amp;ssl=1 13w\" sizes=\"(max-width: 435px) 100vw, 435px\" \/><figcaption class=\"wp-element-caption\">Onda padr\u00e3o de ECG, destacando a onda P, complexo QRS, onda T e os principais intervalos entre ondas.<\/figcaption><\/figure>\n\n\n\n<p>O ECG padr\u00e3o tem o seguinte formato: A primeira onda \u00e9 a P, que caracteriza a despolariza\u00e7\u00e3o dos \u00e1trios e \u00e9 positiva. Depois temos o complexo QRS, que caracteriza a despolariza\u00e7\u00e3o dos ventr\u00edculos. Em sequ\u00eancia temos a onda T, que representa a repolariza\u00e7\u00e3o dos ventr\u00edculos, geralmente \u00e9 positiva e com tamanho m\u00e1ximo de 25% da onda R. \u00c9 importante entendermos que a onda gerada pela repolariza\u00e7\u00e3o dos \u00e1trios geralmente n\u00e3o \u00e9 observada, pois ela \u00e9 sobreposta pelo complexo QRS. <\/p>\n\n\n\n<p>Em equinos e bovinos n\u00f3s utilizamos a deriva\u00e7\u00e3o base-\u00e1pice, que nos d\u00e1 uma leitura um pouco diferente, com o complexo QRS invertido. A onda T pode ser positiva ou bif\u00e1sica. Um outro detalhe bem importante \u00e9 que a onda P pode ser b\u00edfida em equinos adultos, devido o tamanho dos \u00e1trios. <\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large is-resized\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"624\" height=\"268\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/ECG.png?resize=624%2C268\" alt=\"\" class=\"wp-image-1860\" style=\"width:513px;height:220px\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/ECG.png?w=624&amp;ssl=1 624w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/ECG.png?resize=300%2C129&amp;ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/ECG.png?resize=16%2C7&amp;ssl=1 16w\" sizes=\"(max-width: 624px) 100vw, 624px\" \/><figcaption class=\"wp-element-caption\">Tra\u00e7ado eletrocardiogr\u00e1fico padr\u00e3o em equinos. Observar o complexo QRS invertido e onda P b\u00edfida. Fonte:<a href=\"http:\/\/10.1007\/s00399-013-0260-z\" class=\"rank-math-link\"> Kaese et al., 2013<\/a>.<\/figcaption><\/figure>\n\n\n\n<hr class=\"wp-block-separator aligncenter has-css-opacity\"\/>\n\n\n<div id=\"advads-927200846\"><a href=\"https:\/\/www.sdamed.com\/\" aria-label=\"Banner-SDAMed NAVE\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/04\/Banner-SDAMed-NAVE-1.gif?fit=496%2C68&#038;ssl=1\" alt=\"\"  width=\"1000\" height=\"137\"   \/><\/a><\/div>\n\n\n<hr class=\"wp-block-separator aligncenter has-alpha-channel-opacity\"\/>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"alteracoes-nas-ondas-de-ecg\">Altera\u00e7\u00f5es nas Ondas de ECG<\/h4>\n\n\n\n<p>H\u00e1 uma gama de altera\u00e7\u00f5es na onda de ECG, dezenas delas, sendo que algumas arritmias s\u00e3o bem evidentes, outras muito sutis. Nessa videoaula n\u00f3s vamos abordar as principais altera\u00e7\u00f5es nas ondas de ECG durante a anestesia. Destacamos que todas as figuras abaixo foram obtidas do site <a href=\"https:\/\/ecg-educator.blogspot.com\/\" class=\"rank-math-link\" target=\"_blank\" rel=\"noopener\">ecg-educator.blogspot.com<\/a> , de propriedade de Jason Winter. L\u00e1 n\u00f3s podemos encontrar dezenas de tra\u00e7ados diferentes, todos com explica\u00e7\u00f5es bem detalhadas.<\/p>\n\n\n\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\" style=\"grid-template-columns:37% auto\"><figure class=\"wp-block-media-text__media\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"283\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Bradycardia.jpg?resize=800%2C283\" alt=\"\" class=\"wp-image-1863 size-full\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Bradycardia.jpg?resize=1024%2C362&amp;ssl=1 1024w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Bradycardia.jpg?resize=300%2C106&amp;ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Bradycardia.jpg?resize=768%2C272&amp;ssl=1 768w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Bradycardia.jpg?resize=1536%2C543&amp;ssl=1 1536w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Bradycardia.jpg?resize=16%2C6&amp;ssl=1 16w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Bradycardia.jpg?w=1600&amp;ssl=1 1600w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p style=\"font-size:15px\"><strong>Bradicardia Sinusal<\/strong>: A frequ\u00eancia card\u00edaca est\u00e1 abaixo do padr\u00e3o para o indiv\u00edduo, mas a morfologia das ondas est\u00e1 normal, com os intervalos R-R regulares e preserva\u00e7\u00e3o do intervalo P-QRS.<\/p>\n<\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity is-style-default\"\/>\n\n\n\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\" style=\"grid-template-columns:37% auto\"><figure class=\"wp-block-media-text__media\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"283\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Sinus-Arrest.jpg?resize=800%2C283\" alt=\"\" class=\"wp-image-1864 size-full\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Sinus-Arrest.jpg?resize=1024%2C362&amp;ssl=1 1024w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Sinus-Arrest.jpg?resize=300%2C106&amp;ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Sinus-Arrest.jpg?resize=768%2C272&amp;ssl=1 768w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Sinus-Arrest.jpg?resize=1536%2C543&amp;ssl=1 1536w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Sinus-Arrest.jpg?resize=16%2C6&amp;ssl=1 16w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/Sinus-Arrest.jpg?w=1600&amp;ssl=1 1600w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p style=\"font-size:15px\"><strong>Parada Sinusal (<em>Sinus arrest<\/em>):<\/strong> Isso ocorre quando temos um tra\u00e7ado normal, com onda P seguida do complexo QRS e onda T, todas com morfologia normal mas, em algum momento h\u00e1 uma pausa, gerando um intervalo R-R maior do que o dobro do normal.<\/p>\n<\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\" style=\"grid-template-columns:37% auto\"><figure class=\"wp-block-media-text__media\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"142\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/SECOND-DEGREE-AV-BLOCK.jpg?resize=400%2C142\" alt=\"\" class=\"wp-image-1865 size-full\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/SECOND-DEGREE-AV-BLOCK.jpg?w=400&amp;ssl=1 400w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/SECOND-DEGREE-AV-BLOCK.jpg?resize=300%2C107&amp;ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/SECOND-DEGREE-AV-BLOCK.jpg?resize=16%2C6&amp;ssl=1 16w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p style=\"font-size:15px\"><strong>Bloqueio atrioventricular<\/strong>: Tamb\u00e9m chamado de BAV, essa arritmia card\u00edaca ocorre quando o intervalo entre a onda P e o complexo QRS aumenta. Nesse caso, h\u00e1 uma lentifica\u00e7\u00e3o do disparo do n\u00f3 atrioventricular. Pode ocorrer apenas um retardo no intervalo P-Q, conhecido como BAV de 1\u00ba grau ou at\u00e9 a necessidade de um novo disparo do n\u00f3 sinoatrial, gerando um BAV de 2\u00ba (ao lado) ou 3\u00ba graus.<\/p>\n<\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\" style=\"grid-template-columns:37% auto\"><figure class=\"wp-block-media-text__media\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"142\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/T-sinus.jpg?resize=400%2C142\" alt=\"\" class=\"wp-image-1868 size-full\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/T-sinus.jpg?w=400&amp;ssl=1 400w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/T-sinus.jpg?resize=300%2C107&amp;ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/T-sinus.jpg?resize=16%2C6&amp;ssl=1 16w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p style=\"font-size:15px\"><strong>Taquicardia Sinusal<\/strong>: A frequ\u00eancia card\u00edaca est\u00e1 acima do padr\u00e3o para o indiv\u00edduo, mas a morfologia das ondas est\u00e1 normal, com os intervalos R-R regulares e preserva\u00e7\u00e3o do intervalo P-QRS.<\/p>\n<\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\" style=\"grid-template-columns:37% auto\"><figure class=\"wp-block-media-text__media\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"283\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/VPC.jpg?resize=800%2C283\" alt=\"\" class=\"wp-image-1869 size-full\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/VPC.jpg?resize=1024%2C362&amp;ssl=1 1024w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/VPC.jpg?resize=300%2C106&amp;ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/VPC.jpg?resize=768%2C272&amp;ssl=1 768w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/VPC.jpg?resize=1536%2C543&amp;ssl=1 1536w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/VPC.jpg?resize=16%2C6&amp;ssl=1 16w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/VPC.jpg?w=1600&amp;ssl=1 1600w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p style=\"font-size:15px\"><strong>Complexo Ventricular Prematuro<\/strong>: O disparo do batimento card\u00edaco n\u00e3o ocorre pelo n\u00f3 sinusal, muito menos pelo n\u00f3 atrioventricular. H\u00e1 uma despolariza\u00e7\u00e3o com origem em uma outra regi\u00e3o do ventr\u00edculo, gerando um tra\u00e7ado sem onda P e com complexo QRS de caracter\u00edstica bizarra. Caso ocorram v\u00e1rios CVP em sequ\u00eancia, d\u00e1-se o nome de <strong>taquicardia ventricular<\/strong>.<\/p>\n<\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\" style=\"grid-template-columns:37% auto\"><figure class=\"wp-block-media-text__media\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"283\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/PAC-1.jpg?resize=800%2C283\" alt=\"\" class=\"wp-image-1874 size-full\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/PAC-1.jpg?resize=1024%2C362&amp;ssl=1 1024w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/PAC-1.jpg?resize=300%2C106&amp;ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/PAC-1.jpg?resize=768%2C272&amp;ssl=1 768w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/PAC-1.jpg?resize=1536%2C543&amp;ssl=1 1536w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/PAC-1.jpg?resize=16%2C6&amp;ssl=1 16w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/PAC-1.jpg?w=1600&amp;ssl=1 1600w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p style=\"font-size:15px\"><strong>Complexo Atrial Prematuro<\/strong>: H\u00e1 despolariza\u00e7\u00e3o dos \u00e1trios por um foco anormal, que n\u00e3o o n\u00f3 sinoatrial. Isso gera contra\u00e7\u00e3o atrial juntamente com a despolariza\u00e7\u00e3o dos ventr\u00edculos, ou at\u00e9 mesmo antes dele. H\u00e1 sobreposi\u00e7\u00e3o da onda P sobre a onda T.<\/p>\n<\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"possiveis-interferencias-na-obtencao-da-onda\">Poss\u00edveis interfer\u00eancias na obten\u00e7\u00e3o da onda<\/h4>\n\n\n\n<p>O tra\u00e7ado de ECG obtido durante a anestesia \u00e9 bem confi\u00e1vel e muito \u00fatil na monitora\u00e7\u00e3o. Entretanto, h\u00e1 algumas interfer\u00eancias que podem nos dar padr\u00f5es alterados das ondas, mas que n\u00e3o refletem a atividade el\u00e9trica card\u00edaca. Basicamente podemos ter valores de <em>frequ\u00eancia card\u00edaca errada<\/em>, caso a morfologia das ondas esteja adequada, gerando ondas P ou T muito altas. O monitor acaba &#8220;entendendo&#8221; que a onda P, T ou mesmo uma onda bizarra de CVP \u00e9 na verdade uma onda R, considerando um batimento. <em>Artefatos<\/em> que geram interfer\u00eancia na leitura tamb\u00e9m s\u00e3o comuns. Os principais s\u00e3o falta de aterramento do monitor card\u00edaco, interfer\u00eancia el\u00e9trico com o colch\u00e3o t\u00e9rmico ou mesmo mal posicionamento dos eletrodos no paciente.<\/p>\n\n\n\n<p>Assim, devemos lembrar sempre que a monitora\u00e7\u00e3o deve ser a mais completa poss\u00edvel, com outros par\u00e2metros que possam ser correlacionados entre si ou mesmo ratificar os valores que observamos em um tipo de monitora\u00e7\u00e3o.<\/p>\n\n\n\n<p>Quer saber mais sobre <strong>Monitora\u00e7\u00e3o Anest\u00e9sica<\/strong>? <a href=\"http:\/\/nave.vet.br\/en\/video-aulas\/basico\/monitoracao-anestesica-anestesia-e-o-basico-13\/\" class=\"rank-math-link\">Ent\u00e3o veja esse link aqui<\/a>.<\/p>\n\n\n\n<p><strong>Aproveite e veja os outros v\u00eddeos da&nbsp;<a href=\"http:\/\/nave.vet.br\/en\/categorias\/video-aulas\/naveondas\/\">webserie NAVE ONDAS!<\/a><\/strong><\/p>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<h6 class=\"wp-block-heading\" id=\"leia-tambem\">Read also about:<\/h6>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"http:\/\/nave.vet.br\/en\/video-aulas\/naveondas\/capnografia\/\">Interpretando as ondas de Capnografia \u2013 NAVE Ondas #1<\/a><\/li>\n\n\n\n<li><a href=\"http:\/\/nave.vet.br\/en\/video-aulas\/naveondas\/oximetria-de-pulso\/\">Oximetria de pulso (Onda Pletismogr\u00e1fica) \u2013 NAVE Ondas #2<\/a><\/li>\n\n\n\n<li><a href=\"http:\/\/nave.vet.br\/en\/video-aulas\/naveondas\/onda-de-pressao-arterial\/\">Evaluating Arterial Blood Pressure Waveform - NAVE Waves #3<\/a><\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio has-small-font-size\"><em>Find out more:<\/em><\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio has-small-font-size\">\u2013 Carregaro AB, Silva ANE. Monitora\u00e7\u00e3o Anest\u00e9sica. In: Luna SPL, Carregaro, AB. Anestesia e Analgesia de Equideos, Ruminantes e Su\u00ednos. 247-280, 2019.<br><a class=\"rank-math-link\" href=\"https:\/\/ecg-educator.blogspot.com\/\" target=\"_blank\" rel=\"noopener\">\u2013 ECG Educator Blog. Promoting ECG Education to help save more live<\/a><a class=\"rank-math-link\" href=\"http:\/\/10.0.4.128\/ajpheart.00218.2019\">s.<\/a><br><a class=\"rank-math-link\" href=\"http:\/\/10.1007\/s00399-013-0260-z\">&#8211; Kaese et al. The ECG in cardiovascular-relevant animal models of electrophysiology. Herzschrittmacherther Elektrophysiol, 24:84-91,2013.<\/a><br>&#8211; Tilley LP. Essentials of canine and feline electrocardiography: Interpretation and treatment. Lea &amp; Febiger, 500p, 1992.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p><strong>Suggestions? Thoughts? Comments? Share!<\/strong><\/p>","protected":false},"excerpt":{"rendered":"<p>A eletrocardiografia, tamb\u00e9m conhecida como ECG, \u00e9 certamente a monitora\u00e7\u00e3o gr\u00e1fica mais antiga que temos. O ECG \u00e9, na verdade, uma composi\u00e7\u00e3o de v\u00e1rias ondas sequenciadas, que representam a atividade el\u00e9trica gerada pelo cora\u00e7\u00e3o em um batimento. Para obtermos as ondas de ECG na anestesia, geralmente&#8230;<\/p>","protected":false},"author":2,"featured_media":1853,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"video","meta":{"give_campaign_id":0,"colormag_page_layout":"default_layout","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[2,711],"tags":[834,831,833,832,413,829,824,822,825,828,426,823,817,430,415,793,364,781,820,826,818,827,819,830,816],"class_list":["post-1852","post","type-post","status-publish","format-video","has-post-thumbnail","hentry","category-video-aulas","category-naveondas","tag-arritimias-na-anestesia","tag-arritmias-cardiacas-ecg","tag-arritmias-cardiacas-veterinaria","tag-bloqueio-atrioventricular","tag-ecg","tag-ecg-facil","tag-ecg-interpretacao","tag-ecg-na-anestesia","tag-ecg-waveform-explanation","tag-ekg-waveform","tag-eletrocardiografia","tag-eletrocardiograma","tag-eletrocardiograma-na-anestesia","tag-monitoracao-anestesica-veterinaria","tag-monitorizacao-cardiaca","tag-monitorizacao-veterinaria","tag-nave-anestesia","tag-naveabc","tag-no-atrioventricular","tag-no-sinoatrial","tag-ondas-de-ecg","tag-ondas-de-electrocardiograma","tag-ondas-de-eletrocardiografia","tag-ondas-del-ecg","tag-tracado-de-ecg-normal","post_format-post-format-video"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/05\/NAVE-Ondas-ECG.png?fit=1920%2C1080&ssl=1","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/posts\/1852","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/comments?post=1852"}],"version-history":[{"count":25,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/posts\/1852\/revisions"}],"predecessor-version":[{"id":3428,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/posts\/1852\/revisions\/3428"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/media\/1853"}],"wp:attachment":[{"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/media?parent=1852"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/categories?post=1852"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/tags?post=1852"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}