Arrhythmias

Question 1

Normal sinus rhythm P waves

Answer 1

Upright in 1 and/or 2

Never inverted in 2 and aVF

Question 2

Atrial rate of Ectopic Supraventricular Tachycardias

Answer 2

130-220 bpm

Question 3

Atrial rate of atrial flutter

Answer 3

220-360 bpm

Sawtooth flutter waves

Question 4

Atrial rate less than 220, discrete, separate p waves

Answer 4

Atrial tachycardia with AV block

Question 5

Atrial rate more than 220, flutter atrial waves

Answer 5

atrial flutter

Question 6

If atrial activity is indiscernible, and QRS is narrow with regular R to R with rate at 110-220 bpm

Answer 6

Regular narrow QRS tachycardia

Question 7

Differential diagnosis of regular narrow QRS tachycardia:

Answer 7

Sinus tachycardia
Reentrant supraventricular tachycardia
Atrial flutter with 2:1 block

Question 8

Indiscernible atrial activity, narrow and regular QRS tachycardia at greater than 180 bpm in adult pt who is not exercising

Answer 8

Paroxysmal reentrant supraventricular tachycardia

Question 9

Indiscernible atrial activity, narrow and regular QRS tachycardia at less than 140 bpm

Answer 9

Sinus or atrial flutter with 2:1 AV block

Question 10

Unmasking atrial flutter:

Answer 10

1. Saw tooth pattern in inferior leads (2, 3, aVF)
2. Look for extra “p” in V1 and V2 halfway between discernible “p” waves
3. Transpose PR found in V1 or 2 back into lead 2 –> sinus p wave there?

Question 11

Indiscernible atrial activity, irregularly irregular R to R intervals with either wide or narrow QRS’s

Answer 11

Atrial fibrillation

Question 12

Indiscernible atrial activity, wide QRS’s with regular R to R intervals, use ___ analysis

Answer 12

Ventricular rhythm

Question 13

(Narrow/Wide) QRS: ventricular escape rhythm rate

Answer 13

Wide

20-40

Question 14

(Narrow/Wide) QRS: accelerated idioventricular rhythm rate

Answer 14

Wide

55-110

Question 15

(Narrow/Wide) QRS: ventricular tachycardia

Answer 15

Wide

140-180- 200+

Question 16

Junctional escape rhythm
Rate:
Describe R-R:
QRS narrow or wide:

Answer 16

40-60
Regular
Narrow

Question 17

Accelerated junctional rhythm
Rate:
Describe R-R:
QRS narrow or wide:

Answer 17

70-130
Regular
Narrow

Question 18

Paroxysmal reenterent supraventricular tachycardia
Rate:
Describe R-R:
QRS narrow or wide:

Answer 18

140-220
Regular
Narrow

Question 19

AR > VR, PR vary, R-R grossly vary

Answer 19

Wenckebach (Mobitz I) 2nd degree block

Question 20

AR > VR, PR vary, R-R does not grossly vary

Answer 20

3rd degree block, describe escape rhythm via ventricular analysis

Question 21

AR > VR, PR does not vary

Answer 21

2:1 or Advanced (>3:1) or Mobitz II 2nd degree AV block

Question 22

VR > AR, RP varies, regular R-R

Answer 22

Interference Dissociation. Describe atrial and ventricular mechanisms as per atrial and ventricular analysis.

Question 23

1:1 P: QRS ratio, constant but prolonged PR interval

Answer 23

First degree AV block

PR >0.20 sec

Question 24

Progressively prolongation of PR for conducted p waves until p wave is completely blocked

Answer 24

Mobitz I

Question 25

PR constant for conducted p waves then suddenly p wave not conducted (no QRS)

Answer 25

Mobitz II

Question 26

2 p waves for each QRS and a constant PR

Answer 26

2:1 second degree AV block

Question 27

3:1, 4:1 ..etc per QRS with constant PR

Answer 27

Advanced second degree AV block

Question 28

Variable PR

One form of complete AV dissociation

Answer 28

3rd Degree/complete AV block