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ECG Workout > Arrhythmias- Part 2 > Flashcards

Arrhythmias- Part 2 Flashcards

1
Q

List 8 AV junctional rhythms/ AV blocks

A

Premature junctional contraction
Junctional rhythm
Accelerated junctional rhythm
Junctional tachycardia
1st degree AV block
Second degree AV Block, Mobitz I
Second degree AV Block, Mobitz II

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2
Q
A

Premature junctional contraction

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3
Q

The AV junction consists of the AV node and _____

A

The bundle of His

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4
Q

The three regions of the AV junction
AKA upper, middle and lower regions

A

Atrial-Nodal
Nodal
Nodal-His

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5
Q

The _____ nodal region is where impulses are slowed down in their progression from the atria to the ventricles
Doesn’t contain pacemaker cells

A

Middle

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6
Q

The _____ junctional regions contain pacemaker cells and can assume the role as secondary pacemaker

A

Upper and lower

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7
Q

______ is the normal response of the AV junction if the sinus rate falls below the junctional rate or the impulse fails to reach the AV junction

A

Junctional rhythm

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8
Q

T/F
Junctional rhythms produce negative p waves due to retrograde stimulation of the atria

A

True

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9
Q

An early beat that originates in an ectopic pm site in the AV junction that is followed by a non-compensatory pause

A

Premature junctional contraction (PJC)

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10
Q

Ways to differentiate between PACs and PJCs

A

PJC p wave will be negative in lead II, with short PR interval or hidden in QRS

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11
Q

Ectopic beat occurring late instead of early
Result of increased vagal effect on the SA node, sinus arrest, sinus block, Nonconducted PACs, type 1 second degree block
Protective mechanism

A

Junctional escape beats

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12
Q
A

Junctional rhythm

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13
Q
A

Accelerated junctional rhythm

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14
Q

Causes of PJCs

A

Digitalis toxicity
Enhanced automaticity of the AV junction
CAD
HF
Valvular disease

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15
Q

Causes of junctional rhythm

A

Disease of the SA Node
Increased vagal effect on the SA node
Acute MI (inferior wall esp)
Drug effects (digitalis, quinidine, BB, CCB)
CHB

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16
Q

Causes of accelerated junctional rhythm

A

Enhanced automaticity secondary to digitalis toxicity
Damage to AV node secondary to acute inferior wall MI
HF
Acute rheumatic fever
Myocarditis
Valvular heart disease
Cardiac surgery (esp valve surgery)

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17
Q
A

Paroxysmal junctional tachycardia

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18
Q

How to differentiate between PAT and PJT

A

PAT- p wave hidden in preceding T wave, positive
PJT- p wave hidden in QRS, negative

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19
Q

How to differentiate between PAT and PJT

A

PAT- p wave hidden in preceding T wave, positive
PJT- p wave hidden in QRS, negative

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20
Q

If unable to differentiate between PAT and PJT, the rhythm is called ______

A

Paroxysmal supraventricular tachycardia

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21
Q

Which is more common- PAT or PJT?

A

PAT
PJT in adults is rare

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22
Q

Any rhythm above the bifurcation of the bundle of His

A

Supraventricular

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23
Q

Causes of junctional tachycardia

A

Usually a manifestation of digitalis toxicity or of catecholemine or theophylline infusion
Damage to AV node secondary to acute inferior MI
HF
Acute rheumatic fever
Myocarditis
Valvular heart disease
Cardiac surgery (esp valve surgery)

24
Q
A

1st degree AV Block

25
Q

Block where the sinus impulse is conducted normally to the AV node where there is a delay (PR > 0.20)

A

1st degree AV block

26
Q

Block where the sinus impulse is conducted normally to the AV node where there is a delay (PR > 0.20)

A

1st degree AV block

27
Q

Causes of 1st degree AV block

A

Drug therapy (digitalis, BB, CHB, amiodarone)
Increased vagal tone
Hyperkalemia
Acute rheumatic fever
Myocarditis
MI
Aging
Idiopathic

28
Q
A

Second-degree AV block, type I
Mobitz I or Wenckebach

29
Q
A

Second-degree AV block, type I
Mobitz I or Wenckebach

30
Q

A failure of some of the sinus impulses to be conducted to the ventricles
P waves at regular intervals with PR intervals that progressively lengthen from beat to beat until a p wave appears that is not followed by a QRS

A

Second degree AV Block, type I
Mobitz I or Wenckebach

31
Q

How to differentiate between Mobitz I and the Nonconducted PAC
Both have P waves not followed by a QRS but instead by a pause

A

Mobitz I- P waves are regular
PAC- abnormal p wave that occurs prematurely

32
Q

This AV Block may be a normal variant in athletes at rest because of a physiologic increase in vagal tone

A

Second degree, Mobitz I

33
Q

Ore than one P waves before each QRS with only one of the impulses conducted to the ventricles
P waves identical and regular
Located in the bundle of His or bundle branches

A

Second degree AV block, type II
Mobitz II

34
Q

Causes of Second degree AV block type II

A

Anterior wall MI
Acute myocarditis
Age related degeneration of electrical conduction system

35
Q
A

Second degree AV Block, type II
Mobitz II

36
Q
A

Third degree AV Block
Complete heart block

37
Q

Complete absence of conduction between the atria and the ventricles
Atria and ventricles beat independently of each other
Ventricles paced by AV junction or ventricles

A

Third degree AV Block
Complete heart block

38
Q

Review AV blocks

A
39
Q

Name 7 ventricular arrhythmias

A
  • ventricular standstill
  • Idioventricular rhythm
  • accelerated idioventricular rhythm
  • PVC
  • VT
    -VF
  • bundle branch block
40
Q

Depolarization of one ventricle before the other

A

Sequential depolarization

41
Q

Which ventricular rhythms don’t have QRS complexes

A

VF and ventricular standstill

42
Q

An obstruction in the transmission of the electrical impulse through one branch of the bundle of His

A

Bundle-branch block

43
Q

Impulse travels down unblocked branch first, stimulates that ventricle, and then travels from cell to cell through the myocardium to stimulate the other ventricle

A

Bundle branch block

44
Q

Most common cause of RBBB

A

Coronary artery disease

45
Q

Most common cause of LBBB

A

Hypertensive heart disease

46
Q

When would temporary cardiac pacing be indicated for the treatment of BBB?

A
  • if a new RBBB or LBBB develops as a result of an acute MI
  • if a RBBB is associated with a block in a fascicle of the LBB
  • if a RBBB or LBBB is complicated by AV block, esp if patient has acute MI
47
Q
A

Bundle-branch block

48
Q

Premature ectopic impulse that originates in either the right or left ventricle resulting in sequential depolarization d/t not entering the conduction system

A

PVC
Premature ventricular contraction

49
Q
A

PVCs

50
Q

A PVC that has occurred during the vulnerable period of ventricular repolarization
May precipitate repetitive ventricular contractions (VT or VF)

A

R-on-T phenomenon

51
Q
A

V Tach

52
Q
A

Ventricular fibrillation

53
Q
A

Idioventricular rhythm
Ventricular escape rhythm

54
Q
A

Accelerated Idioventricular rhythm

55
Q
A

Ventricular standstill
Asystole

ECG Workout (5 decks)

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