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atrial Flashcards

1
Q

Name three causes of atrial dysrhythmias

A

Altered automaticity
Triggered activity
Reentry

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2
Q

Disorders of impulse formation in atrial dysrhythmias include:
a. Altered autmotacity
B. Triggered activity
C. Reentry

A

A & B

Altered automaticity and triggered activity are disorders of impulse formation

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3
Q

What conditions predispose cardiac cells to altered automaticity?

A

Ischemia
Drug Toxicity
Hypocalcemia
Electrolyte imbalance

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4
Q

What does altered automaticity produce?

A 
Produce atrial dysrhythmias
premature atrial complexes
supraventricular tachycardia
atrial flutter
atrial fibrilation
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5
Q

This is an abnormal condition of myocardial cells or non pacemaker which causes cells to depolarize more than once after stimulation by a single electrical impulse; sometimes happens during repolarization after the cells are normally quiet
A. altered automaticity
B. Triggered activity
C. Re-entry

A

Triggered activity

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6
Q

This occurs in normal pacemaker cells or myocardial cells that do not normally function as pacemaker cells; causes cells to fire before a normal SA node such as with sinus tachycardia
A. Altered automaticity
B. Triggered activity
C. Reentry

A

A. Altered automaticity

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7
Q

Name 4 causes of triggered activity

A

Hypoxia
Increased catelcholamines
Myocardial Ischemia
Medications

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8
Q

Name a medication associated with triggered activity

A

Quinidine

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9
Q 
Triggered activity can result in:
A.  Atrial Beats
B.  Ventricular Beats
C.  patterns in which they occur in pairs, or 3 or more
D.  Sustained ectopic rhythm
E.  All of the above
A

E. all of the above

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10
Q

Condition in which an impulse returns to stimulate tissue that was previously depolarized and results in a single premature beat, or repetitive electrical impulses resulting in short periods of rapid rhythms.
A. Altered automaticity
B. Triggered activity
C. Reentry

A

C. Reentry

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11
Q

Causes of reentry include:

A

Hyperkalemia
Myocardial Ischemia
Antidysrhythmia medications

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12
Q

Name 3 things required for reentry to occur.

A

Potential conduction circuit or circular conduction pathway
block within the circuit
Delayed conduction

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13
Q

Atrial dysrhythmias include what two things?
A. PAC’s
B. SVT or paroxysmal supraventricular tachycardia
C. None of the above
D. All of the above

A

D. All of the above

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14
Q

T or F: atrial dysrhythmias are not usually life threatening but may compromise cardiac output

A

True

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15
Q

T or F: atrial dysrhythmias may produce very fast atrial rates

A

False; they produce very fast ventricular rates

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16
Q 
How do you recognize a PAC?
A.  Shortened P-R interval
B.  QRS is extended beyond 0.10
C.  P-waves are premature and occur earlier then expected and may appear different in shape
D.  QRS are inverted
A

C. P waves are premature

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17
Q

WHen you see a pause which follows PVC this is known as:
A. Compensatory Pause
B. non compensatory pause

A

B. compensatory pause

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18
Q

When you see an incomplete pause often following a PAC and causes a delay in which SA node resets its rhythm this is
A. Compensatory pause
B. Non compensatory pause

A

B. Non compensatory pause

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19
Q

This type of PAC is associated with a wide QRS complex and conduction through ventricles is abnormal?

A

Aberrantly conducted PAC

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20
Q

This type of PAC occurs prematurely and close to T-wave of preceeding beat; only p wave may be seen with no QRS after it (appears as pause)

A

Non conducted or blocked PAC

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21
Q 
What might cause a blocked PAC
A.  P wave occurred too early to be conducted
B.  AV junction is still refactory and unable to conduct impulses
C.  Pause is compensatory
D.  Pause is non compensatory
E  Both A & B
F.  Both ABC
G  Both ABD
A

E. Both a & B

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22
Q

If you see a hump which might indicate a hidden p wave and the pwave appears early in the t wave & t wave is of higher amplitude what do you probably have?
A. Aberrantly conducted PAC
B. Non conducted or blocked PAC
C. non compensatory pause

A

B. Non conducted or blocked PAC

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23
Q

Name the causes of PAC’s

A 
(EVA HAS CF not ED)
Emotional Stress
Valvular heart disease
Acute coronary syndrome
hyperthyroidism
Atrial enlargement
Stimulants
CHF
Fatigue
Electrolyte imbalance
Digitalis toxicity
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24
Q

These are characterized by at least 3 different p waves seen in same lead and has multiple pacemakers that shift back & forth?

A

Multi Formed atrial rhythm or wandering atrial pacemaker

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25
Q

T or F: MAR’s have normal rates and rhythms.

A

False: the rhythm is irregular

26
Q

When a multiformed atrial rhythm is greater than 100 bpm it is called?

A

Multifocal atrial tachycardia (MAT)

27
Q

The MAT looks very similar to what?

28
Q

Name 3 types of supraventricular tachycardia

A

AT (atrial tachycardia)
AVNRT (atriventricular nodal reentrant tachycardia)
AVRT (atrioventricular reentrant tachycardia)

29
Q

This type of atrial rhythm causes a series of rapid beats from an atrial ectopic focus & often follows a PAC, its rapid rate overrides the SA node and becomes pacemaker
A. AT
B. AVNRT
C. AVRT

30
Q

When you have an AT that starts and ends suddenly this is called?

A

Paroxysmal Atrial Tachycardia

31
Q

Causes of AT include:

A 
IS MEA
infection
stimulant use(albuterol, cocaine)
myocardial infarction
Electrolyte imbalance
Acute illness with excessive catecholamines released
32
Q

Name the symptoms of AT

A 
APFCDFDS
Asymptomatic
Palpitations
Flutter in heart
Chest pressure
Dizziness
Fatigue
Dyspnea
Syncope
33
Q

How can you treat AT?

A

Vagal maneuvers
Adenosine
Calcium Channel blockers
Beta Blockers

34
Q

What is the drug of choice for treating AT

35
Q

This type of arrhythmia begins above bifurcation of bundle of HIS and includes rhythms that begin in SA node atrial tissue or av junction

A

Supraventricular arrhythmia

36
Q

Name 6 examples of a vagal maneuver

A 
Coughing
Squatting
Carotid sinus pressure
cold stimulus to face
valsalva's maneuver
gagging
37
Q

what is the maximum time a vagal maneuver should be applied?

A

no more than 10 seconds

38
Q

what happens when vagal maneuvers are used?

A

baroreceptors in internal carotid arteries and aortic arch are stimulated
causes release of catecholamine
slows conduction through av node

39
Q

This type of SVA will result when an impulse originates as wave of excitation that spins around AV nodal, the p waves may be buried in the qrs
A. AT
B. AVNRT
C. AV

40
Q

This type of SVA is a reentrant mechanism, causes a circus movement or bypass tract
A. AT
B. AVNRT
C. AV

41
Q

This type of SFV causes a firing outside of SA node at a rapid rate, fires automatically
A. AT
B. AVNRT
C. AV

42
Q

Name causes of the MAT (multifocal atrial tachycardia)

A 
CHAD RE H&H
COPD
Hypoxia
Acute Coronary Syndrome
Rheumatic heart disease
Electrolyte imbalance:  hypokalemia, hypomagnesemia
Digoxin toxicity
43
Q

If your patient is symptomatic but you are unsure if it is MAT vs a fib what can you do?

A

Vagal maneuver

Adenosine

44
Q

What medications can be given for MAT?

A

Calcium channel blocker

Beta blockers

45
Q

THis type of pattern is a result of random & chaotic firing of multiple sites in atria and does not involve reentry through AV node, adenosine or vagal maneuvers may slow down temporarily

46
Q

What are 3 main types of atrial rhythms in this unit?

47
Q

What are the 3 types of SVT’s?

A

AT
AVNRT
AVRT

48
Q

What is the drug of choice used for AT?

49
Q

What drugs are used for MAT

A

Ca or Beta blockers

50
Q

What 3 things can frequent PAC’s initiate?

A

Atrial fibrillation
Atrial Flutter
PSVT

51
Q

How do you treat PAC’s?

A

Treat underlying cause

52
Q

The MAT is also known as?

A

Wondering Atrial Pacemaker

53
Q

T or F: PAC’s are a very significant problem in a healthy heart and must be treated immediately

54
Q

This type of atrial rhythm may appear in runs or bursts?

55
Q

Name the types of patterns seen with PAC, 4 patterns

A

Coupled or pairs
Runs or bursts which is greater than 3 PAC’s
Atrial bigeminy, in which every other beat is a PAC
Atrial Trigeminy, every 3rd beat is a PAC

56
Q

If you see premature p-waves of different shape than normal, a rate wnl, normal P-R interval and normal QRS what do you have?
A. PAC
B. MAT
C. SVT

57
Q

If you see a regular rhythm, but your rate is 100-250 bpm where one positive p wave preceeds each qrs complex in lead II but P waves differ in shape, you see an isoelectric baseline between 2 p waves what is this?
A. PAC
B. AT
C. SVT

58
Q

If you have a rate at 60-100 bpm or is greater than 100 bpm with “irregular rhythm” in which size shape, & direction of P wave changes direction from beat to beat and 3 different p wave configurations occur in same lead with variable p-r intervals what do you probably have?

A

MAT or wandering atria pacemaker

59
Q

what is a key difference between MAT and a fib?

A

The p waves are clearly visible with MAT

60
Q

This pattern is often observed in athletes and during sleep?

A

Wandering atrial pacemaker

multi formed atrial rhythm

61
Q 
Atrial tachycardia is a type of?
A.  SVA
B.  MAT
C.  MAR
D.  PAC
62
Q

This type of SVT is the most common; caused by reentry in the area of AV node?
A. AT
B. AVNRT
C. AVRT

atrial rhythms (1 decks)

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