Atrial and Ventricular Dysrhythmias

Question 1

Atrial Dysrhythmias: Types (2)

Answer 1

atrial flutter
atrial fibrillation

Question 2

Atrial Flutter

Answer 2

-originates in the AV node (overrides the SA node and takes full control)
-reentry impulse that is REPETITIVE & CYCLIC
-regular atrial rhythm with an ATRIAL rate of >250 bpm
-ventricular rate is SLOWER
-P wave is classical “sawtooth” appearance
-QRS usually narrow
-May be 2:1, 3:1, or 4:1 (P waves : QRS)

Question 3

Atrial Flutter: Causes (8)

Answer 3

Coronary heart disease
Cardiomyopathy
Heart valve disease
Congenital heart disease
Inflammation of the heart (such as myocarditis)
High BP
Other conditions such as lung disease or overactive thyroid
Electrolytes

Question 4

Atrial Fibrillation (afib or AF)

Answer 4

multiple irritable spots in the atria
IRREGULARLY IRREGULAR (both atrial and ventricular)
HR: 100-175 bpm
NO identifiable P wave
“fibrillation” waves

Question 5

afib: Clinical Manifestations (7)

Answer 5

may be asymptomatic
palpitations
heart racing
fatigue
dizziness
chest discomfort
SOB

Question 6

afib: Causes (3)

Answer 6

electrolytes
hypoxia
cardiovascular disease (all)

Question 7

afib: Complications (3)

Answer 7

decreased cardiac output
heart failure
EMBOLUS–> stroke

Question 8

afib: Stats

Answer 8

An estimated 2.7 million people are living with it
Untreated afib DOUBLES your risk of heart-related death, and causes a 4 TO 5 TIMES GREATER RISK of stroke
About 15-20% of people who have strokes also have afib

Question 9

afib: Treatment

Answer 9

the MOST common type of treated dysrhythmia
Pharmacological:
-rate control: beta
blockers, CCB, digitalis,
amiodarone
-stroke prevention:
anticoags, antiplatelets
Non-pharmacological:
-abalation, cardioversion

Question 10

Ventricular Dysrhythmias: Types (3)

Answer 10

Premature Ventricular Contractions
Ventricular Tachycardia
Ventricular Fibrillation

Question 11

Premature Ventricular Contractions (PVCs)

Answer 11

-contraction coming from an ectopic focus in the VENTRICLES
-it comes EARLIER than the QRS should come and doesn’t follow a normal rhythm or P wave
-wide and distorted in shape compared to normal QRS
-treat the cause

Question 12

Premature Ventricular Contractions (PVCs): Causes (7)

Answer 12

stimulants
ELECTROLYTES
hypoxia
fever
exercise
emotional stress
CVD

Question 13

Premature Ventricular Contractions (PVCs): Subtypes (3)

Answer 13

bigeminy
trigeminy
quadrigeminy

Question 14

Ventricular Tachycardia (Vtach)

Answer 14

-Consists of 3 or more PVCs together
-Ectopic focus within ventricles takes control and fires repeatedly–> NO atrial contractions occurring
-SERIOUSLY decreases cardiac output
- considered DEADLY rhythm

Question 15

Vtach: Characteristics

Answer 15

rate usually 150-200 bpm, usually regular
NO P wave evident, PR not measurable

Question 16

Vtach: Associations (6)

Answer 16

MI
CAD
Significant electrolyte abnormalities
Heart failure
Drug toxicity
“Other bad things”

Question 17

Vtach: Treatment

Answer 17

ACLS–> depend on pulse, patient will be symptomatic very quickly unless converts back to other rhythm
-may need an anti-
dysrhythmic med like a
beta blocker or CCB
-electrolyte replacement
first question: if it’s going for more than 10-15 seconds, check for pulse or no pulse?–> if no pulse, start CPR

Question 18

Ventricular Fibrillation (Vfib)

Answer 18

DEADLY RHYTHM
irregular waveforms of varying shapes and sizes
the ventricles are just “quivering”
NO effective contractions: NO CARDIAC OUTPUT