Atrial Arrhythmias Flashcards
What is sinus arrhythmia?
Normal sinus rhythm with a small increase in HR during inspiration and a small decrease in HR during expiration
What are the three pathways that transmit the signal from the SA node to the AV node?
Anterior, posterior and middle intermodal pathways
From the SA node, how does the electrical signal get to the LA?
Bachman’s bundle.
What is the part of the EKG that represents the slowing down of the impulse while in the AV node?
Horizontal piece of baseline between P wave and QRS.
What are the three levels of automaticity foci and when do they begin to pace?
Atrial foci, Junctional foci, and ventricular foci in the purkinje fibers. These will pace if the SA Node fails. The fastest one will begin pacing first and as failure occurs the slower ones will begin. It’s always the next fastest rate that will pace.
What happens when there is a premature atrial beat?
The SA node resets itself to the premature atrial beat. It keeps the same rate as before, it just lines itself up one cycle after the PAB.
What are the two options of response of a premature atrial beat?
- It can create a wide QRS because one bundle branch can be ready for it but the other is still in refractory mode, so its response it delayed. Essentially, you have one ventricle responding right away while the other waits a bit, hence wide QRS.
- Or the AV node is still in refractory, so you don’t get a response at all. You will see the P wave, but no QRS following it.
Explain atrial bigeminy and atrial trigeminy?
Bigeminy is when a PAB is continually occurring after a normal P wave. It happens after every normal cycle. Trigeminy is when a PAB occurs after two normal cycles.
What is the rate of paroxysmal tachycardia, flutter, and fibrillation?
150-250
250-350
350-450
Good definition of paroxysmal tachycardia?
You have a foci that is very irritable and suddenly begins pacing super fast.
What do we need to do when we recognize a paroxysmal tachycardia?
Determine where the foci is…atria, junctional, or ventricular
What does the EKG look like with PAT with AV block and what is usually the cause of the arrhythmia?
2 p waves for each QRS. Too much digitalis.
What is going on with Multifocal Atrial Tachycardia?
3 or more atrial foci are pacing and there is not one dominant foci so they all add to the rate.
3 features of MAT on EKG?
Rate over 100, P waves will vary because there are at least 3 foci, and ventricular rhythm is irregular.
These people with MAT are suffering from what health problem?
Obstructive COPD
