Atrial Dysrhythmias Flashcards
Atrial Flutter
Originates: Av Node - Overrides the SA Node
Re-Entry impulse that is REPETITIVE & CYCLIC
Regular atrial rhythm with an ATRIAL rate of > 250 bpm
Ventricular rate is slower
P wave classic “Sawtooth” appearance
QRS usually narrow
May be 2:1 3:1 4:1
Atrial Flutter: Causes
- Coronary Heart Disease
- Cardiomyopathy
- Heart Valve Disease
- Congenital Heart Disease
- Inflammation of the heart (myocarditis)
- High BP
- Other conditions such a lung disease or overactive thyroid
- Electrolytes
**Something is wrong with the Heart
Atrial Fibrillation
Multiple irritable spots in the atria (multiple impulse locations)
IRREGULARLY IRREGULAR
(both atrial + ventricular)
-random action potentials
HR: 100-175 bpm
NO identifiable “P” wave
“fibrillation” waves
R-R or P-P totally irregular
Atrial Fibrillation: Clinical Manifestations
Palpations Heart Racing Fatigue Dizziness Chest Discomfort Shortness of breath May be asymptomatic
AFIB w/RVR
Is it rate controlled?
-high HR isn’t going get the CO needed.
Atrial Fibrillation: Causes
Electrolytes
Hypoxia
Cardiovascular disease (all)
Atrial Fibrillation: Complications
Decreased CO
Heart Failure
EMBOLUS»_space; Stoke (common!)
-clotting within atria
Atrial Fibrillation: Treatment
Most common type of treated dysrhythmia
Rate Control: Beta blockers, CCB, digitalis, amiodarone
-same for Atrial flutter
Stroke Prevention: anticoagulants, antiplatelet
Non-pharmacological
-Ablation, Cardioversion
Premature Ventricular Contractions (PVCs)
Contraction coming from an ectopic focus in the VENTRICLES
It comes EARLIER than the QRS should, and doesn’t follow a normal rhythm or P-wave
WIDE and distorted in shape compared to normal QRS
PVC’s Causes
Simulants Electrolytes Hypoxia Fever Exercise Emotional stress CVD
Treat the Cause
Premature Ventricular Contractions (PVCs): Subtypes
- Bigeminy
- every second beat - Trigeminy
- every third beat - Quadrigeminy
Usually an electrolyte problem.
-can be positive or negative
Ventricular Tachycardia (VTACH)
3 or more PVC’s together
Ectopic focus within the VENTRICLES takes control and fires repeatedly: NO atrial contractions occurring
SEROUSLY decreases CO
VTACH: Causes
- MI
- CAD
- Significant Electrolyte abnormalities
- HF
- Drug toxicity
Ventricular Tachycardia (VTACH): Stuff
Rate: 150-200, Usually regular
NO P-wave evident, PR not measurable
VTACH: treatment
Depends on Pulse
-patient will be symptomatic very quickly unless converts back to other rhythm
May need anti-dysrhythmic medications like Beta blockers or CCB
-Electrolyte replacement
First Question: Pulse or Pulseless?
-some will, some won’t, eventually all become PULSELESS
