atrial dysrhythmias Flashcards
early P wave that may be inverted, hidden in T wave, or have different morphology
PAC (premature atrial contraction)
what can cause PACs?
nicotine, caffeine, ETOH
myocardial ischemia, HF
meds (digitalis)
electrolyte imbakance (low K and mag)
describe rhythm in PAC
regukar, but interrupted by PAC
PAC treatment
none in most cases eleiminate exposure to cause
sudden burst of 3 or more PACs that become the rhythm for a short time
-starts and stops suddenly
PAT (paroxysmal atrial tachycardia)
why does PAT occur?
emotions, nicotine, ETOH
MI
meds (digitalis)
What does PAT normally begin with, and what does it look like?
begins with PAC, looks like a quick run of tachycardia with a new P wave occuring before a T wave can occur
treatment option of PAT are similar to what?
SVT
rapid, sustained atrial tachycardia when the mechanism is unknown
SVT (supraventricular tachycardia)
what dysrhythmias fall under SVT?
ones that originate above AV node
-sinus tach
-atrial flutter
-atrial fibrilaltion
what is SVT treamtent targeted toward?
heart rate reduction
describe rate, rhythm, P waves, and PR interval in SVT
rate = >130
rhythm = regular
P waves = non-identifiable (too fast / hidden in T wave)
PR = immesurable
adverse effects of SVT
dec. CO and hypoTN
SVT treatment (stable/unstable)
stable: first = valsalva maneuver
next = carotid massage
then, adenosine (stop/start heart)
then, amiodarone, CC blockers, beta blockers
unstable or if all fails: electrical cardioversion
when is the shock delivered in a cardioversion
on R wave
what would happen if a shock was delivered on T wave?
v-fib or lethal dysrhythmias
a SVT characterized by atrial rate of around 300
a flutter
what does a flutter look like
sawtooth
is the sawtooth atrial pattern P waves?
NO
they are called F waves
what are ventricular conduction rates in a flutter?
2:1, 3:1, 4:1
2:1 is fastest
4:1 is slowest
what conditions does a flutter often occur in?
CAD
cor pulmonae
rheumatic heart disease
what conditions resule from lack of atrial contraction in a flutter?
PE
stroke
MI
what are the 2 goals of a flutter treatment
convert back or sinus
OR
achieve ventricular rate control (HR < 100)
treatment of a flutter (stable/unstable)
long term anticoagulats
stable: amiodarone (convert to NSR), beta blockers, CC blockers, digoxin
unstable: synchronized cardioversion
