Atrial Dysrhythmias

Question 1

Atrial dysrhythmias

Answer 1

originate from ectopic focus in atria, not the SA node
occurs premature (pre normal sinus)

Question 2

Automaticity

Answer 2

heart self-generates an electrical impulse

Question 3

Premature Atrial Contractions
(PAC’s)

Answer 3

regular sinus rhythm is interrupted by early abnormally-shaped atrial P wave
* normal or narrow QRS (dependent on AV node health)

Question 4

PAC cause

Answer 4

• nicotine, caffeine, ETOH
• strong emotions
• MI
• digitalis
• low Mag/K+

Question 5

PAC ECG

Answer 5

Rhythm –> regular
P wave –> present (may be hidden)

Question 6

PAC treatment

Answer 6

remove causitive factor

Question 7

Paroxysmal Atrial Tachycardia
(PAT)

Answer 7

burst of 3 PACS
same causes
may have lightheadedness/palpations

Question 8

PAT EKG

Answer 8

• starts with PAC
• rate 160-250
• different P wave
• PR 0.12-0.20

Question 9

SupraVentricular Tachycardia
(SVT)

Answer 9

rapid, sustained artrial tachycardia
* sinus tach
* atrial flutter
* atrial fib

Question 10

SVT clinical manifestations

Answer 10

increased rate decreases filling time = ↓ CO

Question 11

SVT treatment

Answer 11

heart rate reduction
1. valsalva maneuver
2. carotid massage
3. adensosince
4. amiodarone/CCB/BB
5. Cardioversion

Question 12

SVT SKG

Answer 12

rate: >130
P wave: not identifiable
QRS <0.12

Question 13

Electrical Cardioverson

Answer 13

Synchronized electrical shock with R-wave

Question 14

What would happen if you delievered a shock during repolarization?

Answer 14

VFIB

Question 15

Atrial flutter

Answer 15

SVT
Rate: 300 BPM
P waves not present
1:1 300BPM
2:1 150BPM
4:1 7BPM

Question 16

A flutter clinical manifestations

Answer 16

• ↓CO
• thrombi can form on atria walls (d/t no contraction) = PE, Stroke, MI

Question 17

A flutter treatments

Answer 17

• Amiodarone
• BB/CCB/Digoxin
• Synchronized Cardioversion
• Long-term anticoagulation

Question 18

Atrial Fibrillation

Answer 18

ectopic rhythm of 350-500BPM
absent P wave
ventricular (QRS) is irregularly regular (Rapid >100BPM) or controlled (<100BPM)

Question 19

AFib commonly occurs in

Answer 19

• Heart failure
• CAD
• Pulmonary disease
• Severe Mitral Valve Disease

Question 20

AFIB EKG

Answer 20

Atrial –> indiscernible
350-500BPM
Ventricular –> irregular
controlled or RVR
QRS <0.12

Question 21

A fib treatment

Answer 21

• Amiodarone
• BB/CCB/Digozin
• cardioversion,** TEE prior/anticoagulation before if stable**
• Long term anticoagulation
• Ablation therapy (radiofrequency)