Atrial Rhythm Charecteristic Chart

Question 0

WAP (wandering atrial pacemaker)

Answer 0

Pacemaker shift between 3 different pacemaker locations
Each P wave will have 3 different morphology in same lead

Intrinsic Rate- A) <0.12 sec - 0.20 (normal or wide)

Question 1

PAC (premature atrial complex)

Answer 1

Early ectopic beats that originate outside SA node
P wave has different morphology

Compensatory pause-
P-P March out, meaning PAC didn’t reset SA node

Non compensatory pause-
Do NOT march out, SA node was reset by PAC

Bigeminal- every other beat , trigeminal- every 3rd beat, ect…

Question 2

MAT (multifocal atrial tachycardia)

Answer 2

Intrinsic Rate- A)100-150 BPM V)100-150 BPM A&V-up to 250BPM
Regularity- Irregularly irregular
P Wave- Present, 3 different morphology
P:QRS ratio- 1:1 married
PR Interval- 0.12 sec - 0.20 sec (normal,variable)
QRS Width- <0.12 sec - 0.20 (normal or wide)

Question 3

( Ectopic) Atrial Tachycardia

Answer 3

When ectopic focus in atria beats so fast it takes over as pacemaker
Over rides SA node
Sustained- it’s been there
Paroxysmal- comes & goes, onset witness

Intrinsic Rate- A) 150-250 BPM V) 150-250 BPM
Regularity- Regular ( unless paroxysmal)
P Wave- Present , different from underlying rhythm
P:QRS ratio- 1:1 married
PR Interval- 0.12 sec - 0.20 sec (normal,short or variable )
QRS Width- <0.12 sec - 0.20 (normal or wide)

Question 4

Narrow Complex Tachycardia (svt)

Answer 4

Rate so fast P waves are buried in T waves
SVT= group of rhythms
Most common SVT 1) sinus tac 2) A-fib 3) A-flutter 4) AV Nodel re entry Tachycardia (AVNRT) 5) atrial tac 6) MAT 7) Junctional tac (JT)

Intrinsic Rate- A) >150 BPM V) >150 BPM
Regularity- Regular
P Wave- Not Present
P:QRS ratio- Indeterminate
PR Interval- Indeterminate
QRS Width- <0.12 sec - 0.20 (normal or wide)

Question 5

Atrial Flutter

Answer 5

Very rapid regular atrial tachycardia
Saw tooth pattern (pathognomonic) marches out
Conduction ratio 2:1 ( most common)
If conduction not constant = Variable conduction

Intrinsic Rate- A) 200-400 BPM V) 100-300 BPM
Regularity- Conduction ratio dependent
P Wave- Absent , F wave
P:QRS ratio- F:QRS ratio consistent or variable
PR Interval- Absent since there is no P wave
QRS Width- <0.12 sec - 0.20 (normal or wide)

Question 6

Atrial Fibrillation (A-Fib)

Answer 6

Chaotic asynchronous(out of sync) firing
SA node is suppressed by other electrical activity
Very little to no atrial contraction, stagnant blood can clot
1) paroxysmal- spontaneous (switches from sinus to a-fib on its own)
2) persistent- chronic but stops with med/electricity
3) permanent- chronic with NO conversion

Intrinsic Rate- A) Indeterminate (400-700) BPM V) Variable BPM
Regularity- Irregularly irregular
P Wave- None , f- waves
P:QRS ratio- none
PR Interval- none
QRS Width- <0.12 sec - 0.20 (variable,wide or narrow)