atrial rhythms

Question 1

dysrhythmias originated in the atria

Answer 1

• wandering atrial pacemaker
• multifocal atrial tachycardia
• premature atrial contractions
• paroxysmal supraventricular tachycardia
• atrial flutter
• atrial fibrillation

Question 2

dysrhythmias originated in the atria: wandering atrial pacemaker

Answer 2

• slightly irregular rhythm
• origination varies among the SA node, atrial tissue, and AV junction
• P waves are variable or absent**
• PRI- varies depending on source of impulse

Question 3

wandering atrial pacemaker

Answer 3

• etiology- variant of sinus dysrhythmia, which is a natural phenomenon in the very young or old
• may also be caused by ischemic heart disease or atrial dilation
• clinical significance- none but may be precursor to other atrial dysrhythmias
• treatment- typically none required
• rhythms are coming from different foci therefore the rhythm is irregular

Question 4

dysrhythmias originating in the atria: multifocal atrial tachycardia

Answer 4

• rate is more than 100
• rhythm is irregular
• pacemaker site is the ectopic sites in the atria
• P waves - organized, nonsinus P waves -> at least 3 forms
• PRI- varies depending on source of impulse
• QRS- variable
• WAP but tachycardic

Question 5

multifocal atrial tachycardia

Answer 5

• etiology- often seen in acutely ill patients
• may result from pulmonary disease, metabolic disorders, ischemic heart disease, or recent surgery, COPD
• clinical significance presence of multifocal atrial tachycardia often indicates a serious underlying illness
• treatment- treat the underlying illness
• rhythm is coming from different foci

Question 6

dysrhythmias originated in the atria: premature atrial contractions

Answer 6

• rate depends on underlying rhythm
• rhythm usually regular expect for the PAC
• pacemaker site is ectopic sites in atria
• P waves- occurs earlier than expected
• PRI- varies dependent on foci of impulse
• p waves and t waves are combining and colliding
• a lot more off than a dysrhythmia

Question 7

premature atrial contractions

Answer 7

• etiology- single electrical impulse originating outside the SA node
• may result from use of caffeine, tobacco, or alcohol, sympathomimetic drugs, ischemic heart disease, hypoxia, or digitalis toxicity, or may be idiopathic
• clinical significance- none, presence of PACs may be a precursor to other atrial dysrhythmias
• treatment- none if asymptomatic
• treat symptomatic patients by administering high flow, high concentration oxygen and establishing IV access

Question 8

dysrhythmias originating in the atria: paroxysmal supraventricular tachycardia

Answer 8

• rate is 150-250
• rhythm is regular
• pacemaker site is outside the SA node -> atrial
• P waves are often buried in preceding T wave
• combo of the p and t wave

Question 9

paroxysmal supraventricular tachycardia

Answer 9

• etiology- rapid atrial depolarization overrides the SA node
• may be precipitated by stress, overexertion, smoking, caffeine
• clinical significance- may be tolerated well by healthy patients for short peroids
• marked reduction in cardiac output can precipitate angina, hypotension, or congestive heart failure

Question 10

dysrhythmias originating in the atria: atrial fluter

Answer 10

• rate is 250-350
• ventricular rate varies
• rhythm is regular
• pacemaker site is outside the SA node (atrial)
• P waves -> F waves are present (flutter wave)
• waves are repeating

Question 11

atrial rate

Answer 11

-between the waves before the qrs

Question 12

atrial flutter

Answer 12

• etiology- results when the AV node cannot conduct all the impulses
• impulses may be conducted in fixed or variable ratios
• usually associated with organic disease such as congestive heart failure (rarely seen with MI)
• clinical significance- generally well tolerated
• rapid ventricular rates may compromise cardiac output and result in symptoms
• may occur in conjunction with atrial fibrillation
• different ratios

Question 13

dysrhythmias originating in the atria: atrial fibrillation

Answer 13

• most common!
• atrial rate 350-750
• ventricular rate varies
• irregularly irregular rhythm
• pacemaker site is outside the SA node (atrial)
• P waves- none discernible
• PRI- none
• QRS- normal

Question 14

atrial fibrillation

Answer 14

• etiology- results from multiple ectopic foci
• AV conduction is random and highly variable
• often associated with underlying heart disease
• clinical significance- atria fail to contract effectively, reducing cardiac output
• well tolerated with normal ventricular rates
• high or low ventricular rates can result in cardiac compromise