Atrial Rhythms

Question 1

Altered automaticity and triggered activity are disorders in impulse ______ while reentry is a disorder in impulse _____

Answer 1

formation, conduction

Question 2

What do atrial dysrhythmias associated with altered automaticity include what?

Answer 2

premature atrial complexes, supraventricular tachycardia, atrial flutter, atrial fibrillation

Question 3

What three things can cause atrial dysrhythmias?

Answer 3

altered automaticity, triggered activity, reentry

Question 4

What causes triggered activity?

Answer 4

when escape pacemaker and myocardial working cells depolarize more than once after stimulation by a single impulse

Question 5

How would you define reentry/reactivation?

Answer 5

condition in which an impulse returns to stimulate tissue that was previously depolarized-> an impulse enters a cell during its relative refractory period

Question 6

What three things does reentry need?

Answer 6

a potential conduction circuit or pathway, a block within part of the circuit, delayed conduction with the remainder of the circuit

Question 7

What atrial dysrhythmias are associated with reentry?

Answer 7

premature atrial complexes (PAC’s), Paroxysmal supraventricular tachycardia (PSVT)

Question 8

How can you identify a PAC?

Answer 8

early/premature P waves, positive (upright) P waves in lead II that differ in shape from sinus P waves, and early P wave may or may not be followed by a QRS complex

Question 9

What is this showing?

Answer 9

premature atrial complex

Question 10

What is this showing and how do you know?

Answer 10

P wave with no QRS after, nonconducted PAC

Question 11

PAC patterns
atrial _____ : every other beat is a PAC
atrial ______ : every third beat is a PAC
atrial ______: every fourth beat is a PAC

Answer 11

bigeminy, trigeminy, quadrigeminy

Question 12

What term defines when the size, shape and direction of P waves vary?

Answer 12

wandering atrial pacemaker/ multiformed atrial rhythm

Question 13

What is this and how do you know?

Answer 13

wandering atrial pacemaker, at least 3 different P wave configurations are required to make this diagnosis

Question 14

What term describes when wandering atrial pacemaker is associated with ventricular response of 100 beats/min or greater?

Answer 14

multifocal atrial tachycardia

Question 15

What is this showing?

Answer 15

multifocal atrial tachycardia

Question 16

What bucket term describes tachydysrhythmias that originate above the bifurcation of the bundle of His, or dysrhythmias with a rapid ventricular rate and narrow QRS complex but with an uncertain specific origin?

Answer 16

supraventricular tachycardia

Question 17

What term is a series of rapid beats from an atrial ectopic focus, often precipitated by a PAC and rapid atrial rate overrides the SA node and becomes the pacemaker?

Answer 17

atrial tachycardia

Question 18

What rate does atrial tachycardia have to be between?

Answer 18

150-250 beats/min

Question 19

What does this signify?

Answer 19

atrial tachycardia

Question 20

What type of atrial rhythm has a rate of 250-350 in type 1 and 350-450 in type 2?

Answer 20

atrial flutter

Question 21

What is this and how do you know?

Answer 21

atrial flutter, looks like shark teeth

Question 22

t/f, chronic atrial flutter is normal

Answer 22

false, very unusual and usually reverts to sinus rhythm or atrial fibrillation

Question 23

What is the clinical significance of atrial flutter?

Answer 23

beats so fast that blood pools and stays there which can increase risk of clotting and stroke

Question 24

What term occurs when there is a rate of 400-600 beats/min so the atria quivers due to multiple reentry circuits in the atria?

Answer 24

atrial fibrillation

Question 25

true or false, there is no p wave in atrial fibrillation because of the quivering of the atrial muscle and because there is no uniform wave of depolarization

Answer 25

true, this is why there is no p wave

Question 26

What is this?

Answer 26

atrial fibrillation

Question 27

What is this?

Answer 27

a fib with AV block

Question 28

a fib tends to turn into ____ which means you should ____

Answer 28

v-fib, defibrillate