Atrial Rhythms Flashcards
1
Q
Name : Atrial Dysrhythmias Types (5)
A
- Contractions auriculaires prématurées (PAC)
- Stimulateur auriculaire errant
- Tachycardie auriculaire multifocale
- Flutter auriculaire
- Fibrillation auriculaire
2
Q
Describe : Contractions auriculaires prématurées (PAC) (3)
A
- PACs can occur for a number of different reasons i.e., diet, fatigue, stress, disease, ischemia to name a few.
- frequently occur in bradycardic rhythms, but may occur almost any time.
- occur when an early electrical impulse occurs from a location in the atria other than the SA node.
3
Q
Describe EKG : Contractions auriculaires prématurées (PAC)
A
- This early impulse causes an early cardiac complex which disrupts the underlying rhythm.
- The locus of stimulation being different, results in a change in the morphology of the P wave.
- PACs can occur occasionally or frequently.
- PACs ECG can be observed with or without a pattern
- The P wave with PAC’s will always be upright
4
Q
Describe : Stimulateur auriculaire errant (2)
A
- Wandering Atrial Pacemaker is aptly named due to the electrical impulses causing the atrial activity are moving or wandering.
- These changes in the locus of stimulation affect the morphology of the P waves.
5
Q
Describe analyse : Stimulateur auriculaire errant (3)
A
- In Wandering Atrial Pacemaker ECG, you must observe at least three different shaped P waves.
- No other changes in the tracing may be observed. The rhythm may or may not be regular.
- The PR interval is often affected, but does not have to be.
6
Q
Décrire : Tachycardie auriculaire multifocale (5)
A
- A faster version of Wandering Atrial Pacemaker.
- The criteria is the same as Wandering Atrial Pacemaker with the only difference being the heart rate exceeds 100 bpm.
- These changes in the locus of stimulation within the atria affect the morphology of the P waves.
- Remember, you must observe at least three different shaped P waves.
- Due to the presence of irregular R to R intervals coupled with the changing P wave morphology, some people have confused this rhythm with Atrial Fibrillation.
7
Q
Describe : Flutter (5)
A
- Occurs when there is an obstruction within the atrial electrical conduction system.
- Due to this impediment a series of rapid depolarizations occur.
- These depolarizations may occur two, three, four or more times per QRS complex.
- The AV node functions like a “gatekeeper” blocking the extra impulses until the ventricular conduction system is able to accept the impulse.
- The impulse that is accepted will cause the QRS complex to occur.
8
Q
Describe analysis : Flutter (5)
A
- Each atrial flutter ECG wave represents atrial depolarization. This will be noted next to the P wave step in rhythm analysis.
- Instead of P waves, this tracing has “F” waves.
- No P waves mean there is no PR interval measurement.
- When the tracing is interpreted, the ratio of F waves to each QRS complex will be documented along with the rhythm i.e. Atrial Flutter 4:1 (indicates 4 “F” waves to each QRS complex).
- Not all Atrial Flutter rhythm strips will have a regular rhythm. In that case just document and report your observations.
9
Q
Describe : FA (5)
A
- Occurs when multiple electrical impulses occur within the atria. This chaotic electrical activity results in a chaotic wave form between the QRS complexes.
- P waves are absent. They are replaced by lower case “f” waves.
- No P waves means there is no PR interval measurement.
- This rapid electrical activity overwhelms the AV node causing impulses to enter the ventricular conduction system at irregular points.
- This results in ** irregular R to R intervals**.
10
Q
Describe why heart rate is high in FA (3)
A
- When a patient experiences A-fib, the atria are not contracting as they normally would.
- They are just quivering. This absence of contraction of the atria can result in a loss of cardiac output anywhere from 15 - 30% due to the absence of “atrial kick”.
- This is why the heart rate is so high. The body is trying to maintain homeostasis.
11
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