Atrial Rhythms Flashcards
Atrial rhythms originate from
Cells in the atria that are not the SA node
A premature atrial contraction can be identified by
An early beat with a P wave (That may look funky) that has a regular P-R interval
True or false: P waves can be inverted
True: A P waves morphology depends on the direction from which it originates. If the P-R interval is normal, it is atrial- not Junctional
Normal P-R duration
0.12-0.2 seconds
A typical P wave is positive in what leads
I, II, III, aVF, V5, V6
What defines a noncompensatory PAC
The rhythm does not march on after the ectopic beat
A P falling on a T may result in
A humped T wave
A blocked P wave
Does not result in ventricular contraction
What distinguishes an ectopic atrial rhythm
-Regular rhythm
-Non sinus P waves
-Rate is <100
-PR intervals may be slightly prolonged
What distinguishes ectopic atrial tachycardia
-Regular rhythm
-Non sinus P waves
-Rate is 100-180
A PAC often triggers
Ectopic atrial tachycardias
EAT with a block is called
Paroxysmal atrial tachycardia
PAT will have
A 2nd or 3r degree heart block
Wandering atrial pacemaker is distinguished by
-Irregularly irregular
-Non sinus P waves (At least 3 different morphologies)
-HR is 100 bpm or less
Multifocal atrial tachycardia is distinguished by
-Irregularly irregular
-Non sinus P waves (At least 3 different morphologies)
-HR is greater than 100 bpm
Etiology of MAT
- COPD
- Respiratory failure
- Electrolyte abnormalities 3. Electrolyte abnormalities
- Drugs: nicotine, alcohol,
caffeine, etc. - Theophylline
- Idiopathic
Etiology of EAT
- Idiopathic
- Sympathomimetics
- Caffiene, Nicotine, ETOH
- Stress/anxiety 4. Stress/anxiety
- Cardiomyopathy
- Valvularheart disease
- Myocardial infarction
- COPD and lung disease
- Digitalis toxicity
- Other drugs: theophylline
- Post-catheter ablation and surgery
EAR Etiology
- Idiopathic and benign
- Anxiety
- Drugs: nicotine, alcohol, 3. Drugs: nicotine, alcohol,
caffeine, etc. - Structural heart disease
- Electrolyte disorders
PAC Etiology
- Idiopathic and benign
- Anxiety
- Fatigue
- Drugs: Nicotine, alcohol, 4. Drugs: Nicotine, alcohol,
caffeine, etc. - Enlarged atria
- Heart disease
- Electrolyte disorder
- Sympathomimetics
- Digitalis Toxicity
Atrial Flutter is distinguished by
-HR of 250-350 commonly
-Sawtooth P waves
-Often 2:1 but may be higher
May have dropped beats
Wide ventricular complex may occur in atrial flutter due to
Aberrancy, BBBs, Electrolyte imbalances
A-Flutter etiology
Myocardial infarction
Atherosclerosis
Drugs: digoxin
Rheumatic heart disease
Alcoholic holiday heart
Thyrotoxicosis
Pulmonary emboli
Pericarditis
Pneumonia: Right middle lobe
Atrial Fibrillation can be distinguished by
-A variable rate
-Irregularly irregular
-Chaotic fibrillation
The three classifications of Afib are
Paroxysmal, Persistent, Permanant
What is Ashmans phenomenon
Aberrancy that develops when a short pause follows a long pause
Digoxin creates a ____ shape after the QRS
Scoop
AFIB etiology
- Atrialenlargement (especially left)
2.Age
3.MAD RAT PPP - Idiopathic (or lone atrialfibrillation)
Right atrial hypertrophy appears as
Sharp P waves
Left atrial hypertrophy appears as
Humped P waves
MAD RAT PPP stands for
Myocardial infarction
Atherosclerosis
Drugs: digoxin
Rheumatic heart disease Rheumatic heart disease
Alcoholic holiday heart
Thyrotoxicosis
Pulmonary emboli
Pericarditis
Pneumonia: Right middle lobe
What may result from Afib
Stroke.
Afib with RVR presents as
Afib with a ventricular rate of over 150
A SVT that is irregular is probably
Afib RVR
SVT appears as
A regular rhythm too fast to distinguish the nature of the P wave.
