Atrial Rhythms Flashcards
DiGoxin
Decreases intrinsic firing in the SA node.
Decreases conduction in the AV node.
Increases automaticity, decreases refractory period in ventricles and His/perkinje
Atrial Tach
common in peds
PAC Etiology
- Hypoxemia - early sign
- Fatigue
- Damaged atria
- Frequent PAC - early CHF
- CAD
- Digoxin toxicity
- Hypokalemia, hypomagnesemia
- Stimulant abuse (Meth)
20cc’s per KG
fluid bolus for peds
Paroxysmal Atrial Tachycardia (PAT)
Starts and stops abruptly
Atrial Tachycardia
- Increased Sympathetic tone
- Hypoxemia
- Digitalis toxicity
- Damaged Atria
- CHF
PAT Etiology
- Common in young women
- Sudden onset
- Sudden termination
- Mitral Valve Prolapse
- Digitalis toxicity
- Hypoxemia
- Damaged Atrium
- Caffeine/nicotine
- Stimulant abuse
Narrow regular QRS
SVT, ATAK
50, 75, 100, 200
Narrow irregular
Afib, Aflutter
120-(150, 175)200
Wide regular
VTAK
100, 150, 175, 200
Wide and irregular
Vfib, torsades
200 biphasic
360 monophasic
Adenosine additional action
Acts on sinus pacer cells and vagus nerve terminals
WPW
Wolff Parkinson White (bundle of kent)
Bundle of Kent (oral boards)
additional pathway (produces delta wave between pr)
sick sinus syndrome
Sinus pause, sinus block
A flutter
Saw tooth pattern and F wave
Uncontrolled A-fib
> 100
Controlled A-fib
<100
Atrial flutter with 3:1 conduction
3 saw teeth with 1 qrs
Atrial fib characteristics
no discernable P waves
grossly irregular
Atrial fib rx
not treated unless above 180
Holiday heart syndrome
tied to alcohol and stress
Wandering atrial pace maker
WAP
WAP
P wave may be: 3 different
i. Upright ii. Diphasic iii. Inverted iv. Behind QRS v. Lost
3 rhythms classified as SVT
Afib Aflutter Sinus tach Atak
Increase in automaticity
Causes increase in ventricular rate
Paroxysmal SVT
?
Lown-Ganang-Levine
“James” fibers that bypass the AV node and shorten the PRinterval
Variable conduction
Irregular A flutter
Types of PAC’s
- Blocked (P wave in T wave, no time for ventricular response)
- Paired (two complete complexes – early)
- Isolated (one)
- Runs (3 or more)
- Bigeminal (Every other)
- Trigeminal (Every third): normal, normal, early
P wave of early beat differs from the sinus beat, it may be:
a. Notched
b. Peaked
c. Diphasic (+ & -)
Lost in preceding T wave (you won’t know because it
gets lost)
Atrial Tachycardia
Rate is 150-250 beats per minute
Rhythm is regular
P-waves all alike (same as PAC). Usually different than “normal” p wave
Usually triggered by a PAC, rest of P waves will now look like the trigger P wave
