Atrial Rhythms Flashcards by Shane Connolly

How is the morphology of atrial arrhythmia’s P-wave (5)

Flattened
Notched
Peaked
Sawtoothed
Diphasic

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What does diphasic mean?

There is an upward deflection and then dips below the isoelectric line

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When is the wandering pacemaker caused?

When the pacemaker role switches from beat to beat from the SA node to the atria and back again

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Wandering pacemaker

Regularity

Slightly irregular

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Wandering pacemaker

Rate

60-100

Not more than 150

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Wandering pacemaker

P wave morhphology

Morphology changes from one complex to the next

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Wandering pacemaker

PRI time

Less than .20

Varies

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Wandering pacemaker

QRS time

Less than .12 second

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What is an ectopic beat?

A single beat that arises from a focus outside the SA node

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When does an ectopic beat initiate?

When a site somewhere becomes irritable and overrides the SA node for a single beat

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An early or premature ectopic beat indicates what?

Irritability

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An ectopic beat that is preceded by a prolonged R-R cycle is what?

Escape beat

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What is an atrial ectopic caused by irritability called?

Premature Atrial complex (PAC)

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Premature Atrial Complex

Regularity

Depends on underlying rhythm

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Premature Atrial Complex

Rate

Depends on underlying rhythm

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Premature Atrial Complex

P wave morphology (3)

Flattened
Notched
Lost in preceding t wave

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Premature Atrial Complex

PRI

.12-.20

Can exceed .20

Premature Atrial Complex

QRS

Less than .12

What is atrial tachycardia?

When a single focus in the atria become so irritable it overrides the SA node for the entire rhythm

Atrial tachycardia

Regularity

Regular

Atrial tachycardia

Rate

150-250

Atrial tachycardia

P wave morphology

Atrial p waves (flattened, notched, diphasic)

Can be lost in t wave

Atrial tachycardia

PRI time

.12-.20

Atrial tachycardia

QRS time

Less than .12

What is atrial flutter?

When the atrial become so irritable that they fire faster than 250 bpm

What is a variable block?

When the AV node becomes very erratic about conducting impulses the ratio between F waves and QRS complexes can vary which creates and irregular RRI

Atrial flutter | Regularity

Atrial rhythm is regular | Ventricle rhythm usually is regular unless there's a variable block

Atrial flutter | Rate

250-350

Atrial flutter | P wave morphology

Sawtooth pattern

Atrial flutter | PRI

Unable to determine

Atrial flutter | QRS

Less than .12 second

What is atrial fibrillation?

When the atrial become so irritable they are no longer beating but are quivering ineffectively

What are the fibrillatory waves of atrial fibrillation called?

f waves

What is atrial fibrillation with a rapid ventricular response (uncontrolled)?

Atrial fibrillation with a rate greater than 100

Atrial fibrillation | Regularity

Grossly irregular

Atrial fibrillation | Rate

Atrial rate greater than 350 | Ventricular rate varies

Atrial fibrillation | P wave morphology

No discernible p waves (f waves)

Atrial fibrillation | PRI

Unable to measure

Atrial fibrillation | QRS

Less than .12

What are little f waves a sign of?

Fibrillation

What are big F waves used for?

Fluttering

When are atrial rhythm caused?

When the atrial rate becomes faster than the sinus rate