ECG/Arrhythmias Flashcards
How often should electrodes be changed?
every 24 hours
How much time does one tiny box on an ECG translate to?
0.04 seconds
How much time does one large box on an ECG translate to?
0.20 seconds
How much time does one standard ECG strip cover?
6 seconds
What does the P wave represent?
atrial depolarization
What does the QRS complex represent?
ventricular depolarization
What does the ST segment represent?
Beginning of ventricular repolarization
What does the T wave represent?
ventricular repolarization
What is the range for a HR on an ECG to be considered “normal” pace?
60-100 bpm
How do you measure bpm by looking at an ECG strip?
count # of R waves x 10
What should the P:QRS ratio be on an ECG?
1:1
If the P waves on an ECG look different what does this mean?
the wave is coming from a different point of origin that is not the SA node
What is the time range for a PR interval to be considered “normal”?
0.12-0.20 seconds (3-5 small boxes)
How long should the QRS complex be to be considered “normal”?
</= 0.12 seconds (3 little boxes or less)
What are the types of sinus rhythms?
sinus rhythm, sinus bradycardia, sinus tachycardia, and sinus arrhythmia
What are the classifications for a sinus rhythm?
rate: 60-100 bpm
regular rhythm
1:1 P:QRS ratio
PR interval 0.12-0.20 seconds
QRS complex < 0.12 seconds
What are the classifications of sinus bradycardia?
rate < 60 bpm
regular rhythm
1:1 P:QRS ratio
PR interval of 0.12-0.20 seconds
QRS complex less than 0.12 seconds
What are the classifications of sinus tachycardia?
rate > 100 bpm
regular rhythm
1:1 P:QRS ratio
PR interval of 0.12-0.20 seconds
QRS complex less than 0.12 seconds
What are the types of atrial rhythms?
PACs, atrial fibrillation, and atrial flutter
Are PACs normal?
yes in healthy people- only problematic if they are frequent and/or symptomatic
What does a PAC look like?
a P wave being masked by a T wave
What are the classifications for atrial fibrillation?
irregular rhythm
no P waves
usually narrowed QRS complex
What are the classifications for atrial flutter?
usually a regular rhythm
sawtooth pattern
3:1 or 4:1 P:QRS interval
What are the different ventricular rhythms?
PVCs, ventricular tachycardia, and ventricular fibrillation
What are the classifications for PVCs?
- no P wave
- no PR interval
- wide QRS complex
- T wave is usually in the opposite direction of the QRS complex
What are the classifications for ventricular tachycardia?
usually regular rhythm
fast rate
no P waves
essentially just a lot of PVCs that don’t stop
What are the classifications for ventricular fibrillation?
just looks like chaos
What can cause bradycardia?
lower metabolic needs, vagal stimulation, medication side effects (beta-blockers, CCBs), sick sinus syndrome, and heart disease
When should bradycardia be treated?
only when it is symptomatic
What are the treatment options for bradycardia?
treating the underlying cause (meds or physiological issue), medications (atropine and epinephrine), and pacemaker (only when too low to maintain good CO)
What can cause tachycardia?
stress to the body (blood loss, shock, anxiety, exercise, etc.), meds and illicit drugs, autonomic dysfunction (POTS)
What are the treatment options for tachycardia?
meds (beta-blockers, CCBs), vagal maneuvers
What is SVT?
any HR greater than 150
What is the treatment for SVT?
- synchronized cardioversion (in unstable/symptomatic cases)
- adenosine per ACLS guidelines
What causes PACs?
atrial dilation, cardiac ischemia/infarct, anxiety/stress, substances, electrolytes (low K)
What causes PVCs?
ischemia/infarct, increased workload to heart, substances, electrolytes (low K and Mg)
What are the treatments for PACs and PVCs?
treat underlying cause, meds (amiodarone and betablockers)
When should premature contractions be treated?
only when symptomatic
What causes atrial flutter/fibrillation?
impairment to cardiac system, age, diabetes, obesity, OSA, ETOH abuse, smoking, genetics
A-fib increases the risk of what complication?
emboli due to pooled blood
What are possible treatments of a-fib/flutter?
procedures (TEE/cardioversion, ablation, pacemaker), meds for rate management (beta-blockers and CCBs), meds for rhythm management (antiarrythmics), clot prevention meds (anticoagulants, antiplatelets)
What causes ventricular fibrillation?
cardiac damage, acid-base and electrolyte imbalances, medication AEs
What is the treatment for ventricular fibrillation?
defibrillation
