EKG-LVH and Pacemaker Flashcards
What causes INC signaling on EKG during depolarizations?
HYPERtrophy- atria or ventricle.
LVH MC
This EKG has a tall P-wave that is peaked. What is this and what leads?
Right atrial hypertrophy. LEADs I-II,
- Peak >2.5mm Lead 2, 3, AVF.
- Right shift of p-wave
- deflection of p-wave in V1 OR V2 >1.5mm
This EKG has a wide, notched P-wave that is peaked. What is this and what else my be seen in each lead?
Left atrial hypertrophy-Lead II.
Other V1-biphasic P wave
What are cause of RAE?
Pulmonary HTN, COPD, Tricupsid stenosi, Tetraology,
What are cause of LAE?
Mitral stenosis, LVH+ AS, HCM, HTN
What is required in LAE?
- V1 negative biphasic deflection is 1 box.
- L shift of p-wave
- Notched and wide Pwave Lead 1 or 2
What is natural progression of R wave for LV?
V1-2- biphasic, large neg S wave.
V3-V6 tall R wave
What should be considered if RVH is suspected?
Right AXis Deviation. V1- Pos. Large S wave. Lead I neg deflection
This EKG has abnormal deep S wave in V1-2 and Tall R wave in V5-6?
LVH. R wave >11-13mm AVL
What else is seen on EKG for LVH?
LAD and/or LBBB- wide QRS, notched
For RVH what are other waves showing?
ST depression, upward convex and
V1-V2-T wave inversion
Which leads are needed to add in order to determine if LVH?
DEEpest V1 or V2 - S wave + V5 or V6 taller R wave
Must= >35mm
Used to treat d/t slow HR post MI. Other cardia surgery, MED OD, emergent. Complications are common and include infection, local trauma, pneumothorax, arrhythmias and cardiac perforation. Carry pulses from the generator to atrium and both ventricles. The pulses help coordinate electrical signaling between the two ventricles.
Temporary pacemaker- each lead placed in chambers
Pt has a slow HR from MI w/ recent cardiac surgery. PMH of drug overdose? What pacemake is needed?
Temporary pacemaker- emergency while waiting for implant
If a patient has sick sinus syndrome, Brady arrythmias, Heart Block, Afib,flutter?
Permanent Pacemaker
Speed up a slow heart rhythm.
control an abnormal or fast heart rhythm.
ventricles contract normally if the atria are quivering
Coordinate signaling btwn the upper and lower chambers of the heart.
Coordinate signaling btwn the ventricles. Prevent dangerous arrhythmias caused by a disorder called long QT syndrome, and CHF
cardiac resynchronization therapy (CRT)
A disease characterised by abnormal sinus node functioning with bradycardia to tacycardia<50bpm and cardiac insufficiency.
Sick sinus syndrome
What blocks are seen in sick sinus syndrome?
Sinus arrest/sinoatrial block (via Holter recording), brady-tachy syndrome atrial tachyarrhythmias, probable coexistence with AV block
pacemaker monitors your heart rhythm. It only sends electrical pulses to your heart if your heart is beating too slow or if it misses a beat. Or if falls below preset value.
Demand pacemaker- sensing + pacing mech.
pacemaker will speed up or slow down your heart rate depending on how active you are. To do this, the device monitors your sinus node rate, breathing, blood temperature, and other factors to determine your activity level.
Rate Responsive
WHich system paces the R ventricle?
Single chamber
WHich systmem paces RA and RV?
Dual chamber pacemaker
What do pacemaker do?
They act synchronously when a slow naturalheart rateis detected to mimic the sequential physiological contraction of theatriaandventricles.
Which are much more commonly used in practice, are appropriate where conduction between the atria and ventricles is impaired.
Single-chamber ventricular pacemakers
Fires at a specific preset rate regardless of patient’s own heart rate
Only pacing mechanism
Fixed Pacemaker
On ECG, what is seen with Atrial sensing Ventricular pacing?
pacemaker conduction spike at Q wave. Means detected a ventricular depolarization. Sensing will only spike if sense somethin wrong at the complex
On ECG, what is seen with Atrial PACEING Ventricular pacing?
pacemaker conduction spike at BEG of p-wave and Q-wave. Both chambers were dysf
On ECG, what is seen with Atrial PACE Ventricular SENSE?
pacemaker conduction at P-wave. Atrial need help
On ECG, what is seen with Atrial and Ventricular SENSE
no sharp condutcions spike. NSR- Neither need spike
What occures when a pacing stimulus is gerated but fails to trigger depoloriazion?
Failur to capture aka trigger. PURPOSE- starte depolarization.
Oversensing, lead problem, batter, interference all cause of what
Failure to caputure
WHat will EKG heart look like if failued caputre?
Spikes then multiple dropped QRS
What cause P and T waves with spikes in middle of complex?
Oversensing, bc failed to capture. Inapproatiet sensing of extra activity
What is cause of oversensing?
signal are picked up, pacemake doens fire
What is used for fast HR?
Automatic implantable cardioverter defibrilater- Patho- Tachy arrhythmia, Vtach, Vfib
