EKG Regularity and Rate Flashcards
What is an Arrhythmia?
Any disturbance in the regularity, rate, site of origin, or conduction of the cardiac electrical impulse.
● An arrhythmia can be a single aberrant beat, a prolonged pause between
beats, or a sustained rhythm disturbance that may possibly persist for the
lifetime of the patient
T/F not every arrhythmia is abnormal or
dangerous
T
What is this rhythm called?
Supraventricular
Tachycardia, Rapid
and regular, with
depolarization
originating at or
above the junction.
What is this rhythm called?
Third Degree AV Block, with total
dissociation of atrial and ventricular
depolarization.
What is this rhythm called?
Ventricular
Tachycardia, with the
rhythm originating in
the ventricular
conduction system
rather than from
above the junction.
What is this rhythm called?
Asystole, the absence
of distinguishable
current flow occurring
in the heart.
Common causes of arrythmias (HIS DEBS)
■ H- Hypoxia (severe chronic pulm disorders or acute pulm conditions, like a PE)
■ I- Ischemia and Irritability (ischemic heart disease and/or inflamed myocardium)
■ S- Sympathetic stimulation (hyperthyroidism, CHF, nervousness, etc)
■ D- Drugs (illicit and even some prescribed drugs)
■ E- Electrolyte disturbances (calcium, magnesium, and the notorious hypokalemia)
■ B- Bradycardia (a very slow heart rate seems to predispose to arrhythmias)
■ S- Stretch (enlargement and hypertrophy of atria/ventricles can cause
arrhythmias)
T/F Many arrhythmias are asymptomatic and can go unnoticed for years, or may
not be found until picked up on a routine EKG. This can include dangerous
arrhythmias, like Atrial Fibrillation.
T
several characteristic symptoms of arrythmias:
■ Palpitations- Patient notices fluttering or pounding sensation in their chest.
■ Lightheadedness and/or Syncope- Secondary to decreased cardiac output.
■ Angina- Chest pain due to ischemia secondary to increased oxygen demands.
■ Congestive Heart Failure- In those with underlying cardiac disease.
■ Sudden Death- Often due to acute MI or Hypertrophic Cardiomyopathy.
Four Main Types of Arrhythmias
Sinus Arrhythmias
Atrial Arrhythmias
Junctional Arrhythmias
Ventricular Arrhythmias
the first 5 steps to evaluating a 12-Lead EKG
○ Is the rhythm REGULAR?
○ What is the RATE?
○ Are the P-WAVES uniform, upright, and one before each QRS (in Lead II)?
○ Is the PR-INTERVAL normal and regular? (3-5 little boxes (0.12-0.20 seconds))
○ Are the QRS COMPLEXES normal (< 3 little boxes (less than 0.12 seconds)) or are they wide?
There are 3 main possibilities when determining regularity:
○ Regular
○ Regularly Irregular
○ Irregularly Irregular
If the rhythm is “regular,” the RR Interval is _____
constant and marches out in
a regular fashion.
Regularly Irregular
○ If the rhythm is “regularly irregular,” the RR Interval is NOT constant, but
the overall, underlying pattern or rhythm is regular.
○ The classic example of regularly irregular is the rhythm are certain types
of AV Blocks.
What type of rhythm is this?
Regularly irregular
What type of rhythm is this?
Irregularly irregular
