Lecture 2 Flashcards
1
Q
sinus arhythmia
A
predictable pattern
2
Q
Atrial Rhythms
A
- originate in the atria (vs. SA node)
- P wave positive, different shape than a NSR d/t the electrical impulse follows a different path to the AV node
- Usually tachycardia, flutter, fibrillation
3
Q
Normal atrial rhythm
A
- 60-80 bpm
- wandering atrial pacemaker
4
Q
atrial flutter
A
-250 - 350 bpm
5
Q
atrial fibrillation
A
- 400 - 600 bpm
- AV junction bombarded by relentless atrial stimuli
- if every stimulus passed through the AV junction, ventricular rate would be about 600 bpm
- AV jn is refractory to most impulses and allows only a fraction to reach the ventricles
- ventricular rate = IRREGULAR
- irregular wavy baseline
- no defined P wave
- ventricular rate is irregular!
6
Q
multifocal atrial tachycardia
A
100-250 bpm
7
Q
Junctional Rhythm
A
- 40-60 bpm
- AV junction acting as ectopic pacemaker
- Abnormal or absent P waves (positive P wave in aVR or negative P wave in lead II)
- Normal ventricular depolarization = QRS
8
Q
idioventricular rhythm
A
- originates in ventricles
- QRS is wide, bizarre; no p waves
- rhythm is more or less regular
- rate: 20-40 bpm
9
Q
Premature Atrial contractions
A
- occur before next normal P wave is due
- stimulus originates from atria (outside SA node)
- visible P wave usually has slightly different shape and/or PR interval from normal sinus beats
- after PAC, may be a slight pause
10
Q
Premature ventricular contractions
A
- no p wave present in complex
- stimulus originates from ventricles (wide QRS complex)
11
Q
premature contractions
A
- unfocal vs bifocal
- couplet, triplet, etc. (two or more consecutive contractions)
- grouped premature contractions (bigeminy, trigeminy, quadrigeminy, etc. - alternating between sinus beat and premature beat)
12
Q
Supraventricular arrhythmia
A
- any tachy-dysrhythmia arising from above the level of the Bundle of His
- typically narrow-complex tachycardia
- wider if BBB is present (aberrancy)
- Atrial flutter and atrial fibrillation (flutter = 250-350 bpm, saw tooth; fibrillation = 400-600 bpm, tremulous)
13
Q
ventricular tachycardia
A
- run of consecutive PVCs
- classified by duration (non vs sustained) and morphology (mono vs polymorphic)
- sustained VT is life threatening
- unable to maintain adequate BP
- degenerate to ventricular fibrillation/cardiac arrest
14
Q
Ventricular fibrillation
A
- ventricles fibrillate and quiver asynchronously and ineffectively w/o coordinated fashion
- no cardiac output occurs and patient becomes unconscious immediately
- requires immediate defibrillation with an unsynchronized DC shock
- generally stat dose of IV anti-arrhythmic drug in attempt to suppress further ventricular ectopy
15
Q
torsade depointes
A
- polymorphic VT - twisting of the points
- occurs in the setting of delayed ventricular repolarization
- evidenced by prolongation of the QT intervals or presence of U waves
