Rhythm Recognition

Question 1

Bradyarrhythmia definitions - 1st degree HB?

Answer 1

PR interval prolonged >0.20s

May be physiological, other causes may be fibrosis, ischaemia, structural heart disease, AV blocking drugs

Rarely causes symptoms

Question 2

Bradyarrhythmia definitions - 2nd degree AV block - Type 1 Wenckebach AV block?

Answer 2

Progressive PR prolongation until P wave without QRS complex

Usually pathological
Can be due to inferior infarction

Does not need immediate management but may need treatment if symptomatic or risk of developing more severe AV block/asystole

Question 3

Bradyarrhythmia definitions - 2nd degree Type 2 AV block?

Answer 3

Constant PR interval but non conducted P waves

2:1 or 3:1 or 4:1

Usually needs immediate management if symptoms

Question 4

Defintion 3rd degree HB?

Answer 4

No relationship between P waves and QRS complexes

Question 5

Definition escape rhythms?

Answer 5

If SA fails, escape rhythm will be slower then normal sinus rhythm

Junctional rhythm may be narrow or broad (depending if conducted normally or with bundle branch block)

Idioventricular rhythm broad complex

Question 6

Define agonal rhythm?

Answer 6

Dying patients

Slow irregular wide ventricular complexes, varying morphology

Progress to asystole

Question 7

Causes of short QTC

Answer 7

Hypercalcaemia
Digoxin toxicityC

Question 8

Causes of prolonged QTC

Answer 8

Hypokalaemia
Hypomagnasaemia
Hypocalcaemia
Hypothermia
Myocarditis
Myocardial ischaemia
Genetics