Rhythym Analysis

Question 1

Sinus Bradycardia

Answer 1

All characteristics of normal sinus rhythm, but is slower. May cause fatigue and dizziness.
- Rate

Question 2

Sinus Pause, Sinus Arrest

Answer 2

A pause that occurs longer than 3 seconds when the SA node fails to fire and resets the regularity of the rhythm. Ends by the SA node firing, impulse generated by another atrial foci, or a ventricular escape beat.
- Rate 40-110 bpm
- rhythm irregular b/c of pause (underlying rhythm may be reg)
- P wave upright in lead II, followed by QRS
- PR interval 0.12-0.20 sec
QRS

Question 3

SA block

Answer 3

Creates a pause that may look like a sinus pause, however the SA node is generating an impulse it is just blocked from conduction into atrial tissue.
- the pause will be a length that is a multiple of the R-R interval. (Dropped beats)
- Rate. 40-100 bpm
Irregular rhythm be of pause- underlying rhythm may be reg
- P wave upright in lead II, followed by QRS
- PR interval 0.12-0.20 sec
- QRS

Question 4

Sinus Tachycardia

Answer 4

Rapid Rate- over 100 bpm
Rates may be conducted as high as 180-200 bpm (SA node limit) 
Regular sinus rhythm
P upright on lead II, followed by QRS
PR interval 0.12-0.20 sec

Question 5

Wandering Atrial Pacemaker

Answer 5

Has Subtle changes in rhythm.
Rate generally 60-100bpm
Rhythm is regular or slightly irregular
P waves of different shapes/sizes, generally upright in lead II before QRS
PR varies- 0.12-0.20 sec
QRS

Question 6

Premature Atrial contractions

Answer 6

Rate: 60-100bpm
Rhythm: Regular besides PAC 
P wave upright in lead II, before each QRS- all look the same besides the PAC b/c it originates in the atria NOT the SA node
PR interval - 0.12-0.20 sec
QRS

Question 7

Atrial Tachycardia (SVT)

Answer 7

Rate > 100 bpm
Rhythm regular
QRS

Question 8

Atrial Flutter

Answer 8

Originates in Right atrium at an irratable ectopic focus.
Rhythm regular or irregular
Rate variable _ 40-180bpm
No normal P waves - Sawtooth atrial wave forms occur rapid and regular
Variable # of atrial wave forms for each QRS (2:1, 3:1)
QRS

Question 9

Atrial Fibrillation

Answer 9

Rhythm is generally irregular, can in some. Instances be regular
Rate may be fast, slow, or controlled
P wave not evident, baseline is wavy with coarse Or fine appearance
QRS

Question 10

RE-entrant Supraventricular. Tachyarrhythmias

Answer 10

Require two functionally distinct pathways- a unidirectional block in one pathway and a delayed in the other- once initiated by a premature impulse conduction becomes self perpetuating

Pathways include - within AV node (AV nodal reentrant tachycardia)

• extra nodal path (reentrant occurs using concealed bypass tract)
• within SA node (SA nodal reentrant)

Question 11

Multi focal Atrial Tachycardia

Answer 11

Increased automaticity originating from a minimum of 3 different foci (common is patients with COPD, acute respiratory failure, & LV dysfunction)

Question 12

Sick SInus Syndrome

Answer 12

Heart has periods of irregular tachyarrhythmias followed by prolonged pauses

Question 13

Junctional premature beats

Answer 13

Originate at junctional tissue above the Ventricles - narrow complex’s
Rate- sinus or slower
Rhythm mildly irregular
P wave will be smaller, inverted, or mildly slurred be depolarization may spread to the ventricle first or both A and V at the same time.
QRS

Question 14

Sinus Arrhythmia

Answer 14

• Rate: 60-100 bpm (can be slower)
• Rhythm irregular
• Each P wave upright in lead II followed by QRS
• PR interval 0.12 - 0.20 sec
• QRS