Sinus & Atrial Dysrhythmias Flashcards
NSR Rate…
60-100
NSR P waves…
normal (0.06-0.10s),
precede each QRS complex
NSR QRS
WNL (0.06-0.12s)
NSR PR Interval
WNL (0.12 - 0.20s)
NSR rhythm
regular
rhythm, P waves, QRS, PR intervals WNL
Rate < 60
What arrhythmia?
sinus bradycardia
rhythm, P waves, QRS, PR intervals WNL
Rate between 100-160
What arrhythmia?
sinus tachycardia
Rate, P waves, QRS, PR intervals WNL
Rhythm patterned irregular
What arrhythmia?
Sinus Arrhythmia
With sinus arrhythmia, when does the rate increase?
with inspiration
SA node transiently stops firing
1-2 beats dropped
sinus Pause
SA node transiently stops firing
3 or more beats dropped
Sinus Arrest
Complexes all WNL, but long period of absent complexes (1-4 beats long)
Sinus pause/arrest
Shortened QT
P waves superimposed in QRS, increased amplitude but WNL
PR not identifiable
Rate 100-160
Regular rhythm
Sinus tachycardia
Three mechanisms of atrial dysrhythmias
automaticity
triggered activity
reentry
The below features generally signify…
differing P waves
abnormal, shortened, or prolonged PR intervals
narrow and normal looking QRS
atrial dysrhythmias
What dysrhythmia?
Rate: WNL
Rhythm: slightly irregular
P waves: changing appearance (3 or more)
QRS: WNL
PR Interval: variable
wandering atrial pacemaker
What dysrhythmia?
Rhythm: Irregular, premature beat
P Waves: abnormal before early beat
PR Interval: abnormal or normal
QT: May be shortened
Non-Compensatory pause after premature beat
PAC
PACs can lead to (3)
atrial tachy
atrial flutter
atrial fib
What can serve as an early indicator of an
electrolyte imbalance or congestive heart
failure in patients experiencing an acute
myocardial infarction
PACs
Early beat + wide QRS complex without compensatory pause…
PACs with aberrant ventricular conduction
PVCs are differentiated from PACs w. aberrant ventricular conduction how?
PVCs have compensatory pause
Rate: 150-250
P wave: Abnormal, might be hidden in T wave
Short PR interval ( < 0.12s)
Atrial tachycardia/paroxysmal atrial tachycardia
Rate: 120-150
Rhythm: Irregular
P waves: change from beat to beat
Appears as faster wandering atrial pacemaker
Multifocal Atrial Tachycardia
Appears as atrial tachycardia, but P waves cannot be seen due to the high rate…
What rhythm?
supraventricular tachycardia
Rate: 250-350 in the atria (p waves), Ventricular rate (QRS rate) normal
Rhythm: regular, or irregular
P waves: Absent, replaced by saw tooth flutter waves (F waves)
Atrial flutter
atrial flutter is commonly associated with ____ block. You can tell by measuring the…
AV block
measure conduction ratio (F waves : QRS complexes)
If you notice sinus tachycardia looking ECG strip with a rate of 150, you should re-evaluate for…
atrial flutter with 2:1 conduction ratio… P waves may be hidden in QRS complex
If sinus tachy with rate of 150, what can you do to the rhythm strip to be able to identify whether it is actually flutter waves?
turn it upside down
Rhythm: Irregularly irregular
Rate: 350 in atria
P waves: absent, chaotic looking. replaced by f waves
a fib
if a fib with ventricular rate > 100… what is it called? what can occur?
uncontrolled a fib
HF, angina, syncope
