Atrial Rhythms {100%Success}
Atrial Rhythms
Study this set o nline at: https://www.cram.co m/flashcards/atrial-rhythms-4617372
E arl y (premature) P waves Posi ti ve (upri ght) P waves (i n l ead I I ) that di f f er i n
H ow are PACs i denti f i ed? shape f rom si nus P waves T he earl y P wave may or may not be f ol l owed by a QRS
compl ex
Beat came earl y. So PAC, PJC or PVC. H ow do you know i f i ts a PAC? P wave bef ore my QRS i ts PAC (upri ght P Wave bef ore the compl ex)
E moti onal stress Congesti ve heart f ai l ure Myocardi al i schemi a or i nj ury Mental
and physi cal f ati gue Atri al enl argement D i gi tal i s toxi ci ty H ypokal emi a
H ypomagnesemi a H yperthyroi di sm E xcessi ve i ntake of caf f ei ne, tobacco, or
Causes of PAC?
al cohol I n persons wi th heal thy hearts, occasi onal PACs are not cl i ni cal l y
si gni f i cant I f PACs are f requent, the pati ent may compl ai n of a “ski p” or
occasi onal “pal pi tati ons”
H i story of pati ent: atri a enl argement? H i story of H F , H T N - pati ent f eel s ski pped
What do we want to ask? beats D o you f eel warm? I t's OK. I f i t's new - i s thi s pati ent goi ng i nto f ai l ure,
stretched out atri a becomi ng stretched? f ul l of f l ui d?
What are arrrhythmi as due to? I rri tabi l i ty (PAC) or escape
I f they happen f requent (occasi onal no probl em) may l ead to atri al dysrhythmi a ,
atri al f l utter, or PSVT precursor thi ngs aren't goi ng wel l Stress reducti on Reduced
PAC I nterventi ons
consumpti on of caf f ei ne-contai ni ng beverages T reatment of congesti ve heart
f ai l ure Correcti on of el ectrol yte i mbal ance
Rate: 150-250 beats/mi n Rhythm: Regul ar P Wave: One posi ti ve P Wave precedes
QRS compl exes but P wave di f f ers i n shape f rom si nus P wave wi th rapi d rates;
E CG Atri al T achycardi a characteri sti cs di f f i cul t to di sti ngui sh P waves f rom T Waves PR I nterval : Maybe l onger or
shorter maybe be di f f i cul t to measure because of P wave absorbed i nto T Wave
QRS: 0.12 or l ess
Not at al l . I don't know i f i t's not worki ng. We can't assume. Atri a have j ust taken
D o I know my SA Node i sn't worki ng at thi s poi nt?
over
, Atrial Rhythms {100%Success}
Atrial Rhythms
Study this set o nline at: https://www.cram.co m/flashcards/atrial-rhythms-4617372
H ow do I know I am atri al tachycardi ac? I rregul ar PR i nterval (shortened) (0.10) - not normal QRS - normal H R: >150
Atri al f l utter i s an ectopi c atri al rhythm i n whi ch an i rri tabl e si te depol ari zes
What i s atri al f l utter? regul arl y at an extremel y rapi d rate T he extremel y rapi d atri al rate resul ts i n
wavef orms that resembl e the teeth of a saw, or a pi cket f ence
T he AV node protects the ventri cl es f rom the extremel y f ast atri al rates by
bl ocki ng some i mpul ses bef ore they reach the ventri cl es I f the AV node bl ocks the
H ow does the AV node operate i n atri al f l utter? i mpul ses at a regul ar rate, the resul ti ng ventri cul ar rhythm wi l l be regul ar I f the AV
node bl ocks i mpul ses at an i rregul ar rate, the resul ti ng ventri cul ar rhythm wi l l be
i rregul ar
What does 4 to 1 atri al f l utter mean? F or every 4 atri al beats one gets down and depol ari zes the ventri cl es
Rate: Atri al 250-350, usual l y 300 dependi ng on AV bl ockade. Ventri cul ar rate
does not exceed 180 dependi ng on i nstri nsi c rate of AV conducti on Rhythm: Atri al
E CG characteri sti cs of Atri al F l utter? What are the mai n cri teri a regul ar, ventri cul ar regul ar or i rregul ar dependi ng on on conducti on/bl ockade P
waves: Not i denti f i abl e; saw toothed f l utter waves are present PR I nterval : Not
measurabl e QRS: <0.12 (sti l l know i t's above the ventri cl es)
Atri al f l utter i s usual l y a paroxysmal rhythm preci pi tated by a PAC May l ast f or
seconds to hours and occasi onal l y l asts 24 hours or more Chroni c atri al f l utter i s
Causes of atri al f l utter?
unusual T he rhythm usual l y reverts to si nus rhythm or atri al f i bri l l ati on, ei ther
spontaneousl y or wi th treatment
Adul t (Rarel y occurs i n adul t pati ents wi thout cardi ac di sease) May occur i n
condi ti ons such as: Pul monary embol i sm Chroni c venti l atory f ai l ure T hyrotoxi cosi s
Atri al f l utter causes i n adul ts
Al cohol i ntoxi cati on I schemi c heart di sease H ypoxi a D i gi tal i s or qui ni di ne
toxi ci ty
Usual l y occurs i n f etal l i f e or shortl y f ol l owi ng bi rth I t i s rarel y seen beyond the
Atri al f l utter causes i n pedi atri cs? newborn peri od except i n the setti ng of underl yi ng congeni tal heart di sease and
cardi ac surgery
Atrial Rhythms
Study this set o nline at: https://www.cram.co m/flashcards/atrial-rhythms-4617372
E arl y (premature) P waves Posi ti ve (upri ght) P waves (i n l ead I I ) that di f f er i n
H ow are PACs i denti f i ed? shape f rom si nus P waves T he earl y P wave may or may not be f ol l owed by a QRS
compl ex
Beat came earl y. So PAC, PJC or PVC. H ow do you know i f i ts a PAC? P wave bef ore my QRS i ts PAC (upri ght P Wave bef ore the compl ex)
E moti onal stress Congesti ve heart f ai l ure Myocardi al i schemi a or i nj ury Mental
and physi cal f ati gue Atri al enl argement D i gi tal i s toxi ci ty H ypokal emi a
H ypomagnesemi a H yperthyroi di sm E xcessi ve i ntake of caf f ei ne, tobacco, or
Causes of PAC?
al cohol I n persons wi th heal thy hearts, occasi onal PACs are not cl i ni cal l y
si gni f i cant I f PACs are f requent, the pati ent may compl ai n of a “ski p” or
occasi onal “pal pi tati ons”
H i story of pati ent: atri a enl argement? H i story of H F , H T N - pati ent f eel s ski pped
What do we want to ask? beats D o you f eel warm? I t's OK. I f i t's new - i s thi s pati ent goi ng i nto f ai l ure,
stretched out atri a becomi ng stretched? f ul l of f l ui d?
What are arrrhythmi as due to? I rri tabi l i ty (PAC) or escape
I f they happen f requent (occasi onal no probl em) may l ead to atri al dysrhythmi a ,
atri al f l utter, or PSVT precursor thi ngs aren't goi ng wel l Stress reducti on Reduced
PAC I nterventi ons
consumpti on of caf f ei ne-contai ni ng beverages T reatment of congesti ve heart
f ai l ure Correcti on of el ectrol yte i mbal ance
Rate: 150-250 beats/mi n Rhythm: Regul ar P Wave: One posi ti ve P Wave precedes
QRS compl exes but P wave di f f ers i n shape f rom si nus P wave wi th rapi d rates;
E CG Atri al T achycardi a characteri sti cs di f f i cul t to di sti ngui sh P waves f rom T Waves PR I nterval : Maybe l onger or
shorter maybe be di f f i cul t to measure because of P wave absorbed i nto T Wave
QRS: 0.12 or l ess
Not at al l . I don't know i f i t's not worki ng. We can't assume. Atri a have j ust taken
D o I know my SA Node i sn't worki ng at thi s poi nt?
over
, Atrial Rhythms {100%Success}
Atrial Rhythms
Study this set o nline at: https://www.cram.co m/flashcards/atrial-rhythms-4617372
H ow do I know I am atri al tachycardi ac? I rregul ar PR i nterval (shortened) (0.10) - not normal QRS - normal H R: >150
Atri al f l utter i s an ectopi c atri al rhythm i n whi ch an i rri tabl e si te depol ari zes
What i s atri al f l utter? regul arl y at an extremel y rapi d rate T he extremel y rapi d atri al rate resul ts i n
wavef orms that resembl e the teeth of a saw, or a pi cket f ence
T he AV node protects the ventri cl es f rom the extremel y f ast atri al rates by
bl ocki ng some i mpul ses bef ore they reach the ventri cl es I f the AV node bl ocks the
H ow does the AV node operate i n atri al f l utter? i mpul ses at a regul ar rate, the resul ti ng ventri cul ar rhythm wi l l be regul ar I f the AV
node bl ocks i mpul ses at an i rregul ar rate, the resul ti ng ventri cul ar rhythm wi l l be
i rregul ar
What does 4 to 1 atri al f l utter mean? F or every 4 atri al beats one gets down and depol ari zes the ventri cl es
Rate: Atri al 250-350, usual l y 300 dependi ng on AV bl ockade. Ventri cul ar rate
does not exceed 180 dependi ng on i nstri nsi c rate of AV conducti on Rhythm: Atri al
E CG characteri sti cs of Atri al F l utter? What are the mai n cri teri a regul ar, ventri cul ar regul ar or i rregul ar dependi ng on on conducti on/bl ockade P
waves: Not i denti f i abl e; saw toothed f l utter waves are present PR I nterval : Not
measurabl e QRS: <0.12 (sti l l know i t's above the ventri cl es)
Atri al f l utter i s usual l y a paroxysmal rhythm preci pi tated by a PAC May l ast f or
seconds to hours and occasi onal l y l asts 24 hours or more Chroni c atri al f l utter i s
Causes of atri al f l utter?
unusual T he rhythm usual l y reverts to si nus rhythm or atri al f i bri l l ati on, ei ther
spontaneousl y or wi th treatment
Adul t (Rarel y occurs i n adul t pati ents wi thout cardi ac di sease) May occur i n
condi ti ons such as: Pul monary embol i sm Chroni c venti l atory f ai l ure T hyrotoxi cosi s
Atri al f l utter causes i n adul ts
Al cohol i ntoxi cati on I schemi c heart di sease H ypoxi a D i gi tal i s or qui ni di ne
toxi ci ty
Usual l y occurs i n f etal l i f e or shortl y f ol l owi ng bi rth I t i s rarel y seen beyond the
Atri al f l utter causes i n pedi atri cs? newborn peri od except i n the setti ng of underl yi ng congeni tal heart di sease and
cardi ac surgery
