EKG Block 2: Supraventricular Arrhythmias, Ventricular Arrhythmias,
an Bradyarrhythmias
1. Symptoms of Supraventricular Tachycardia (SVT): -Fatigue, palpitations,
dizziness, SOB, chest discomfort, pre-syncope, and syncope [sx's of poor
perfusion]
-May be dominated by fever, physical stress, hypovolemia, HF,
sympathomimetic or parasympatholytic medications, thyrotoxicosis,
and pheochromocytoma
2. When would a holter monitor be useful for SVT diagnosis?: if the
arrhythmia is likely to be detected by 24 to 48 hours of monitoring
3. What type of testing would definitively distinguish SVT from
ventricular tachycardia?: electrophysiologic testing
4. Group of SVTs that originate from focal anatomic locations in the atria
and propagate in a centrifugal pattern.: atrial tachycardia
5. Sudden rapid firing of irritable atrial focus (150-250 bpm): paroxysmal
atrial tachycardia
6. -Focal tachycardia originating in the AV junction
-Sudden rapid firing of irritable focus in AV junction
-150-250 bpm: paroxysmal junctional tachycardia
7. This device, implanted like pacemakers, delivers biphasic shocks and
records the electrogram during arrhythmia and treatment. It can also
provide dual-chamber pacing or resynchronization pacing therapy.:
Implantable Car- dioverter-Defibrillators (ICD)
8. This occurs when the conduction of supraventricular depolarizations to
the ventricles are totally blocked, and an automaticity focus escapes to pace
the ventricles at its inherent rate.: complete AV block (3rd Degree)
9. -Vagal stimulation
-Myocardial Infarction
-Hypoxia
-Medications (Beta-blockers, Calcium Channel Blockers, Digoxin)
-Coronary Artery Disease
-Hypothyroidism
-Iatrogenic Illness
-Inflammatory Conditions: Causes of Bradycardia
10. -Dizziness or light-headedness
-Syncope
-Fatigue
-Shortness of Breath
-Confusion or memory problems: Symptoms of Bradycardia
11.In patients with Mobitz Type I (Wenckebach), symptomatic bradycardia,
and hypotension, they usually respond well to what medication?: atropine
1/5
, EKG Block 2: Supraventricular Arrhythmias, Ventricular Arrhythmias,
an Bradyarrhythmias
12.If patients with Mobitz Type I (Wenckebach), symptomatic
bradycardia, and hypotension don't respond to atropine, then what would
be the next step?: transcutaneous or transvenous pacing
13.Treatment for Mobitz Type II and Third Degree Block: require
permanent pacemaker
14.Bradycardia Treatment for Unstable Patients: Atropine or Isoproterenol
infu- sion; temporary pacemaker (transcutaneous or transvenous)
15.Bradycardia Treatment for Stable Patients: -remove any precipitations
med- ications
-consider implantable pacemaker for any symptomatic bradycardia
(esp Type II Mobitz and 3rd Degree block)
16. What do you expect to see in ECG reading in patients with a
pacemaker?-
: pacemaker spikes
17. Type of Pacer Rhythm
-2 spikes before QRS
-None before the P wave
-Underlying flutter: biventricular pacing
18. -Flat line on ECG
-HR, Rhythm, QRS: Absent
-P wave: absent or present
-Consider end of life
-Don't shock: asystole
19. - Any supraventricular rhythm without an effective/detectable pulse
- Rate: variable
- Etiology: 5 H's and 5 T's
- Clinical Manifestations: pulseless, nonfunctioning heart: Pulseless
Electrical Activity
20.5 H's of ALS: Hypovolemia, Hypoxemia, Hydrogen ion excess
(acidosis), Hy- per/Hypokalemia, Hypothermia
21.5 T's of ALS: Tamponade, Tension PTX, Thrombosis (PE),
Thrombosis (MI), Toxins
22.Group of SVTs that originate from focal anatomic locations in the atria
and propagate in a centrifugal pattern; AVNRT and AVRT.: Atrial
Tachycardia
23. -Sudden rapid firing of irritable Atrial Focus
-150 to 250 BPM
-Upright, different P-waves: Paroxysmal Atrial Tachycardia
2/5
an Bradyarrhythmias
1. Symptoms of Supraventricular Tachycardia (SVT): -Fatigue, palpitations,
dizziness, SOB, chest discomfort, pre-syncope, and syncope [sx's of poor
perfusion]
-May be dominated by fever, physical stress, hypovolemia, HF,
sympathomimetic or parasympatholytic medications, thyrotoxicosis,
and pheochromocytoma
2. When would a holter monitor be useful for SVT diagnosis?: if the
arrhythmia is likely to be detected by 24 to 48 hours of monitoring
3. What type of testing would definitively distinguish SVT from
ventricular tachycardia?: electrophysiologic testing
4. Group of SVTs that originate from focal anatomic locations in the atria
and propagate in a centrifugal pattern.: atrial tachycardia
5. Sudden rapid firing of irritable atrial focus (150-250 bpm): paroxysmal
atrial tachycardia
6. -Focal tachycardia originating in the AV junction
-Sudden rapid firing of irritable focus in AV junction
-150-250 bpm: paroxysmal junctional tachycardia
7. This device, implanted like pacemakers, delivers biphasic shocks and
records the electrogram during arrhythmia and treatment. It can also
provide dual-chamber pacing or resynchronization pacing therapy.:
Implantable Car- dioverter-Defibrillators (ICD)
8. This occurs when the conduction of supraventricular depolarizations to
the ventricles are totally blocked, and an automaticity focus escapes to pace
the ventricles at its inherent rate.: complete AV block (3rd Degree)
9. -Vagal stimulation
-Myocardial Infarction
-Hypoxia
-Medications (Beta-blockers, Calcium Channel Blockers, Digoxin)
-Coronary Artery Disease
-Hypothyroidism
-Iatrogenic Illness
-Inflammatory Conditions: Causes of Bradycardia
10. -Dizziness or light-headedness
-Syncope
-Fatigue
-Shortness of Breath
-Confusion or memory problems: Symptoms of Bradycardia
11.In patients with Mobitz Type I (Wenckebach), symptomatic bradycardia,
and hypotension, they usually respond well to what medication?: atropine
1/5
, EKG Block 2: Supraventricular Arrhythmias, Ventricular Arrhythmias,
an Bradyarrhythmias
12.If patients with Mobitz Type I (Wenckebach), symptomatic
bradycardia, and hypotension don't respond to atropine, then what would
be the next step?: transcutaneous or transvenous pacing
13.Treatment for Mobitz Type II and Third Degree Block: require
permanent pacemaker
14.Bradycardia Treatment for Unstable Patients: Atropine or Isoproterenol
infu- sion; temporary pacemaker (transcutaneous or transvenous)
15.Bradycardia Treatment for Stable Patients: -remove any precipitations
med- ications
-consider implantable pacemaker for any symptomatic bradycardia
(esp Type II Mobitz and 3rd Degree block)
16. What do you expect to see in ECG reading in patients with a
pacemaker?-
: pacemaker spikes
17. Type of Pacer Rhythm
-2 spikes before QRS
-None before the P wave
-Underlying flutter: biventricular pacing
18. -Flat line on ECG
-HR, Rhythm, QRS: Absent
-P wave: absent or present
-Consider end of life
-Don't shock: asystole
19. - Any supraventricular rhythm without an effective/detectable pulse
- Rate: variable
- Etiology: 5 H's and 5 T's
- Clinical Manifestations: pulseless, nonfunctioning heart: Pulseless
Electrical Activity
20.5 H's of ALS: Hypovolemia, Hypoxemia, Hydrogen ion excess
(acidosis), Hy- per/Hypokalemia, Hypothermia
21.5 T's of ALS: Tamponade, Tension PTX, Thrombosis (PE),
Thrombosis (MI), Toxins
22.Group of SVTs that originate from focal anatomic locations in the atria
and propagate in a centrifugal pattern; AVNRT and AVRT.: Atrial
Tachycardia
23. -Sudden rapid firing of irritable Atrial Focus
-150 to 250 BPM
-Upright, different P-waves: Paroxysmal Atrial Tachycardia
2/5
