Normal Sinus Rhythm - correct answer 60-100 bpm
all complexes normal and evenly spaced (P, QRS, T)
Sinus Arrest - correct answer - SA node doesn't
... [Show More] fire
- notice absence of P-wave for a complete cycle (a missed cycle)
Sinus arrhythmia - correct answer all complexes normal but rhythmically irreg
- normal finding (esp in young pts) that has to do with breathing (rate: inhale-increase, exhale-decrease)
Sinus Bradycardia - correct answer <60
normal sinus rhythm
Sinus Tachycardia - correct answer >100 (100-150)
normal sinus rhythm
Wandering atrial pacemaker - correct answer Hint: try never to pick this
- impulse originate from varying points in atria
- variation in P wave contour, PR-I, PP-I and thus RR-I
P wave vs T wave - correct answer P generally smaller than T
MAT (multifocal atrial tachy) - correct answer - impulse originates at diff places in atria so P waves diff and intervals might not be consistent
- assoc w/ severe pulm dz
Atrial Fibrillation - correct answer A: 350-450 (atria quivering)
- irreg-irreg rhythm (R-RI=irreg)
**unsure/no P-wave (non-distinguishable)**
- irreg rhythm BUT reg QRS!
Danger: increase the risk of thromboemoblic events don't convert unless occurring less than 48 hrs, if don't know pt need to be put on thrombolytics)
Atrial Flutter - correct answer A: 250-350
- "saw tooth" p-waves
- a continuous rapid sequence of atrial complexes from a single rapid-firing atrial focus
(hint: if see 2 P waves and QRS think A Flutter)
Junctional Escape beats - correct answer retrograde atrial depolarization
P' is inverted
Junctional rhythm - correct answer 40-60 Regular!
-impulse from AV node w/ retro/antegrade transmission
- P wave often inverted/buried/follow QRS
- slow rate
- narrow QRS (not wide like ventricular)
Junctional Tachycardia - correct answer >60 bpm (ms. K; 150-250)
- KEY: will be regular (consistent)
- AV junction produces a rapid sequence of QRS-T cycles
- p-wave often inverted/buried/follow QRS
Premature junctional contractions (PJC) - correct answer - premature slightly widened QRS
- +/- inverted P', before or after QRS, sometimes disappears w/in QRS
Premature atrial contractions (PAC's) - correct answer - originates suddenly in irritable atrial foci
- P' is earlier than expected and diff shape than P (often have a pause following PAC)
- can occur in Bigeminy, Trigeminy, Quadgeminy pattern
Supraventricular Tachycardia (SVT)
aka
Paroxysmal atrial tachycardia (PAT) - correct answer 150-250 "sudden rapid heart rate"
- an irritable atrial focus discharging
- very fast and EVEN!
- +/- inverted P waves
- P often overlaps prior T wave
First-degree AV block - correct answer - PRI >5 boxes/.20 sec
- Fixed but prolonged PRI
(consistent but long)
- normally get bradycardia here
Second-degree block: Mobitz Type I Wenckebach) - correct answer "walk it back"
- PRI gradually lengthens then drops QRS "grouping and then a miss"
- typically pattern exists
(constant P-P interval, QRS is what is moving back)
- not really serious or dangerous
Second-degree AV block: Mobitz Type II - correct answer - normal PRI then sudden drop of QRS
- P wave doesn't always produce QRS
- P-R interval is constant (diff from 3rd degree)
- no hint just drops out -> is serious and dangerous pt needs tx! [Show Less]