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Atrial Arrhythmias

Terms in this set (28)

PAC
Premature atrial contraction

Will see a different P wave morphology than in a normal sinus P wave (inverted)

P-QRS occurs prematurely

conducted normally through the AV node and the ventricles so QRS looks normal
Noncompensatory pause
The interval on the electrocardiogram that follows a premature atrial contraction (PAC). Because PAC's reset the sinus pacemaker, the next sinus beat does not appear when it would have if there had been no extra beat
Compensatory pause
The pause following an extrasystole, when the pause is long enough to compensate for the prematurity of the extra systole; the short cycle ending with the extrasystole plus the pause following the extra systole together equals two of the regular cycles
Nonconducted PAC
a PAC that does not end with ventricular contraction (no QRS complex after the p wave)
T or F PAC's are Supraventricular?
TRUE
How to identify a Paroxysmal supraventricular tachycardia
Rhythm: IRREGULAR over time
Rate: 140-250BPM
P wave: May be difficult to see because of rate/ hidden in T-Wave
PR Interval: normal
QRS complex: regular (<.10)

KEY IDENTIFIER: Sudden onset and termination


Starts normal then tachycardia starts suddenly
Difference between supra ventricular and sinus tachycardia
Sinus tachy has a gradual onset

supra ventricular tacky has a sudden onset
What type of disorder is Paroxysmal supra ventricular tachycardia?
Impulse formation disorder
Atrial flutter
Atrial conduction is taking place along a re-entrant


Rate: 250-350BPM
(Each atrial depolarization seen as a flutter wave on ECG)
P-Waves: No true P-waves
(Sawtooth pattern)
QRS Complex: Normal
Atrial fibrillation
Occurs at NUMEROUS ectopic pacemaker sites in the atria
Rate: >400BPM
P-wave: NO EFFECTIVE ATRIAL CONTRACTION

results in an irregularly irregular rhythm
What is the SECOND most common rhythm next to sinus rhythms?
Atrial Fibrillation
Atrial fibrillation in the 5-step process
Rhythm: Irregularly irregular
rate: >300BPM
p-Wave: None (results in WAVY baseline)
PR interval: Not determinable
QRS Complex: Normal if ventricular conduction is normal
Identifying characteristics: irregularly irregular ventricular rate, absence of P-waves
Atrial fibrillation puts you at risk for what?
-Blood clots
-Stroke
-Heart failure
Both atrial flutter and atrial fibrillation can be a result of what?
Sick sinus syndrome
Chronotopic incompetence
Inability of heart rate to respond to workload

ecg at rest: normal
ecg during exercise: abnormal for low HR during exertion

diagnosis: Positive outcome if the patient HR does not increase progressively during exertion
Chronotopic incompetence 5-step analysis
Will look completely REGULAR which is not normal at levels of physical exertion
What is the #! under prescribed class 1 indication for the implementation of pacemakers?
Chronotopic incompetence
accessory pathway
An irregular muscle connection between the atria and ventricles that bypasses the atrioventricular node
Wandering atrial pacemaker rhythm (WAP)
Occurs when pacemaker sites wander, or travel from the SA node to other pacemaker sited in the atria, the internal pathways or the AV node. The SA node remains the basic pacemaker in these rhythms.

For a diagnoses of a wandering atrial pacemaker, observation of at least three different P waves on an EKG strip is required

*notable change in P-wave morphology
5-step approach as it pertains to WAP's
Rhythm: slightly irregular
Rate: 60-100bpm
P wave: Changes in morphology
pr interval: variable
QRS: regular
How to identify a WAP
usually produces no symptoms and can only be recognized by EKG observation
Multifocal atrial tachycardia (MAT)
Variant of a WAP.

When the rate of a WAP reaches 100BPM or greater.
can be confused with A-Fib.

difference between MAT and A-Fib is p waves will usually be visible in a MAT rhythm
Hallmark indicator in diagnosis of WAP rhythms
Changes in the appearance of P waves!
When is an arrhythmia called frequent?
When it occurs more than 6 times per minute
What is one of the most common dysrhythmias encountered in elderly patients?
Atrial fibrillation
What is Atrial fibrillation commonly associated with?
Congestive heart failure or rheumatic heart disease
Atrial fibrillation results in a ________% decrease in cardiac output because why?
30, atrial kick does not occur
Triggered activity
Results from abnormal electrical impulses that occur during depolarization when cells are normally quiet.

The ectopic pacemaker cells may depolarize more than once after stimulation by a single electrical impulse
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