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CHAPTER 6 ATRIAL DYSRHYTHMIAS ECG

Terms in this set (58)

What are atrial dysrhythmias caused by?
Ectopic impulse in left or right atrium
The P Wave represents what?
Atrial depolarization (contraction)
What conditions cause atrial dysrhythmias?
Conditions that cause pressure on the atria (MI, neurological problems)
Early electrical impulses that originate in the atria, interrupting the inherent regular rhythm.
Premature Atrial Complexes
Rhythm of Premature Atrial Complexes
Regular with the exception of early complexes
Rate of Premature Atrial Complexes
60-100 bpm
P Wave Morphology of Premature Atrial Complexes
(Normal Complexes) Upright, constant. (PACs) May be flattened, notched, biphasic, or equiphasic; may be hidden in T Wave.
PR Interval of Premature Atrial Complexes
Normal limits
What must you determine with Premature Atrial Complexes
Underlying rhythm, always document
Pattern in which every third complex is a premature beat
Trigeminy
A person who had a prior cardiac disease that is experiencing Premature Atrial Complexes may show signs and symptoms of? Why?
Low cardiac output. The atria are not completely filling before depolarization
Frequent Premature Atrial Complexes may indicate
A more serious atrial dysrhythmia may follow
A cardiac cell or group of cells that produces an ectopic beat
Focus (foci)
What may a person with Premature Atrial Complexes experience?
Palpitations
Rhythm in which the pacemaker site shifts between the SA node, other sites in the atria, and/or the AV junction
Wandering Atrial Pacemaker
How many different P Wave morphologies indicate a Wandering Atrial Pacemaker?
3
Rhythm of Wandering Atrial Pacemaker
Slightly irregular
Rate of Wandering Atrial Pacemaker
60-100 bpm
P Wave Morphology of Wandering Atrial Pacemaker
Continuously changing
PR Interval of Wandering Atrial Pacemaker
Varies
Wandering Atrial Pacemaker is a normal finding in
Children, older adults, athletes
Wandering Atrial Pacemaker may be related to more serious conditions such as
Organic heart disease or drug toxicity
Multifocal Atrial Tachycardia is commonly confused with? It is similar to?
AFIB. Wandering Atrial Pacemaker.
Rhythm of Multifocal Atrial Tachycardia
Irregular
Rate of Multifocal Atrial Tachycardia
100-150 bpm
P Wave Morphology of Multifocal Atrial Tachycardia
Changes in appearance from beat to beat. May be upright, buried, notched, etc.
PR Interval of Multifocal Atrial Tachycardia
Varies due to impulse origin changing
What is Multifocal Atrial Tachycardia usually triggered by
Acute exacerbation of emphysema, congestive heart failure, or acute mitral valve regurgitation
This rhythm occurs when a rapid impulse originates in the atrial tissues
Atrial Flutter
The ectopic focus of Atrial Flutter may be originating from where?
Ischemic areas of the heart with enhanced automaticity or from a reentry pathway
Extra pathway that has developed in which a group of cells are generating an impulse faster than the SA node
Reentry pathway
What is the characteristic pattern of Atrial Flutter
Sawtooth
What letter represents flutters
F
Most often, Atrial Flutter is a ___ dysrhythmia. It leads to what?
Transient; more serious atrial dysrhythmias if not treated
Rhythm for Atrial Flutter
PP is regular. RR usually regular, but can be irregular
Rate of Atrial Flutter
250-350 bpm (flutters x 10)
P Wave Morphology of Atrial Flutter
P Waves not seen, only flutter (F Waves) present
Where are flutters (F waves) most likely seen?
Leads II, III, and aVF
PR Interval of Atrial Flutter
Not identifiable
The extra blood that can be ejected into the ventricles by the atria as a result of the electrical impulse slowing as it enters the AV node
Atrial kick
What is not present in Atrial Flutter since the atria do not contract completely? What does it result in?
Atrial kick. 10-30% decrease in cardiac output.
What treatment is common for Atrial Flutter?
Oxygen therapy
What strip is needed for Atrial Flutter to determine if changes occur?
Continuous rhythm strip
Dysrhythmia that occurs when electrical impulses come from areas of reentry pathways or multiple ectopic foci
Atrial Fibrillation
In Atrial Fibrillation, what is depolarizing
Only a small group of atrial cells rather than the whole atrium
Since the atrium does not contract as a whole, it ____ during Atrial Fibrillation
Quivers like Jello
Ineffective electrical activity due to Atrial Fibrillation result in
Loss of stroke volume 20-30%. Higher number in patients with heart disease
Letter that represents filbrillatory waves of Atrial Fibrillation
f waves
Rhythm of Atrial Fibrillation
PP cannot be determined. RR is irregular
Rate of Atrial Fibrillation
Cannot be determined, electrical impulse activity is in the range of 375-700
P Wave Morphology of Atrial Fibrillation
Cannot be identified, chaotic activity resulting in f waves
PR Interval of Atrial Fibrillation
Cannot be measured
QRS of Atrial Fibrillation
WNL and irregular
When people first present with Atrial Fibrillation, what is their ventricular rate? What is it called?
100 bpm, new onset AFIB
What do patients with new onset Atrial Fibrillation often complain of?
Dizziness, nausea, and other signs of low cardiac output
What is the treatment of uncontrolled Atrial Fibrillation
Slowing ventricular response using medication and then cardioversion in necessary
What can form in the atria due to blood collecting during Atrial Fibrillation
A blood clot (thrombus) can for and become an embolism (travelling clot)
A thrombus can cause
CVA, MI, pulmonary embolism, renal infarction
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