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Terms in this set (108)
What's Unique about Normal Sinus Rhythm?
Sinus rhythm is the only rhythm for which all five steps are within normal limits
What's unique about Sinus Bradycardia?
For sinus bradycardia, the heart rate is less than 60 and all other measurements are within normal limits
What's unique about Sinus Tachycardia?
For sinus tachycardia, the heart rate is greater than 100 and all other measurements are within normal limits
What's unique about Sinus Dysrhythmia?
For sinus dysrhythmia, the P-P and R-R intervals will progressively widen then narrow following the patient's breathing pattern
What's unique about Sinus Arrest?
During sinus arrest, complete cardiac complexes precede and follow the arrest period. There are no nonconducted QRS complexes and no isolated P waves
What's unique about Premature Atrial Complexes (PAC)?
A premature atrial complex is a beat earlier than it should be with a positively deflected P wave
What's unique about Wandering Atrial Pacemaker Rhythm?
WAP has a changing P wave configuration with at least three variations in one lead. The rhythm may be irregular
What's unique about Multifocal Atrial Tachycardia?
MAT has a clearly changing P wave and a heart rate of 101 to 150 bpm
What's unique about Atrial Flutter?
Atrial flutter has a "sawtooth" atrial pattern between the QRS complexes
What's unique about Atrial Fibrillation?
Atrial Fibrillation shows chaotic disorganized activity between QRS complexes
What's Unique about Premature Junctional Complex?
PJCs have an irregular rhythm and the P wave is inverted and may appear before, during, or after the QRS complex
What's unique about Junctional Rhythm?
A junctional rhythm may have an inverted or absent P wave or a P wave that follows the QRS complex
What's unique about Supraventricular Dysrhythmia?
Supraventricular Dysrhythmias are rate dependent with a rate of greater than 150 bpm
What's unique about First Degree AV block?
With first degree atrioventricular block, the PR interval is constant and measures greater than 0.20 sec
What's unique about 2nd Degree AV Block Mobitz I (Wenckebach)?
A Mobitz I rhythm has a cyclical extending PR interval until the QRS is dropped. Then the cycle begins again (irregular ventricular response)
What's unique about 2nd Degree AV Block, Mobitz Type II?
A Mobitz II rhythm has a constant PR interval with blocked QRS complexes (irregular ventricular response)
What's unique about 3rd Degree (Complete) Heart Block?
In 3rd degree atrioventricular block, the P-P and R-R intervals are regular (constant) but firing at different rates
What's unique about Premature Ventricular Complexes?
A PVC is an early QRS complex that is wide (>0.12 sec) and has a bizarre appearance. There is no P wave
What's unique about Idioventricular Rhythm?
An idioventricular rhythm has an absence of P waves, slow ventricular rate of 20 to 40 bpm, and wide-bizarre QRS complexes
What's unique about Accelerated Idioventricular Rhythm?
The Accelerated Idioventricular Rhythm has an absence of P waves, a ventricular rate of 40 to 100 bpm, and wide-bizarre QRS complexes
What's unique about Ventricular Tachycardia?
Ventricular Tachycardia has a classic "sawtooth" appearance and a rate in excess of 100 bpm, with no P wave
What's unique about Agonal Rhythm?
The accelerated idioventricular rhythm has an absence of P waves, a ventricular rate of less than 20 bpm, and wide-bizarre QRS complexes (dying heart)
What's unique about Ventricular Fibrillation?
Ventricular Fibrillation is the absense of organized electrical activity. The tracing is chaotic in appearance.
Blood ejected into ventricles prior to ventricular systole
Absence of breathing
Pertaining to the nervous system
Lack of oxygen to heart muscle cells
Impulses on the vagal nerve cause inhibitory effect on the heart
An ectopic focus origiinating above the ventricles
What is the rate of a normal sinus rhythm?
60 to 100 bpm
What sinus rhythm has a rate of less than 60 bpm?
What sinus rhythm has a rate of more than 100 bpm?
What rhythm shows an irregularity during inspiration and expiration?
In which period of the cardia cycle is a strong ventricular stimulus potentially dangerous?
The normal PR interval is.....
0.12 to 0.20 sec
What is the range of heart rate for ventricular fibrillation?
Greater than 300 bpm
What is the normal, inherent rate for the AV junction?
40 to 60 bpm
Patient's own heart and the electronic pacemaker compete over electrical control of the heart
Device that delivers electrical energy to cause depolarization (contractions)
Loss of Capture
Pacing activity occurs but is not captured by the myocardium
Pacemaker does not recognize the patient's inherent heart rate
Pacemaker fails to send electrical impulse to the heart
Electrical current from muscle movements or other activities are sensed by the pacemaker
Heart muscle responds to electrical stimulation and depolarizes (contracts)
Electrical current causes the myocardial tissue to depolarize (contract)
Criteria for Classification
3. P wave configuration
4. PR interval
5. QRS duration & configuration
Early beat (has similar shape and shape suggesting only one irritable focus present)
Varied shapes and forms of the PVCs
PVC occurs during the normal R-R interval without interrupting the normal cycle
Every other beat is a PVC
Every third beat is a PVC
Every fourth beat is a PVC
Right Bundle Branch Block
QRS is positively deflected (↑)
Left Bundle Branch Block
QRS is negative (↓)
Bundle Branch Blocks (BBB)
Occur when one or both of the ventricular pathways are damaged or delayed due to cardiac disease, drugs or other conditions. Electrical current will not be able to travel through that tissue to reach the myocardial tissue in its usual fashion
What method do you use to best calculate the heart rate?
Count the # of boxes between the R-R complexes & divide that # into 1500
Analyzing the shape of the P waves to see if they are all the same shape is to determine if
the atrial current is moving in the same pathway
Measuring the PR interval requires the tech to measure the period of time represented by the
beginning of the P wave to the beginning of the QRS complex
QRS duration measurement is essential to determine the time it takes for
Which type of AV block tends to progress quickly to 3rd degree AV block or complete heart block?
2nd degree AV block, Mobitz type II (classical)
BBB rhythm often has similarities to a sinus complex, with the distinguishing criteria of
PR interval ›0.20 sec
A Delta Wave is frequently seen with
The most common type of supraventricular tachycardia (SVT) is
AV nodal reentrant tachycardia (AVNRT)
Wolff-Parkinson-White syndrome is associated with
short PR interval, delta wave, & wide QRS complex
Signs and symptoms experienced during a tachydysrhythmia are usually primarily related to
decreased ventricular filling time & stroke volume
How are frequent PACs usually managed?
Correcting the underlying cause
A wandering atrial pacemaker rhythm with a ventricular rate of 60-100 bpm may also be referred to as
multiformed atrial rhythm
Which medication increases heart rate by accelerating the SA node discharge rate & blocking the vagus nerve?
In a junctional rhythm viewed in lead II, where is the location of the P wave on the ECG if atrial and ventricular depolarization occur simultaneously?
During the QRS complex
In a junctional rhythm viewed in lead II, where is the location of the P wave on the ECG if atrial depolarization precedes ventricular depolarization?
Before the QRS complex
In a junctional rhythm viewed in lead II, where is the location of the P wave on the ECG if ventricular depolarization precedes atrial depolarization?
After the QRS complex
The primary waveform used to differentiate PJCs from PACs is the
To determine whether the ventricular rhythm on an ECG tracing is regular or irregular
Compare R to R intervals
Common causes of junctional dysrhythmias may include acute coronary syndromes and
In the cardiac cycle, a PJC occurs
Early, before the next expected sinus beat
If seen, the P wave of a rhythm originated in the AV junction will appear _______ in lead II
Term for 3+ PVCs occuring in a row at a rate of more than 100 bpm is
a run of ventricular tachycardia
What dysrhythmia may be a normal finding in individuals with no history of cardiac disease, especially in athletes?
First-Degree AV block
Cardiac Stress Test
Variations of exercise electrocardiography include
thallium stress test & persantine-thallium stress test
The time frame that an exercise electrocardiography takes is
During stress test the goal is to achieve target heart rate (THR) without symptoms or complications. The THR is
220 - patient's age x 85%
What % of exercise electrocardiography patients have false positive results, meaning that the test may indicate that disease is present when it is not?
Common Stress Test Protocol
2. Modified Bruce
ECG monitoring requires patient to be attached and move around?
Two most common types of ambulatory monitoring are
continuous and intermittent
Which type of ambulatory monitoring is performed in a medical facility?
The type of ambulatory monitoring most often used for patients with permanent pacemakers is
Which type of monitoring requires patient to activate the monitor while the patient is experiencing symptoms?
Transtelephonic monitor--post-symptom event monitor
Your patient returns to have the ambulatory monitor removed. He states that he forgot his diary in the car and will retrieve it after the monitor is removed. It is really bothering him. What should you do?
Have the patient return to the car to obtain the diary before removal
The ambulatory monitoring results were sent to an outside lab for interpretation. How long does it take to get a final report?
7 to 10 days
The type of ambulatory monitor that was named after its inventor is the
When performing an ECG, what procedures must you always follow to prevent spread of infection?
ECG tracing has a wandering baseline through leads I, II, III, aVR, aVF & aVL. What leads need to be assessed for proper application, tension on leads, & possible elecgtrode replacement?
Electrical activity that causes contraction is called
Electrical activity that causes relaxation is called
An example of somatic tremor from disease is
Mechanism in the electrocardiograph that changes the voltage into a mechanical motion or recording purposes
Name the artifacts
2. AC interference
3. Wandering baseline
4. Interrupted baseline
Which lead portrays the heart beat better than other leads
What is an electrolyte?
A conductive substance that contains moisture
What is a baseline?
A flat horizontal line between cardiac cycle
What are electrodes?
A sensor that detects electrical impulse on the body surface
The graph is a
The next group of leads recorded after bipolar are
The first 3 leads are also known as what type of lead?
5 large squares equal to ______ sec
Repolarization of the heart takes place while the heart muscle
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