Rhythm Part 1- Exam 2

Sinus arrythmia

irregularity in spacing of QRS, consistent morphology

Atrial foci

p wave, narrow, QRS 60-80

Junctional foci

p wave?, narrow QRS, 40-60

Ventricular foci

no p wave, wide QRS, 20-40

Arrhythmias

irregular rhythms, escape, premature beats, and tachyarrythmias

Irregular rhythms

wandering pacemaker, multifocal atrial tachycardia, and atrial fibrillation

Wandering Pacemaker

irregularity and changing morphology. P wave shape varies, rate less than 100, spacing off.

Multifocal atrial tachycardia

irregularity and changing morphology. Closer QRS, spacing and shape of P wave varies. Rate greater than 100.

Atrial fibrillation (a-fib)

chaos, irregularity, and changing morphology, narrow QRS. Could also look like a narrow QRS, chaos, many appear as wavy with no identifiable P waves

Atrial Escape Rhythm

will see sinus arrest, two or more beats after, morphology changes, rate slowing.

Junctional Escape Rhythm

Sinus arrest, two or more beats after, no p wave, narrow QRS, rate slows.

Ventricular Escape Rhythm

wide QRS, slow rate, sinus arrest than one or more beat

Junctional automaticity focus may cause retrograde atrial depolarization

inverted P wave, notched on QRS complex

Atrial escape beat

P wave looks different, QRS narrow, only one beat after sinus arrest

(AV) Junctional Escape Beat

no P wave, narrow QRS, one beat after sinus arrest

Ventricular Escape Beat

wide QRS, no P wave, one beat after sinus arrest

Premature beats are

sinus arrest after premature beat

Atrial and junctional foci become irritable because of

increased sympathetic stimulation, adrenaline release, excess stimulants, or toxins

Premature Atrial Beat

Rhythmicity normal, QRS narrow, QRS comes early, then a sinus arrest, resets one cycle length after.

Premature junctional beat

QRS narrow but early, no P wave before the premature wave, then sinus arrest, could be inverted P wave

Ventricular Fcous

irritability due to hypoxia (low O2)

Premature ventricular contraction

wide QRS, no p wave before premature beat, then sinus arrest. Tall R wave in QRS complex.

Runs of PVCs

v-tach

Multifocal PVC

premature beats in multiple foci, more dangerous

Tachy-arrhythmias

paroxysmal tachycardia, flutter, and fibrillation

paroxysmal means

sudden

paroxysmal atrial tachycardia

narrow QRS, P waves, and sudden increased rate

Paroxysmal Junctional Tachycardia

narrow QRS, no P wave, sudden increased rate

Supraventrciular tachycardia (SVT)

narrow QRS, can;t distinguish P from T wave, but they are T waves

Paroxysmal ventricular tachycardia

wide QRS, sudden fast rate

Atrial flutter

consistency in patter, not chaos, 2 or 3 flutters per QRS complex

Ventricular fibrillation

complete chaos, cannot identify ANY wave forms, quivering