9 - Advanced ECG Rhythms & Pacemakers

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Health

Respiratory Therapy

Cardiology

University/Undergrad

Last updated 6:39 PM on 4/29/26
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16 Terms

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sinoatrial (SA) block

single missed beat due to blocked SA impulse; rhythm remains regular

<p>single missed beat due to blocked SA impulse; rhythm remains regular</p>
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sinus arrest

1 or more missed beats due to absent SA impulse causing an irregular rhythm

<p>1 or more missed beats due to absent SA impulse causing an irregular rhythm</p>
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premature atrial contractions (PAC)

irregular beats with premature P waves + non-compensatory pause

<p>irregular beats with premature P waves + non-compensatory pause</p>
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junctional escape beat (JEB)

compensatory junctional beat that usually follows sinus arrest

<p>compensatory junctional beat that usually follows sinus arrest</p>
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junctional rhythm

rhythm originating from AV junction (40-60 bpm)

  • P wave may be absent (1), inverted (2), or after QRS (3)

<p>rhythm originating from AV junction (40-60 bpm)</p><ul><li><p>P wave may be absent (1), inverted (2), or after QRS (3)</p></li></ul><p></p>
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right bundle branch block (RBBB)

disruption of impulse from bundle of His through right bundle branch

  • QRS > 0.12 sec (V1)

  • V1 = rsR’ pattern (“M,” “bunny ears”)

  • V6 = negative S wave

<p>disruption of impulse from bundle of His through right bundle branch</p><ul><li><p>QRS &gt; 0.12 sec (V<sub>1</sub>)</p></li><li><p>V<sub>1</sub> = rsR’ pattern (“M,” “bunny ears”)</p></li><li><p>V<sub>6</sub> = negative S wave</p></li></ul><p></p>
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left bundle branch block (LBBB)

disruption of impulse from bundle of His through left bundle branch

  • QRS > 0.12 sec (V1)

  • V1 = negative S wave

  • V6 = notched QRS

<p>disruption of impulse from bundle of His through left bundle branch</p><ul><li><p>QRS &gt; 0.12 sec (V<sub>1</sub>)</p></li><li><p>V<sub>1</sub> = negative S wave</p></li><li><p>V<sub>6 </sub>= notched QRS</p></li></ul><p></p>
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timing and purpose of junctional escape beats

  • JEBs usually occur after a pause in cardiac contractions, particularly sinus arrest.

  • JEBs are protective against cardiac arrest; AV junction initiates beats when SA node fails.

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compensatory pause

pause in cardiac contractions that lines up with next R wave to keep rhythm regular

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non-compensatory pause

pause in cardiac contractions that does not line up with next R wave causing irregular rhythm

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role of reentrant rhythms in SVT

Cardiac impulses fail to die out and re-excite previously depolarized tissue in a continuous loop, causing extra beats.

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single chamber pacemaker

pacemaker that initiates contractions in the atria (1) or ventricles (2)

<p>pacemaker that initiates contractions in the atria (1) or ventricles (2)</p>
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dual chamber pacemaker

pacemaker that initiates contractions in the atria and ventricles

<p>pacemaker that initiates contractions in the atria and ventricles</p>
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biventricular pacemaker

pacemaker that initiates contractions in both ventricles using 3 leads

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fixed rate pacemaker

pacemaker that initiates contractions at a fixed rate (usually 70-80 bpm)

  • can cause VT or V-fib

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demand pacemaker

pacemaker that initiates contractions and adjusts rate based on patient’s cardiac demand

  • base rate usually at 70 bpm