Unit 6 atrial Rhythms

Ectopic Atrial Rhythm: looks like a sinus rhythm in everyway except for a negatively deflected P wave in an inappropriate lead

Ectopic Atrial Tachycardia

Does not have to have a negatively deflected P wave (It might) but it doesnt necessarily have to have one.

These stats will be the identifiers:

Rate: 100-180bpm

Rhythm: Regular

P wave: Present, may be different w/ ectopy or Tachycardia (P wave morphology will be inconsistent)

P:QRS ratio 1 to 1

PR interval: Normal, different w/ ectopy (Spacing for PR intervals will be different than other PR intervals, thats how you know its a Ectopic Atrial Tachycardia)

QRS width: < 120 milisecs (0.12)

Wandering Atrial Pacemaker

-Impulses originate from varying points in atria

Rate: < less than 100bpm

Rhythm: irregularly- Irregular

P wave: At least 3 different morphologies

P:QRS ratio: 1:1

PR interval: Variable (will change)

QRS Width: <120 Milisecs (0.12 sec)

Multifocal Atrial Tachycardia

Rate: >100bpm

Rhythm: irregularly-irregular

P wave: at least 3 different morphologies

P:QRS ratio: 1 to 1

PR interval: Variable

QRS width: < 120 milisecs (0.12 sec)

Is basically the same as wandering Atrial Pacemaker except the rate is greater than 100

Atrial Flutter

Is considered re-entry tachycardia, somewhere in the atria depolarization will occur, and the depolarization will be stuck in a re-entry of the branches that carry the impulse from the SA node to the AV node

-occurs 250-300 times per minute, which means the atriums are working extremely fast, not normal

Rate: Atria (25—350 per min), Ventricles (125-175 per minute)

Rhythm: Usually Regular

P wave: Saw toothed “F waves”

P:QRS ratio: Variable, 2:1 is common

PR interval: Variable

QRS width < 120 millisecs (0.12)

The flutter waves will go right into and continue through the QRS complex and T waves

Atrial Fibrillation A-Fib

-common occurance in cardiac patients such as the elderly

-caused by a fibrillating atria, the atria is quivering, not depolarizing normally. It depolarized close to 800 times per minute, which is not sustainable with life

-The entire atria is quivering sending signals down to the ventricles almost 800 times per minute

There are No P waves in atrial difibrillation

chaotic atria activity

There is no true Rhythm

Controlled A-Fib: close to 100 bpm

Rapid A-Fib: will exceed 100bpm, will become in need of treatment depending on the patients condition