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32 Cards in this Set
- Front
- Back
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electrical conduction through the heart
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SA node-- internodal tract--- AV node--- Bundle of His--- Lf and Rt bundle branchs---- purkinje fibers
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contractility
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ability to respond mechanically to an impulse
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conductivity
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ability to transmit an impulse along a membrane in an orderly manner
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automaticity
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ability to initiate an impulse spontaneous and continuous
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excitability
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ability to be electrically stimulated
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normal pacemaker of the heart
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SA node
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Electrphysiologic study [EPS]
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performed to identify different mechanisms of tachydysrythmias, bradydysrythmias, and causes of syncope
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signal-averaged ECG [SAECG]
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high-resolution ECG used to identify the patient AT RISK for developing complex ventriclar dysrhythmias
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holter monitor
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records ECG while patient is ambulatory; records 24-48 hours while patient performs ADL, useful for detecting dysrythmias
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event monitor
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activated by patient and can be used only at the time the patient experiences symptoms
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exercise treadmill testing
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evaluation of cardiac rhythm response to exercise
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Bradycardia
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HR less than 60bpm.
decreases CO and coronary artery perfusion tx= atropine |
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atropine
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increases HR and supports BP
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ectopic beat
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electrical impulse sent from somewhere outside the normal conduction pathway--- causes dysrythmias and decreases CO
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fibrillation
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total disorganization of electric activity
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most lethal fibrillation
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Ventricular fibrillation-- severe derangement of the heart rythm, vent is "quivering", no effective contractio, no CO is occuring
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who is most at risk for atrial fib?
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elderly
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atrial fib
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most common dysrythmia!
atria is just quivering. this causes blood to pool in atria so can lead to an embolus or stroke |
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artial fib tx
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anticoagulants [coumadin], cardioversion [contradicted if clots are present], Ca Channel blockers
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1st degree heart block
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no real symptoms, HR slower, longer PR interval, still has a regular rhythm
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2nd degree- type 1 heart block
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usually transient and well tolerated [PR interval lengthens w/ each heart beat] but is a warning sign for worse degree
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2nd degree- type 2 heart block
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often progresses to 3rd degree, beats are intermittently non-conducted, QRS dropped, results in decreased CO w/ sunsequent hypotension
tx= permanent pacemaker |
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3rd degree heart block
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almost always results in reduced CO w/ subsequent ischemia, HF and shock
COMPLETE HB tx= pacemaker |
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Premature Ventricular Contractions [PVCs]
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vents contract prematurely
cause: anxiety, adrenaline, cocaine, alcohol, digoxin, caffeine, nicotine tx: LIDOCANIE, elimination of triggers, beta-blockers, benzos, O2 |
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most significant complication of PVC?
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ventricular tachycardia
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Ventricular Tachycardia
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step right before VF, rate is 150-250bpm, actually has contractions of the heart
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Ventricular Fibrillation
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vent is "quivering" and no effective contraction and consquently no CO occurs, HR is not measureable and none of the waves are visible
tx: CPR, amioderone |
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electrolyte imbalance most often affects cardiac rhythm
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potassium
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asystole
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FLAT LINE!
there is no blood flow to the brain or body, patients are unresponsive, pulseless tx: CPR, intubation, transcutaneous pacing, epinephrine, atropine SO NOT SHOCK |
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Pulse-less electrical activity
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electrical activity can be observed on the ECG, but there is no mechanical activity of the heart [not contracting]
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tx of pulse-less electrical activity
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PEA
Probable cause, Epinephrine, Atropine [only is SLOW], also CPR |
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pacemaker
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eectronic device used to pace the heart when the normal condition pathway is damaged or diseased
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