Ecg Arrhythmias

Front 1

Back 1

1st degree AV Block
PR interval > 0.20; There is 1 P wave before each QRS complex indicating the impulse from SA node passes through to ventricles but is delayed in AV node or Bundle of His

Front 2

Back 2

2nd Degree AV Block
Type I Wenckebach or Type I Mobitz
Seen as a prolongation of RR intervals until a QRS complex is completely missing, then sequence begins again

Front 3

Back 3

2nd degree AV Block a.k.a
Type I Wenckebach or Mobtiz
Seen as prolongation of the PR intervals until a complete QRS interval is missing, cycle then begins again

Front 4

Back 4

3rd Degree Block
atria & ventricles are paced by independant sources. Recognized by the establishment of a nonexistant relationship between the P waves and QRS complexes

Front 5

Back 5

Atrial Fibrillation
atrium quivers w/no coordinated contraction; No true P waves and ventricular rate may be irregular & result in an abnormal RR interval

Front 6

Back 6

ECG Component Diagram

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Back 7

Mobitz 2nd Degree AV Block
Seen as a series of nonconducted P waves followed by a P wave that is conducted to the ventricles

Hint 7

Sometimes ratio of nonconducted to conducted P waves is fixed at 3:1 or 4:1
Result from MI or ischemia

Front 8

Back 8

Normal ECG
begins w/upright P wave; PR interval of 0.12-0.20 consistently; QRS identical and no longer then 0.12; ST segment is flat; RR interval regular doesn't vary more than 0.12 between QRS complexes.
Heart rate between 60-100

Front 9

Back 9

Normal Sinus Rhythm
60-100 bpm
Identical P waves, PR interval of .12-.20 & consistent; QRS complex no longer than .12 seconds; ST segment is flat; R-R interval regular & don't vary more than .12 seconds between QRS complexes

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Back 10

Sinus Arrhythmia
recognized by irregular spacing between QRS complexes. RR interval varies by more than 0.12 seconds

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Back 11

Premature Atrial Complex (PAC) P wave may be hidden or partially hidden in preceeding T wave; results when abnormal electrical activity in the atria causes the atria to depolarize before the SA node fires.

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Back 12

Paired PAC
P wave may be hidden in preceeding T wave;

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Back 13

Sinus Bradycardia
Heart rate less than 60 bpm
Other than the rate being too slow, sinus bradycardia does not differ from a normal sinus rhythm

Front 14

Type I versus Type II AV Block

Back 14

In type I 2nd degree AV block the PR progressively lengthens until a non-conducted P wave occurs. The PR gets longer by smaller and smaller increments; this results in gradual shortening of the RR intervals. The RR interval of the pause is usually less than the two preceding RR intervals. The RR interval after the pause is longer than the RR interval just before the pause.

In type II AV block, the PR is constant until the nonconducted P wave occurs. The RR interval of the pause is usually 2x the basic RR interval

Front 15

Back 15

Unifocal PVC
unique & bizarre QRS complex which is much wider than normal; No P wave preceeding them

Hint 15

Sources for impulse outside the SA node are called ectopic foci; PVCs are an example of ectopic foci that originate in the ventricles

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Back 16

Ventricular Fibrillation - defined as erratic quivering of the ventricles; No CO present;
VF shows grossly irregular fluctuations w/zig zag pattern;

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Back 17

Ventricular Tachycardia - rates range from 140-220 bpm
run of 3 or more PVCs; recognized as a series of wide, bizzarre QRS complexes that have no preceeding P wave.

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Back 18

Conceptual Framework

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Back 19

Paired PAC

Front 20

Back 20

Sinus Tachycardia

Front 21

Back 21

Atrial Flutter
Normal P wave is absent & replaced by 2 or more regular sawtooth like waves called flutter or ff waves.

Front 22

Back 22

2nd degree AV Block
a.k.a.
Mobitz Type II

Front 23

Back 23

Sinus Arrest (SA Node Arrest)
sudden failure of SA node to initiate an impulse (NO P wave) 2-4 P-QRS-T complexes missing

Front 24

What is the term supraventricular tachycardia (SVT) commonly used to describe?

Back 24

SVT describes any tachycardia that is not of ventricular origin

Front 25

What arrhythmias are included in the general term SVT?

Back 25

sinus tachycardia
atrial tachycardia
junctional tachycardia
atrial flutter
atrial fibrillation
(w/rates >100 bpm)

Front 26

What is the difference between Type I 2nd degree Wenkebach or Mobitz Blocks and Type II 2nd degree Mobitz Block?

Back 26

Type I 2nd degree blocks the PR progressively lengthens until a non-conducted P wave occurs; Type II 2nd degree blocks the PR is constant until the nonconducted P wave occurs

Front 27

In which two ventricular arrhythmias is ther no P wave present?

Back 27

No P wave is present in:
VF & VT

Front 28

What drug is used to manage VT in stable patients?

Back 28

Amiodarone

Front 29

In which ventricular arrhythmia is there no cardiac output present?

Back 29

Ventricular Fibrillation

Front 30

What are some common causes of VF?

Back 30

electrical shock, anesthesia, mechanical irritation of the heart, severe hypoxia, MI and large doses of digitalis or epinephrine

Front 31

What are some serious signs and symptoms due to tachycardia (heart rate > 150)

Back 31

Hypotension, pulmonary congestion, dizziness, shock, ongoing chest pain, SOB, CHF, weakness/fatique, acute altered mental status

Front 32

What are some contributing causes to tachycardia?

Back 32

pulmonary embolism, acidosis, tension pneumothorax, cardiac tamponade, hypovolemia, hypoxia, hypo/hyperalkalemia, MI, OD

Front 33

What is the ideal route for med. admin in emergency situations if a central vein is not cannulated?

Back 33

peripheral IV line

Front 34

What arrhythmias is cardioversion indicated for?

Back 34

SVT, atrial flutter, atrial fibrillation, and VT

Front 35

What drug is commonly used for bradycardia in ACLS situations?

Back 35

Atropine

Front 36

What drug(s) are commonly used for ventricular arrhythmias in ACLS situations?

Back 36

epinephrine, amiodarone or lidocaine

Front 37

What drug(s) are commonly used for hypotension or cardiac arrest in ACLS situations?

Back 37

epinephrine or vasopressin