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20 Cards in this Set
- Front
- Back
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Always irregulary irregular. No P waves or T waves recognizable. QRS duration between 0.06-0.1mm. This is frequently seen as a chronic condition. Uniquely more dangerous to go in and out of than to stay in.
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Atrial Fibrillation
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This rhythm is distinguished from RSR by a single defining characteristic. The PRI is always >.2 sec.
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1st degree AV block.
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This rhythm has QRS duration WNL. The ventricular response is regular. The atrial rate is rapid, up to 350 BPM. The ventricular response is often 2:1 or 4:1. Visually, it has a distinctive "sawtooth" appearance. It is almost always regular.
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Atrial Flutter.
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This is an irregularly irregular rhythm. The PRI and QRS duration are WNL. The rate is rarely not WNL. There is a P wave in front of every QRS. It is characterized by complexes that repeat a sequence of being closer together, followed by a period of being farther apart. This "speed up and slow down" aspect is often in synchronization with the patient's respirations. It is uncommonly clinically significant.
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Sinus dysrhythmia.
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This is always regularly irregular. The cause of this is regularly blocked QRS complexes. It's most distinctive aspect is an ever increasing PRI until the signal doesn't continue past the AV junction, hence the blocked ventricular response. This can be every third, fourth or fifth beat. It is most often a benign and transient rhythm.
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2nd degree AV block type I, also known as Wenckebach.
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This may be irreg irreg, or reg irreg.Usually a regular sinus rhythm underying. Characterized by p waves with no QRS following. Can occur singly, or twice (or more) in a row. May occur in a bigeminy. Very dangerous and needs to be reported immediately to licensed personel. Likely to progress to a more dangerous rhythm.
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2nd degree AVB, Mobitz II
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This is a regular rhythm. The P waves are regular with a consistent morphology, however they do not conduct through to the ventricles. The ventricular rate is typically at a vent pacemaker rate. No correlation between P waves and QRS complexes. The ventricular complexes are also regular, just much slower than the SA node. Tx is immediate pacemaker placement. The pt is usually symptomatic with a slow thready pulse and an acutely compromised CO.
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3rd degree (AKA) Complete heart block.
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Typicall regular. Rate between 40-60. QRS duration WNL. PRI will be <.12 sec when measurable. P wave may be retrograde, stunted, missing, buried in the QRS, or appear after.
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Junctional
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An abrupt onset re-entry rhythm. Regular. The rate is 140-170. QRS duration WNL. Obscured P waves due to rate. CO may be severly affected. Immediate Tx can be vagal stimulation. Often caused by a congenital accessory pathway.
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Paroxysmal Supraventricular Tachycardia PSVT
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Rate WNL. Typically regular. QRS duration and morphology WNL. P wave may be retrograde, stunted, missing, buried in the QRS, or appear after.
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Accelerated junctional
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Rate >100. Regular. QRS duration WNL. P waves may be missing, stunted, retrograde, PRI,<.12sec, after the QRS or buried in it.
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Junctional Tachycardia
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The underlying rhythm is RSR WNL in all respects. Ectopy appears as early QRS complexes not preceeded by a P wave. QRS complexes are wide, bizarre, high amplitude with the T wave opposite in deflection from the QRS.
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RSR with PVC's
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No rate discernable. Characterized by a chaotic isoelectric line. No P, T or QRS waves identifiable. Imminent death without immediate treatment.
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Ventricular fibrillation
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Rate is >100. Frequently 160 up to 240. No P waves seen. QRS complexes are morphologically consistent, wide, bizarre, high amplitude with the T wave in opposite deflection. Emergency treatment necessary. Abrupt onset. Re-entry rhythm.
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Ventricular Tachycardia
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Regular rhythm. Rate is 20-40. No P waves seen. QRS complexes are wide, bizarre, high amplitude with an opposite deflection of the T wave.
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Idioventricular, AKA ventricular escape rhythm.
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Regular. Rate>40. No P waves. QRS complexes are wide, bizarre, high amplitude with an opposite T wave deflection.
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Accelerated Idioventricular
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Regular. Rate70-72. No P waves. QRS complexes are wide, bizarre, high amplitude with an opposite T wave deflection. Each QRS is preceeded by a vertical "spike".
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Ventricular paced rhythm
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RSR with early beats. Ectopic beats have a QRS duration and morphology WNL. The P wave preceeding the ectopic beats may be notched, larger, or otherwise have a different morphology than the underlying rhythm. The PRI is WNL on all beats.
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RSR with PAC's
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RSR with ectopic beats which appear early. Earyl beats have a QRS WNL in duration and morphology. Early beats may have a PRI of<.12 sec, or may be missing the P wave, or it may be retrograde, stunted or appear after or buried in the QRS.
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RSR with PJC's
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RSR with pauses. The pauses are of random duration. The CO may be mildly or profoundly affected depending on the frequency and length of the pauses. Tx with a pacemaker.
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Sinus Arrest
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