-
atrial
depolarization
p wave
-
ventricular
depolarization
QRS
-
ventricular
repolarization
-
-
-
QT
interval
- -
- 0.35 - 0.45 seconds or less than 1/2 the preceding R-R interval
-
Sinus
bradycardia
- (aerobically trained individuals, sleeping) < 60 / minute
- Valsalva maneuver, Beta blockers, Symptomatic
-
Bradycardia
syncope Treatment
atropine
-
Sinus
tachycardia
- (exercise,
- fever, pain, hypovolemia, HF) > 100 / minute.
-
Sinus
tachycardia Treatment
- Treat
- the underlying cause. IV beta blockers.
-
Atrial
fibrillation
- Erratic
- depolarization of atria
-
Atrial
fibrillation Etiology
- ischemic heart disease (CAD)
- Develops acutely with thyrotoxicosis, alcohol intoxication,
- caffiene use, stress, electrolyte imbalance.
- May be seen in absence of disease
-
Atrial
fibrillation
- No discernible P waves
- Wavy baseline
- Irreg. R-R interval
- Narrow QRS
-
Atrial
Fibrillation
- HR A: 350-650 b/p/m
- HR V: slow to rapid
- Rhythm: Irregular
-
Atrial
Flutter
- Irritable site depolarizes regularly at a rapid rate. AV
- node stops all impulses from getting through.
-
Flutter
Atrial rate
- 230-430 / minute (usu. 300)
-
- Ventricular response with - block 150-200
-
- Flutter Most easily recognized in leads - II, III, aVF
-
Atrial
flutter etiology
- Hyperthyroidism
- Valvular heart disease
- Pericardial disease
- Acute pulmonary embolism
- Congenital heart disease
- Sick sinus syndrome
- Idiopathic causes
-
Atrial
Flutter
- HR A: 220-340b/p/m
- HR V: <300
- Rhythm: Regular or variable
-
PVC
- Premature ventricular complexes (PVC) mean that the extra
- beats originate from the lower pumping chamber called the ventricle
-
Ventricula
tachycardia
- Characteristics
- Wide QRS complexes
- Rate 100-250
- R-R nearly regular
- P unrelated to QRS
-
Ventricula
tachycardia Etiology
- MI, CAD, cardiomyopathy
- Electrolyte imbalance (esp. K+, Mg)
-
Ventricula tachycardia Treatment
- Unstable - ID precipitating cause
- Stable - O2, ventricular dysrthmics (amiodarone, lidocaine)
- Unstable - add cardioversion
-
Ventricular
Fibrillation
- HR 300-600
- Rhythm: Extremely Irregular
- P Wave: Absent
- PR Intervals in sec: N/A
- QRS Fibralotory
-
Heart
Block 1st
- Prolonged
- pr interval > 0.20 seconds
-
Heart
Block 2nd °Mobitz I - - wenckebach
progressive pr interval until one complex is dropped
-
Heart
Block Mobitz II
intermittent AV block (every other complex is conducted)
-
3rd
- no
- communication between atria & ventricles
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