Atrial Arrhythmias

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  1. Atrial Arrhythmias occur where?
    In the Atria, NOT in the SA node
  2. Regularity of Premature Atrial Contractions:
    Depends on underlying rhythm
  3. When you see a beat that comes in too early think:
    "I have a premature ____ contraction"

    and find out which one it is
  4. Premature Atrial Contraction on an EKG:
    P wave looks normal, it just comes in a little early (look at P wave in comparison to other P waves)
  5. Questions to ask yourself to determine Premature Atrial Contraction:
    • Does you see any that come in early?   YES
    • Does it have a P wave?   YES

    Does it have a QRS?     YES

    Does it have an overall normal rhythm?   YES

    (normal sinus rhythm with one premature atrial contraction)
  6. PAC (Premature Atrial Contraction) on an EKG indicate:
    Irrability except for occasional premature beats

    (most common are from caffeine and nicotine!)
  7. Treatment with someone that has troublesome PAC (premature atrial contraction)
    • Teach about limiting caffeine and stimulants
    • (Lifestyle modifications)

    Usually PACs do put out cardiac output and are benign/asymptomatic
  8. Atrial Tachycardia on EKG:
    • Rate between 150-250 times a min!
    • Norm QRS
    • May not see P wave because it is going so fast
    • ***it will look like sinus tachy but SA node cannot go that fast, so we know it's Atrial Tach!
  9. Atrial Tachycardia is also called ____ because the irritable point is coming from above the ventricles
    Supraventricular Tachycardia (SVT)
  10. Causes of Atrial Tachycardia
    • Caffeine and Stimulants
    • Hypoxia 
    • Asthma
    • Chemo (adriomysine)

    **anything causing irratibility
  11. Treatment of Atrial Tachycardia
    • Corotid Sinus Massage > stimulates PNS and slows HR
    • *Never do this unless pt is on monitor and there are emergency items around
    • Vagal Maneuvers
  12. When an EKG presents with a rate of 250-400, and more P waves than QRS complexes:
    Atrial Flutter
  13. Sawtooth Pattern on EKG:
    Atrial Flutter
  14. To measure Atrial Rate on EKG, measure from ____ to _____
    P wave to P wave
  15. Treatment of A Flutter
    Beta Blockers, Cal Chan Blockers, Antiarrhythmic, Flecanide
  16. Only arrhythmia that has a totally irregular rhythm
    Atrial Fibrillation (A fib)
  17. Atrial Rate greater than 350 bpm, No discernible P waves, grossly irregular
    A Fib
  18. Ocean Waves appearance on EKG
    A Fib
  19. Treatment of A Fib
    • Calcium Channel Blockers 
    • Beta Blockers
    • Coumadin, Plavix, Zereta (clot prevention)
  20. A fib reduces cardiac output by ____% immediately because there is no strong contraction
  21. EKG changes from A Fib
    Distance between QRS totally irregular
  22. If someone is deteriorating quickly from A Fib you may have to do _____
    Cardioversion Shock
Card Set
Atrial Arrhythmias
Cardio Day Four
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