RELIAS DYSRHYTHMIA BASIC A QUESTIONS
AND ANSWERS
Normal sinus rhythm - ANSWER-heart rhythm originating in the sinoatrial node
with a rate in patients at rest of 60 to 100 beats per minute
Sinus Arrhythmia - ANSWER-Appearance is ALMOST NORMAL:
Respiratory - Circulatory interaction
Rate INCREASES with INSPIRATION (IN=IN)
Sinus Bradycardia - ANSWER-<60
normal sinus rhythm
Sinus Tachycardia - ANSWER->100 (100-150)
normal sinus rhythm
Premature Atrial Contraction (PAC) - ANSWER-Heart Rate: Depends on
underlying rhythm
Regularity: Interrupts the regularity of underlying rhythm
P-Wave: can be flattened, notched, or unusual. May be hidden within the T wave
PRI: measures between .12-.20 seconds and can be prolonged; can be different
from other complexes
QRS: <.12 seconds
Sinus Arrest/Pause - ANSWER-- SA node doesn't fire
- notice absence of P-wave for a complete cycle (a missed cycle)
length of pause ≠ multiple of normal rate (block)
Atrial Fibrillation (A-Fib) - ANSWER-an irregular and often very fast heart rate
originating from abnormal conduction in the atria
Atrial Flutter - ANSWER-irregular beating of the atria; often described as "a-
flutter with 2 to 1 block or 3 to 1 block"
Junctional Rhythm - ANSWER-40-60 Regular!
-impulse from AV node w/ retro/antegrade transmission
,- P wave often inverted/buried/follow QRS
- slow rate
- narrow QRS (not wide like ventricular)
Junctional Tachycardia - ANSWER->60 bpm (ms. K; 150-250)
- KEY: will be regular (consistent)
- AV junction produces a rapid sequence of QRS-T cycles
- p-wave often inverted/buried/follow QRS
Premature Junctional Contraction - ANSWER-Inverted p wave or hidden p wave
PRI<0.12 or none
Normal QRS
Supraventricular Tachycardia (SVT) - ANSWER-an abnormal heart rhythm arising
from aberrant electrical activity in the heart; originates at or above the AV node
First degree heart block - ANSWER-atrioventricular (AV) block in which the atrial
electrical impulses are delayed by a fraction of a second before being conducted to
the ventricles
2nd degree heart block type 1 (Wenckebach) - ANSWER-Progressively longer PR
interval until the P wave is not followed by a QPR
2nd Degree Heart Block (Mobitz II) - ANSWER-Rare, but more serious
Sudden appearance of a non conducted P-wave
P-waves are nl, but some aren't followed by a QRS complex
PR & RR intervals are constant
3rd degree heart block - ANSWER-no obvious correlation between p and qrs, need
pace maker
premature ventricular contraction (PVC) - ANSWER-a ventricular contraction
preceding the normal impulse initiated by the SA node (pacemaker)
Bigeminy PVC - ANSWER-every other beat is a PVC
, PVC couplets - ANSWER-PVC occurring in pairs, no adequate C.O. when this
occurs
monomorphic ventricular tachycardia - ANSWER-presents with wide QRS
complexes of a common shape.
Torsades de pointes - ANSWER-Rate: 120 - 200 usually
P wave: Obscured by ventricular waves
QRS: Wide QRS - "Twisting of the Points"
Conduction: Ventricular only
Rhythm: Slightly irregular
Ventricular fibrillation (V-fib) - ANSWER-abnormal heart rhythm which results in
quivering of ventricles
Idioventricular Rhythm - ANSWER-<40
*looks like vtach but slow*
- no P waves (from vent foci)
- Wide QRS
(serious, death like rhythm)
- called "dying heart" rhythm...occasional ventric beat b4 death (asystole)
Accelerated Idioventricular Rhythm - ANSWER-Rate: 50 - 100 usually (usually
slow)
P wave: Obscured by ventricular waves (occur during ventricular contraction) - SA
node slower than faster ventricular pacing than should be
QRS: Wide QRS
Conduction: Ventricular only
Rhythm: Regular
- benign rhythm that is sometimes seen during acute MI or early after reperfusion. -
Rarely sustained, does not progress to vfib, rarely requires treatment
asystole - ANSWER-absence of contractions of the heart
Failure to capture (pacemaker) - ANSWER-
AND ANSWERS
Normal sinus rhythm - ANSWER-heart rhythm originating in the sinoatrial node
with a rate in patients at rest of 60 to 100 beats per minute
Sinus Arrhythmia - ANSWER-Appearance is ALMOST NORMAL:
Respiratory - Circulatory interaction
Rate INCREASES with INSPIRATION (IN=IN)
Sinus Bradycardia - ANSWER-<60
normal sinus rhythm
Sinus Tachycardia - ANSWER->100 (100-150)
normal sinus rhythm
Premature Atrial Contraction (PAC) - ANSWER-Heart Rate: Depends on
underlying rhythm
Regularity: Interrupts the regularity of underlying rhythm
P-Wave: can be flattened, notched, or unusual. May be hidden within the T wave
PRI: measures between .12-.20 seconds and can be prolonged; can be different
from other complexes
QRS: <.12 seconds
Sinus Arrest/Pause - ANSWER-- SA node doesn't fire
- notice absence of P-wave for a complete cycle (a missed cycle)
length of pause ≠ multiple of normal rate (block)
Atrial Fibrillation (A-Fib) - ANSWER-an irregular and often very fast heart rate
originating from abnormal conduction in the atria
Atrial Flutter - ANSWER-irregular beating of the atria; often described as "a-
flutter with 2 to 1 block or 3 to 1 block"
Junctional Rhythm - ANSWER-40-60 Regular!
-impulse from AV node w/ retro/antegrade transmission
,- P wave often inverted/buried/follow QRS
- slow rate
- narrow QRS (not wide like ventricular)
Junctional Tachycardia - ANSWER->60 bpm (ms. K; 150-250)
- KEY: will be regular (consistent)
- AV junction produces a rapid sequence of QRS-T cycles
- p-wave often inverted/buried/follow QRS
Premature Junctional Contraction - ANSWER-Inverted p wave or hidden p wave
PRI<0.12 or none
Normal QRS
Supraventricular Tachycardia (SVT) - ANSWER-an abnormal heart rhythm arising
from aberrant electrical activity in the heart; originates at or above the AV node
First degree heart block - ANSWER-atrioventricular (AV) block in which the atrial
electrical impulses are delayed by a fraction of a second before being conducted to
the ventricles
2nd degree heart block type 1 (Wenckebach) - ANSWER-Progressively longer PR
interval until the P wave is not followed by a QPR
2nd Degree Heart Block (Mobitz II) - ANSWER-Rare, but more serious
Sudden appearance of a non conducted P-wave
P-waves are nl, but some aren't followed by a QRS complex
PR & RR intervals are constant
3rd degree heart block - ANSWER-no obvious correlation between p and qrs, need
pace maker
premature ventricular contraction (PVC) - ANSWER-a ventricular contraction
preceding the normal impulse initiated by the SA node (pacemaker)
Bigeminy PVC - ANSWER-every other beat is a PVC
, PVC couplets - ANSWER-PVC occurring in pairs, no adequate C.O. when this
occurs
monomorphic ventricular tachycardia - ANSWER-presents with wide QRS
complexes of a common shape.
Torsades de pointes - ANSWER-Rate: 120 - 200 usually
P wave: Obscured by ventricular waves
QRS: Wide QRS - "Twisting of the Points"
Conduction: Ventricular only
Rhythm: Slightly irregular
Ventricular fibrillation (V-fib) - ANSWER-abnormal heart rhythm which results in
quivering of ventricles
Idioventricular Rhythm - ANSWER-<40
*looks like vtach but slow*
- no P waves (from vent foci)
- Wide QRS
(serious, death like rhythm)
- called "dying heart" rhythm...occasional ventric beat b4 death (asystole)
Accelerated Idioventricular Rhythm - ANSWER-Rate: 50 - 100 usually (usually
slow)
P wave: Obscured by ventricular waves (occur during ventricular contraction) - SA
node slower than faster ventricular pacing than should be
QRS: Wide QRS
Conduction: Ventricular only
Rhythm: Regular
- benign rhythm that is sometimes seen during acute MI or early after reperfusion. -
Rarely sustained, does not progress to vfib, rarely requires treatment
asystole - ANSWER-absence of contractions of the heart
Failure to capture (pacemaker) - ANSWER-
