KAISER TELEMETRY EXAM 5 COMPLETE
PREPARATION GUIDE WITH BASIC AND
COMPLEX RHYTHM ANALYSIS SKILLS
◉ Premature Junctional COmplex.
Answer: • Narrow QRS complex, either (1) without a preceding P
wave or (2) preceded by an
abnormal P wave with a PR interval of < 0.12 sec referred as a
"retrograde" P wave
• Occurs sooner than would be expected for the next sinus impulse.
• Followed by a compensatory pause.
◉ Ist degree block what is it? etiology and treatment.
Answer: PR interval - > .20 second conduction delay, and constant.
Etiology: Inferior wall MI (RCA), Ischemia, Digoxin toxicity
Treatment: Rate dependent, observe; if symptomatic atropine
◉ PR.
Answer: 0.12-0.20
,◉ 2ND DEGREE TYPE 1 etiology and tx.
Answer: Wekenbach
The atrial rhythm will be regular (p-
waves are regular), the PR-interval progressively
gets longer until a QRS is dropped and only the p-
wave is present
Etiology: =common with MI, Digitalis toxicity,
myocarditis, s/p open heart surgery
Treatment: Observe; if symptomatic atropine,
epinephrine or temporary pacemaker
◉ 2nd degree type 2 block.
Answer: Mobitz
more unpredictable. drops QRS qithout warning can convert to
Third Degree
◉ 3rd degree block etiology and tx.
, Answer: Complete blockage in the conduction between the atria and
the ventricles. Two
separate pacemakers, one depolarizing the atria and the other
depolarizing the
ventricles. Decreased HR leads to decreased CO (loss of atrial kick
due to atrial-
ventricular desynchronization)
Etiology: Acute MI (high mortality with Anterior MI), drug toxicity:
digitalis, procainamide; chronic condition in elderly with calcified
conduction
Treatment: Transcutaneous Pacemaker as bridge to permanent
pacing.
Can try drugs: Atropine, Epinephrine, Dopamine
◉ Bundle Branch Block:.
Answer: Block in conduction through the either right or left bundle
branches resulting in a delay in the depolarization of
the right or left ventricular muscle accordingly.
Rhythm: BBB with underlying rhythm
Rate: depends on underlying rhythm
PREPARATION GUIDE WITH BASIC AND
COMPLEX RHYTHM ANALYSIS SKILLS
◉ Premature Junctional COmplex.
Answer: • Narrow QRS complex, either (1) without a preceding P
wave or (2) preceded by an
abnormal P wave with a PR interval of < 0.12 sec referred as a
"retrograde" P wave
• Occurs sooner than would be expected for the next sinus impulse.
• Followed by a compensatory pause.
◉ Ist degree block what is it? etiology and treatment.
Answer: PR interval - > .20 second conduction delay, and constant.
Etiology: Inferior wall MI (RCA), Ischemia, Digoxin toxicity
Treatment: Rate dependent, observe; if symptomatic atropine
◉ PR.
Answer: 0.12-0.20
,◉ 2ND DEGREE TYPE 1 etiology and tx.
Answer: Wekenbach
The atrial rhythm will be regular (p-
waves are regular), the PR-interval progressively
gets longer until a QRS is dropped and only the p-
wave is present
Etiology: =common with MI, Digitalis toxicity,
myocarditis, s/p open heart surgery
Treatment: Observe; if symptomatic atropine,
epinephrine or temporary pacemaker
◉ 2nd degree type 2 block.
Answer: Mobitz
more unpredictable. drops QRS qithout warning can convert to
Third Degree
◉ 3rd degree block etiology and tx.
, Answer: Complete blockage in the conduction between the atria and
the ventricles. Two
separate pacemakers, one depolarizing the atria and the other
depolarizing the
ventricles. Decreased HR leads to decreased CO (loss of atrial kick
due to atrial-
ventricular desynchronization)
Etiology: Acute MI (high mortality with Anterior MI), drug toxicity:
digitalis, procainamide; chronic condition in elderly with calcified
conduction
Treatment: Transcutaneous Pacemaker as bridge to permanent
pacing.
Can try drugs: Atropine, Epinephrine, Dopamine
◉ Bundle Branch Block:.
Answer: Block in conduction through the either right or left bundle
branches resulting in a delay in the depolarization of
the right or left ventricular muscle accordingly.
Rhythm: BBB with underlying rhythm
Rate: depends on underlying rhythm
