Basic Dysrhythmia-Relias

normal sinus rhythm - heart rhythm originating in the sinoatrial node with a rate in patients at rest of 60 to 100 beats per minute Sinus Arrhythmia - Appearance is ALMOST NORMAL: Respiratory - Circulatory interaction Rate INCREASES with INSPIRATION (IN=IN) Sinus Bradycardia - 60 normal sinus rhythm Sinus Tachycardia - 100 (100-150) normal sinus rhythm Premature Atrial Contraction (PAC) - 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 - - 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) - an irregular and often very fast heart rate originating from abnormal conduction in the atria Atrial Flutter - irregular beating of the atria; often described as "a-flutter with 2 to 1 block or 3 to 1 block" Junctional Rhythm - 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 - 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 - Inverted p wave or hidden p wave PRI0.12 or none Normal QRS Supraventricular Tachycardia (SVT) - an abnormal heart rhythm arising from aberrant electrical activity in the heart; originates at or above the AV node First degree heart block - 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 (Wenkebach) - Progressively longer PR interval until the P wave is not followed by a QPR 2nd Degree Heart Block (Mobitz II) - Rare, but more serious Sudden appearance of a nonconducted P-wave P-waves are nl, but some aren't followed by a QRS complex PR & RR intervals are constant 3rd degree heart block - no obvious correlation between p and qrs, need pace maker premature ventricular contraction (PVC) - a ventricular contraction preceding the normal impulse initiated by the SA node (pacemaker) Bigeminy PVC - every other beat is a PVC PVC couplets - PVC occurring in pairs, no adequate C.O. when this occurs monomorphic ventricular tachycardia - presents with wide QRS complexes of a common shape. Torsades de pointes - 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) - abnormal heart rhythm which results in quivering of ventricles Idioventricular Rhythm - 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 - 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