Arrhythmias Overview
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Questions and Answers

What is the name of the heart's main pacemaker?

SA node

What is the normal heart rate range in beats per minute (bpm)?

60-100 bpm

What are the important components of electrolyte balance that influence mechanical and electrical heart functions?

  • Sodium, Calcium, Potassium, and Magnesium (correct)
  • Chloride, Phosphate, Sodium, and Potassium
  • Iron, Zinc, Potassium, and Magnesium
  • Calcium, Phosphorus, Magnesium, and Sodium
  • What are the possible causes of sinus tachycardia?

    <p>Exercise, anxiety, fever, drugs, anemia, heart failure, hypovolemia, shock</p> Signup and view all the answers

    Sinus tachycardia is always accompanied by symptoms.

    <p>False</p> Signup and view all the answers

    What does the acronym 'SVT' stand for?

    <p>Supraventricular Tachycardia</p> Signup and view all the answers

    Supraventricular tachycardia is always caused by underlying heart disease.

    <p>False</p> Signup and view all the answers

    What are the possible symptoms that some patients with SVT may experience?

    <p>Angina, hypotension, light-headedness, palpitations, intense anxiety</p> Signup and view all the answers

    What is the purpose of vagal maneuvers?

    <p>To slow down the heart's electrical impulses</p> Signup and view all the answers

    Which of the following is a common vagal maneuver used to potentially slow down a fast heart rate?

    <p>Valsalva maneuver</p> Signup and view all the answers

    Cardioversion is a procedure that involves delivering a controlled electrical shock to the heart to reset the rhythm.

    <p>True</p> Signup and view all the answers

    What is the purpose of catheter ablation?

    <p>To destroy abnormal heart tissue causing arrhythmias</p> Signup and view all the answers

    What are the three types of AV blocks?

    <p>First-degree, second-degree, third-degree</p> Signup and view all the answers

    What is the main characteristic of first-degree heart block?

    <p>Prolonged PR interval</p> Signup and view all the answers

    What are the possible causes of first-degree heart block?

    <p>MI, ischemia, hyperkalemia, hypokalemia, digoxin toxicity, calcium channel blockers, amiodarone, antidysrhythmic medications</p> Signup and view all the answers

    What is the main characteristic of second-degree AV block Mobitz I (Wenckebach)?

    <p>Progressive lengthening of PR intervals until a QRS complex is dropped</p> Signup and view all the answers

    What are some possible causes of second-degree AV block Mobitz I (Wenckebach)?

    <p>MI, digoxin toxicity, calcium channel blockers, beta blockers, increased vagal tone</p> Signup and view all the answers

    What is the main characteristic of second-degree AV block Mobitz II?

    <p>Constant PR interval with sudden drop of QRS complexes.</p> Signup and view all the answers

    Second-degree AV block Mobitz II is typically less serious than second-degree AV block Mobitz I.

    <p>False</p> Signup and view all the answers

    What are some possible causes of second-degree AV block Mobitz II?

    <p>Advanced ACS (Acute Coronary Syndrome), damage to the conduction system, medications that slow AV conduction such as digoxin, calcium channel blockers, and beta blockers</p> Signup and view all the answers

    What is the main characteristic of third-degree heart block (complete heart block)?

    <p>Complete absence of conduction between the atria and ventricles</p> Signup and view all the answers

    What are some possible causes of third-degree heart block (complete heart block)?

    <p>Congenital heart defects, heart diseases, MI, digoxin toxicity, valve problems, structural damage</p> Signup and view all the answers

    Ventricular fibrillation (V-fib) is a life-threatening condition where the ventricles quiver instead of pumping blood effectively.

    <p>True</p> Signup and view all the answers

    What are some possible causes of ventricular fibrillation (V-fib)?

    <p>Heart diseases, low or high potassium levels, hypoxia, drug overdose</p> Signup and view all the answers

    Immediate CPR and defibrillation are crucial for survival in cases of ventricular fibrillation.

    <p>True</p> Signup and view all the answers

    What is cardiac ablation?

    <p>A procedure using heat or cold energy to destroy abnormal heart tissue causing irregular heartbeats</p> Signup and view all the answers

    Study Notes

    Arrhythmias

    • Arrhythmia is an irregular heartbeat
    • Prepared by Dr. Rebar Y. Abdullah, Assistant Professor, University of Duhok- College of Nursing, PhD Family and Community Health
    • The SA node is the heart's primary pacemaker, generating impulses at 60-100 bpm.
    • The AV node acts as a backup pacemaker, firing at 40-60 bpm if the SA node fails.
    • Bundle branches divide into right and left, activating at 30-40 bpm.
    • Purkinje fibers activate at 30-40 bpm.
    • The electrical functions of the heart are influenced by sodium, calcium, potassium, and magnesium.
    • Sinus tachycardia is a faster-than-normal heartbeat (>100 bpm) originating from the SA node.
    • Causes of sinus tachycardia include exercise, anxiety, fever, hypoxemia, hypovolemia, or cardiac failure.
    • Sinus bradycardia is slower than normal (<60 bpm) originating from the SA node.
    • Causes of sinus bradycardia can include drugs, vagal stimulation, hypoendocrine states, hypothermia, or sinus node involvement in MI.
    • Atrial fibrillation (A-Fib) is uncontrolled electrical activity in the atria, causing a rapid and irregular heartbeat.
    • Atrial fibrillation often has a rate greater than 100 bpm, with an irregular rhythm
    • Symptoms of atrial fibrillation often include fatigue, dizziness, or syncope
    • Types of causes include after heart surgery, heart problems, COPD, or sleep apnea
    • Treatment for atrial fibrillation depends on the patient's stability and symptoms.
    • In stable patients, monitoring heart rate less than 100 bpm is important
    • Unstable patients who have dropped blood pressure, reduced cardiac output, and an uncontrolled heart rate (over 100 bpm) require synchronized cardioversion.

    Supraventricular Tachycardia (SVT)

    • An arrhythmia with a rapid rate, making P waves hard to see.
    • Rate is 150-250 bpm; rhythm regular; P waves usually buried in preceding T waves and hard to see; PR interval is usually not measurable; QRS is normal (0.06-0.10 sec) but may be wide if conducted abnormally.
    • Causes include caffeine, nicotine, stress, or anxiety for healthy adults.
    • Some patients may experience angina, hypotension, lightheadedness, palpitations, or intense anxiety.
    • Management involves vagal maneuvers, intravenous beta-blockers, diltiazem, verapamil (class II), or synchronized cardioversion.

    Vagal Maneuvers

    • Physical actions to slow heart rate.
    • Actions include coughing, bearing down, and raising one's legs to 45 degrees.
    • Avoid in patients with low blood pressure, chest pain, shortness of breath, or oxygen shortages.

    Cardioversion

    • A procedure to reset the heart rhythm using electrical energy.

    Catheter Ablation

    • A procedure to destroy abnormal heart tissue causing arrhythmias.
    • Uses thin, flexible tubes (catheters) inserted through a blood vessel

    Atrioventricular (AV) Blocks

    • Conduction defects within the AV junction, impairing AV node function.
    • First-degree AV block: Slowing of electrical signal through the AV node; prolonged PR interval (usually >0.20 seconds); rate typically <60 bpm; QRS complex and rhythm is normal.
    • Second-degree AV block Mobitz Type I (Wenckebach): Gradual lengthening of PR intervals until an atrial impulse is not conducted; rate is usually <60 bpm; pattern is regular until dropped QRS complexes; ventricular rhythm is irregular.
    • Second-degree AV block Mobitz Type II: Constant PR interval, with occasional dropped QRS complexes; rate varies; ventricular rhythm is irregular.
    • Third-degree/complete AV block: Electrical signal from atria doesn't reach ventricles; P waves and QRS complexes are independent; ventricular rate is often <40 bpm and irregular.

    Ventricular Fibrillation (V-Fib)

    • Rapid, chaotic ventricular rhythm, with no cardiac output or pulse.
    • No P waves, QRS complexes, T waves, or PR intervals can be seen.
    • Causes often include heart disease, low/high potassium levels, hypoxia, and drug overdose.
    • Treatment is emergency CPR, oxygen, defibrillation, epinephrine, and antiarrhythmic medications.

    Pacemakers

    • Single chamber pacemakers stimulate only the lower right ventricle.
    • Dual chamber pacemakers stimulate both the upper and lower right ventricles.
    • Biventricular pacemakers (cardiac resynchronization therapy) stimulate both ventricles to help with heart failure.

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    Description

    This quiz provides an overview of arrhythmias, focusing on the electrical functions of the heart and various types of irregular heartbeats. It covers topics such as the role of the SA node, AV node, and other pacemakers, as well as conditions like sinus tachycardia and bradycardia. Test your knowledge on the causes and mechanisms behind these cardiac events.

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