Basic Cardiac Rhythms

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Questions and Answers

What heart rhythm is characterized by a regular rhythm and a rate between 60-100 bpm?

  • Sinus Tachycardia
  • Normal Sinus Rhythm (correct)
  • Sinus Bradycardia
  • Atrial Fibrillation

Which heart rhythm is characterized by a slow heart rate of less than 60 bpm?

  • Sinus Bradycardia (correct)
  • Atrial Fibrillation
  • Sinus Tachycardia
  • Normal Sinus Rhythm

Which of the following rhythms presents with irregularly irregular rhythm and no distinct P waves?

  • Sinus Bradycardia
  • Normal Sinus Rhythm
  • Sinus Tachycardia
  • Atrial Fibrillation (correct)

What heart rhythm is often associated with stress, fever, or exertion?

<p>Sinus Tachycardia (C)</p> Signup and view all the answers

Which heart rhythm requires immediate defibrillation?

<p>Ventricular Fibrillation (A)</p> Signup and view all the answers

Which of the following best describes asystole?

<p>No electrical activity or cardiac output (C)</p> Signup and view all the answers

What can sustained ventricular tachycardia (VT) lead to?

<p>Cardiac arrest (D)</p> Signup and view all the answers

What type of waves are characteristic of atrial flutter?

<p>Sawtooth flutter waves (C)</p> Signup and view all the answers

An EEG records brainwave activity, and what other activity?

<p>Single-lead ECG (C)</p> Signup and view all the answers

Why is it important to differentiate between cardiac syncope and epileptic seizures?

<p>To ensure proper diagnosis (C)</p> Signup and view all the answers

Bradycardia or asystole may show what on EEG?

<p>Slowing or flattening of EEG background (B)</p> Signup and view all the answers

In cardiac arrest, what may an EEG become after prolonged hypoxia?

<p>Isoelectric (flat) (A)</p> Signup and view all the answers

Monitoring ECG during EEG is especially important in patients with which condition?

<p>Known heart disease (A)</p> Signup and view all the answers

In convulsive syncope, what may be seen on EEG?

<p>Brief, generalized slowing or myoclonic jerks (C)</p> Signup and view all the answers

Which arrhythmia is often associated with SUDEP (Sudden Unexpected Death in Epilepsy)?

<p>Terminal cardiac arrhythmia (B)</p> Signup and view all the answers

Cardiac rhythms can sometimes mimic what condition on an EEG?

<p>Seizures (B)</p> Signup and view all the answers

What cardiac change is common during seizures?

<p>Tachycardia (D)</p> Signup and view all the answers

What should be checked on the ECG trace, when the EEG shows slowing or flattening?

<p>Cardiac causes (B)</p> Signup and view all the answers

Understanding cardiac rhythms helps in preventing what type of misdiagnosis?

<p>Cardiac syncope vs. epilepsy (D)</p> Signup and view all the answers

What type of care should be provided by collaborating with cardiology?

<p>Holistic care (D)</p> Signup and view all the answers

In a patient experiencing convulsive syncope, what EEG finding would be most indicative of the condition rather than an epileptic seizure?

<p>Brief, generalized slowing or myoclonic jerks. (B)</p> Signup and view all the answers

Why is it critical to monitor ECG during EEG in patients presenting with atypical 'seizure-like' spells?

<p>To differentiate between cardiac arrhythmias mimicking seizures and true epileptic events. (B)</p> Signup and view all the answers

During an EEG recording, if the EEG trace shows diffuse slowing and intermittent flattening, what immediate action should be taken?

<p>Immediately check the ECG trace for cardiac irregularities or changes. (D)</p> Signup and view all the answers

What EEG change might be expected in a patient experiencing bradycardia or asystole?

<p>Slowing or flattening of the EEG background due to hypoperfusion. (A)</p> Signup and view all the answers

In the context of SUDEP, what is the primary significance of cardiac arrhythmias?

<p>They often represent the terminal event following a seizure, contributing to sudden death. (A)</p> Signup and view all the answers

How does sinus tachycardia typically manifest on an EEG, and what condition alters this presentation?

<p>Generally causes no change unless accompanied by seizure activity. (A)</p> Signup and view all the answers

What EEG changes are expected in cases of cardiac arrest, ventricular fibrillation, or asystole?

<p>The EEG may become isoelectric (flat) after prolonged hypoxia. (D)</p> Signup and view all the answers

Considering the potential for misdiagnosis, which condition could cardiac syncope most closely mimic based on EEG findings?

<p>Epilepsy, potentially leading to inappropriate treatment strategies. (B)</p> Signup and view all the answers

In which clinical scenario is cardiac monitoring during EEG most critical, necessitating immediate evaluation and potential intervention?

<p>Suspected ictal asystole or seizure-related arrhythmia. (A)</p> Signup and view all the answers

What specific aspect of EEG interpretation is vital for both EEG technologists and neurologists to prevent misdiagnosis involving cardiac events?

<p>Understanding basic cardiac rhythms and their potential impact on EEG patterns. (B)</p> Signup and view all the answers

What underlying physiological principle directly links cardiac function to EEG patterns, especially in conditions like bradycardia or asystole?

<p>Cerebral hypoperfusion resulting from compromised cardiac output. (B)</p> Signup and view all the answers

In cases of suspected ictal bradycardia/asystole, prompt detection is crucial to prevent which potential outcome?

<p>Permanent neurological damage due to delayed intervention. (C)</p> Signup and view all the answers

What type of collaborative approach is most beneficial in providing comprehensive patient care when cardiac and neurological symptoms overlap?

<p>Regular case conferences between neurology and cardiology. (D)</p> Signup and view all the answers

What is the MOST likely cause of a flatline EEG in the setting of Cardiac Arrest/VF/Asystole?

<p>Lack of oxygen to the brain. (D)</p> Signup and view all the answers

Why are modern EEG systems equipped with simultaneous single-lead ECG recording?

<p>To differentiate cardiac-related artifacts from true cerebral activity. (A)</p> Signup and view all the answers

Which of the following is a characteristic feature of Atrial Flutter on ECG that distinguishes it from Atrial Fibrillation?

<p>Sawtooth flutter waves (C)</p> Signup and view all the answers

Which cardiac rhythm is most likely to lead to cardiac arrest if sustained, according to provided information?

<p>Ventricular Tachycardia (VT) (B)</p> Signup and view all the answers

A patient's ECG shows a chaotic rhythm with no pulse. What immediate intervention is required?

<p>Initiating immediate defibrillation (A)</p> Signup and view all the answers

What is the key distinguishing feature observed on an ECG for Normal Sinus Rhythm?

<p>P waves present before each QRS complex (B)</p> Signup and view all the answers

Which patient demographic is most likely to exhibit Sinus Bradycardia?

<p>Trained athletes during sleep (A)</p> Signup and view all the answers

Flashcards

Normal Sinus Rhythm

Regular rhythm, rate 60-100 bpm, P waves present before each QRS complex.

Sinus Bradycardia

Slow heart rate (<60 bpm), regular rhythm; often seen in athletes or during sleep.

Sinus Tachycardia

Fast heart rate (>100 bpm), regular rhythm; often due to stress, fever, or exertion.

Atrial Fibrillation

Irregularly irregular rhythm; no distinct P waves; risk of stroke.

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Atrial Flutter

Sawtooth flutter waves; regular or irregular; can reduce cardiac output.

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Ventricular Tachycardia (VT)

Fast, wide QRS complexes; may lead to cardiac arrest if sustained.

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Ventricular Fibrillation (VF)

Chaotic rhythm; no pulse; requires immediate defibrillation.

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Asystole

Flatline; no electrical activity or cardiac output.

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Heart Blocks

Delays or complete block in AV conduction.

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Bradycardia/Asystole EEG Effects

May show slowing or flattening of EEG background due to hypoperfusion.

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Cardiac Arrest/VF/Asystole EEG Effects

EEG may become isoelectric (flat) after prolonged hypoxia.

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Convulsive Syncope EEG

Brief, generalized slowing or myoclonic jerks on EEG, but not epileptic spikes.

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SUDEP

Involves terminal cardiac arrhythmia following a seizure.

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Differentiating Syncope and Seizures

Essential to distinguish between these for proper diagnosis and treatment.

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EEG Slowing: Check ECG

Check the ECG trace for cardiac causes of brain slowing

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Sinus Tachycardia EEG

Often no EEG change unless seizure activity is present.

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Study Notes

Basic Cardiac Rhythms

  • Normal Sinus Rhythm has a regular rhythm, a rate of 60-100 bpm, and P waves present before each QRS complex
  • Sinus Bradycardia is a slow heart rate of less than 60 bpm with a regular rhythm, often seen in athletes or during sleep
  • Sinus Tachycardia is a fast heart rate of more than 100 bpm with a regular rhythm, often due to stress, fever, or exertion
  • Atrial Fibrillation presents as an irregularly irregular rhythm with no distinct P waves and carries a risk of stroke
  • Atrial Flutter is characterized by sawtooth flutter waves that can be regular or irregular and can reduce cardiac output
  • Ventricular Tachycardia (VT) involves fast, wide QRS complexes that may lead to cardiac arrest if sustained
  • Ventricular Fibrillation (VF) is a chaotic rhythm with no pulse, requiring immediate defibrillation
  • Asystole is a flatline with no electrical activity or cardiac output
  • Heart Blocks, including 1st, 2nd, and 3rd degree, involve delays or complete block in AV conduction

EEG and Cardiac Rhythms

  • Modern EEG systems record a single-lead ECG simultaneously with brainwave activity
  • Cardiac rhythms can mimic seizures on EEG, such as syncope from arrhythmias
  • Epileptic seizures can cause cardiac changes like tachycardia or, rarely, life-threatening bradycardia or asystole
  • Differentiation between cardiac syncope and epileptic seizures is essential for proper diagnosis

EEG Patterns and Cardiac Rhythms

  • Sinus Tachycardia often shows no change in EEG unless seizure activity is present
  • Bradycardia/Asystole may show slowing or flattening of the EEG background due to hypoperfusion
  • Cardiac Arrest/VF/Asystole can cause the EEG to become isoelectric (flat) after prolonged hypoxia
  • Convulsive Syncope presents with brief, generalized slowing or myoclonic jerks on EEG, but not epileptic spikes
  • SUDEP often involves terminal cardiac arrhythmia following a seizure

Clinical Relevance

  • Always monitor ECG during EEG, especially in patients with known heart disease, atypical "seizure-like" spells, or suspected ictal asystole or seizure-related arrhythmia
  • Identifying artifacts versus real changes is important
  • When EEG shows slowing or flattening, check the ECG trace for cardiac causes

Summary

  • Understanding basic cardiac rhythms aids in avoiding misdiagnosis, such as mistaking cardiac syncope for epilepsy
  • Detecting dangerous conditions like ictal bradycardia/asystole is crucial
  • Collaborate with cardiology for holistic patient care

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