Cardiac Dysrhythmias and ECG Interpretation

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Questions and Answers

In a sinus dysrhythmia, where does the impulse originate?

  • Ventricles
  • AV node/junction
  • Atria
  • SA node (correct)

An underlying rhythm of AV blocks is always what?

  • Ventricular
  • Atrial fibrillation
  • Sinus (correct)
  • Junctional

In rhythms originating in the AV junction, impulses originate where?

  • Atria
  • Close to the AV node (correct)
  • Ventricles
  • SA node

For a first-degree AV block, what is the status of the QRS?

<p>No dropped QRS (C)</p> Signup and view all the answers

What happens to the PR interval in Wenckebach (Type I second-degree AV block)?

<p>PR interval gradually prolongs (D)</p> Signup and view all the answers

What is a key characteristic of the PR interval in Type II second-degree AV block?

<p>PR interval is constant (B)</p> Signup and view all the answers

In third-degree AV block, what is the relationship between the R-R intervals?

<p>R-R intervals are constant (B)</p> Signup and view all the answers

What is a common cause of junctional rhythms?

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

What is the typical rate for junctional rhythm?

<p>40-60 bpm (D)</p> Signup and view all the answers

In junctional bradycardia, what is the heart rate?

<p>Less than 40 bpm (B)</p> Signup and view all the answers

If a P wave precedes the QRS complex in Junctional Rhythms, what is the PR interval?

<p>&lt;0.12 secs (D)</p> Signup and view all the answers

In accelerated junctional rhythm, what is the rate?

<p>60-100 bpm (A)</p> Signup and view all the answers

In junctional tachycardia, what is the rate?

<blockquote> <p>100 bpm (C)</p> </blockquote> Signup and view all the answers

What is a potential cause of junctional tachycardia?

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

What best describes P waves in Junctional rhythms?

<p>Inverted or absent (B)</p> Signup and view all the answers

What is a rate for Junctional Bradycardia?

<p>&lt;40 bpm (B)</p> Signup and view all the answers

What can cause junctional bradycardia?

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

A PJC is also know as what?

<p>Premature Junctional Contraction (C)</p> Signup and view all the answers

If a P wave precedes a QRS complex in a PJC, what will the PR be?

<p>&lt;0.12 secs (C)</p> Signup and view all the answers

Underlying rhythms of AV blocks are always ___?

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

Typical causes of First Degree AV block is ____?

<p>AV node ischemia (A)</p> Signup and view all the answers

What describes the adverse effects of First Degree AV block?

<p>None (C)</p> Signup and view all the answers

What type of AV block has groups of beats and pauses?

<p>Type I Second Degree AV Block (Wenckebach) (D)</p> Signup and view all the answers

What causes Type I Second Degree AV Block (Wenckebach)?

<p>MI or Digitalis Toxicity (D)</p> Signup and view all the answers

In Third Degree AV Block, which of these is the rate for the atria?

<p>60-100 BPM (A)</p> Signup and view all the answers

Flashcards

The Word on AV Blocks

In AV blocks, the underlying rhythm is always sinus, meaning P waves are sinus P waves.

Problem in AV Blocks

Complete or partial interruption in impulse transmission to the ventricles, occurring at the AV node or bundle branches.

1st Degree AVB

Differentiation of AV Blocks: 1st degree AVB has no dropped QRS and a PR >0.20 secs.

Wenckebach

Differentiation of AV Blocks: Wenckebach has gradually prolonging PR until a QRS is dropped.

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Type II AVB

Differentiation of AV Blocks: Type II has constant PR interval, some QRS dropped.

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Rhythms Originating in AV Junction

Impulses originate close to the AV node, not in the AV node itself. Heart rates vary from slow to fast.

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Impulse Origin Areas

Areas of impulse origin in AV junction: high, low, and mid in the AV junction.

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Junctional Rhythm

A heart rhythm with a rate of 40-60 bpm, regular regularity, inverted or absent P waves, PR <0.12 secs if P wave precedes QRS, and QRS <0.12 secs.

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Junctional Rhythm Causes

Conditions may include vagal stimulation, hypoxia, sinus node ischemia, or heart disease.

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Adverse Effects of Junctional Rhythm

Potential for decreased cardiac output.

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Treatment for Junctional Rhythm

Atropine, consider oxygen, and holding bradycardia-inducing medications.

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Premature Junctional Complex (PJC)

Regular but interrupted by premature beat, P waves inverted or absent.

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Causes of a PJC

Stimulants, hypoxia, heart disease, nicotine.

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Treatment for PJC

Treat the underlying cause.

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Junctional Tachycardia

A heart rhythm with rate >100, regularity is regular, P waves inverted or absent, PR <0.12 secs if P wave precedes QRS, and QRS <0.12 secs.

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Causes of Type I Second Degree AV Block

MI, digitalis toxicity, medications.

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Study Notes

  • The test covers all types of dysrhythmias from sinus through ventricular dysrhythmias.
  • Questions may be multiple choice about the characteristics of a dysrhythmia.

Example Question

  • In a sinus dysrhythmia, the impulse originates in the SA node

Strip interpretation format

  • The format is the same as ECG Exam 1
  • Differentials include BBB, vs ventricular vs pacemaker rhythm
  • It is important to identify the spike and chamber pacing

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