Questions and Answers
What is sinus rhythm characterized by?
What is the heart rate in sinus bradycardia?
Heart rate < 60 bpm
What distinguishes sinus arrhythmia from normal sinus rhythm?
In sinus arrest, the R to R intervals will vary.
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What is a characteristic of premature atrial complexes?
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Wandering atrial pacemaker is defined by:
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In multifocal atrial tachycardia, at least how many different shaped P waves are observed?
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Atrial flutter has no ______ waves; they become F waves.
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What does chaotic electrical activity cause in atrial fibrillation?
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In premature ventricular complexes, P waves are always present.
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What is a characteristic feature of agonal rhythm?
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What defines ventricular fibrillation?
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What does first degree heart block look like?
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In second degree heart block type I, the PR interval is ______ and there is a QRS drop.
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What occurs in third degree heart block?
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Study Notes
Sinus Rhythms
- Sinus Rhythm: Normal rhythm with a heart rate (HR) of 60-100 bpm; characterized by regularity.
- Sinus Bradycardia: HR < 60 bpm; complexes become closer together, potentially burying the P wave within the T wave.
- Sinus Arrhythmia: Normal rhythm with minimal HR variations; resembles sinus rhythm with distinct intervals between cardiac complexes.
Sinus Conduction Issues
- Sinus Arrest: Sudden electrical inactivity leading to a pause, with consistent R to R intervals before and after the pause.
- Premature Atrial Complex: Occurs when an impulse arises from the atria other than the SA node; P wave alterations appear biphasic or irregular.
- Wandering Atrial Pacemaker: Minimum of three different shaped P waves; rhythm may vary in regularity, potentially affecting the PR interval.
Atrial Dysrhythmias
- Multifocal Atrial Tachycardia: Faster variant of wandering atrial pacemaker with at least three different P wave shapes, commonly seen in COPD patients.
- Atrial Flutter: Rapid depolarizations within the atria; absence of P waves replaced by F waves, displays a “saw tooth” pattern.
- Atrial Fibrillation: Chaotic electrical activity leads to absent P waves and a chaotic waveform between QRS complexes.
Ventricular Dysrhythmias
- Premature Ventricular Complexes: Occur from early impulses in ventricles; characterized by absent P waves and bizarre QRS complexes.
- Agonal Rhythm: HR < 60 bpm with absent P waves and wide, bizarre QRS complexes; many patients may be unconscious and may require defibrillation.
- Ventricular Fibrillation: Absence of P waves and QRS complexes; presents as a chaotic waveform with no measurable rate or effective heart function.
Asystole and Blocks
- Asystole: Total electrical activity absence in the heart; clinical death signified by absent P waves and QRS complexes.
- Ventricular Asystole: Similar to asystole but may have P waves; patient is clinically dead.
- First Degree Heart Block: Normal sinus appearance but with a prolonged PR interval (>0.2s); no QRS drop occurs.
- Second Degree Heart Block Type I (Wenckebach): Characterized by progressively prolonged PR intervals followed by QRS drop; regular P-P intervals, irregular R-R intervals.
Advanced Heart Block
- Second Degree Heart Block Type II: QRS complexes appear in a stable pattern correlated with P waves (e.g., 2:1 or 3:1).
- Third Degree Heart Block: Complete blockage leading to independent functioning pacemakers in the atria and ventricles; results in dissociation of P waves and QRS complexes.
Other Conditions
- Supraventricular Tachycardia: Regular rhythm with HR > 140 bpm; presents narrow QRS, ambiguous P wave identification.
- Lown-Ganong Levine Syndrome and Wolf-Parkinson-White Syndrome: Pre-excitation syndrome where conduction bypasses normal AV pathways; characterized by an early R wave upstroke before the QRS and slurred QRS appearance.
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Test your knowledge of EKG rhythm strips with this set of flashcards. Each card presents a term related to heart rhythms and its definition, helping you understand essential concepts in cardiology. Perfect for students and professionals alike.