Atrial Rhythms Flashcards Preview

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Flashcards in Atrial Rhythms Deck (32):
1

DiGoxin

Decreases intrinsic firing in the SA node.
Decreases conduction in the AV node.
Increases automaticity, decreases refractory period in ventricles and His/perkinje

2

Atrial Tach

common in peds

3

PAC Etiology

1. Hypoxemia - early sign
2. Fatigue
3. Damaged atria
4. Frequent PAC - early CHF
5. CAD
6. Digoxin toxicity
7. Hypokalemia, hypomagnesemia
8. Stimulant abuse (Meth)

4

20cc's per KG

fluid bolus for peds

5

Paroxysmal Atrial Tachycardia (PAT)

Starts and stops abruptly

6

Atrial Tachycardia

1. Increased Sympathetic tone
2. Hypoxemia
3. Digitalis toxicity
4. Damaged Atria
5. CHF

7

PAT Etiology

1. Common in young women
2. Sudden onset
3. Sudden termination
4. Mitral Valve Prolapse
5. Digitalis toxicity
6. Hypoxemia
7. Damaged Atrium
8. Caffeine/nicotine
9. Stimulant abuse

8

Narrow regular QRS
SVT, ATAK

50, 75, 100, 200

9

Narrow irregular
Afib, Aflutter

120-(150, 175)200

10

Wide regular
VTAK

100, 150, 175, 200

11

Wide and irregular
Vfib, torsades

200 biphasic
360 monophasic

12

Adenosine additional action

Acts on sinus pacer cells and vagus nerve terminals

13

WPW

Wolff Parkinson White (bundle of kent)

14

Bundle of Kent (oral boards)

additional pathway (produces delta wave between pr)

15

sick sinus syndrome

Sinus pause, sinus block

16

A flutter

Saw tooth pattern and F wave

17

Uncontrolled A-fib

>100

18

Controlled A-fib

<100

19

Atrial flutter with 3:1 conduction

3 saw teeth with 1 qrs

20

Atrial fib characteristics

no discernable P waves
grossly irregular

21

Atrial fib rx

not treated unless above 180

22

Holiday heart syndrome

tied to alcohol and stress

23

Wandering atrial pace maker

WAP

24

WAP

P wave may be: 3 different
i. Upright
ii. Diphasic
iii. Inverted
iv. Behind QRS
v. Lost

25

3 rhythms classified as SVT

Afib Aflutter Sinus tach Atak

26

Increase in automaticity

Causes increase in ventricular rate

27

Paroxysmal SVT

?

28

Lown-Ganang-Levine

"James" fibers that bypass the AV node and shorten the PRinterval

29

Variable conduction

Irregular A flutter

30

Types of PAC's

*Blocked (P wave in T wave, no time for ventricular response)
*Paired (two complete complexes – early)
*Isolated (one)
*Runs (3 or more)
*Bigeminal (Every other)
*Trigeminal (Every third): normal, normal, early

31

P wave of early beat differs from the sinus beat, it may be:

a. Notched
b. Peaked
c. Diphasic (+ & -)
Lost in preceding T wave (you won’t know because it
gets lost)

32

Atrial Tachycardia

Rate is 150-250 beats per minute
Rhythm is regular
P-waves all alike (same as PAC). Usually different than “normal” p wave
Usually triggered by a PAC, rest of P waves will now look like the trigger P wave