Electrophysiology Flashcards

Question

follow a system when reading an ECG

Answer 1

1. check patient details e.g., on the right patient 2. rate 3. rhythm 4. axis 5. the alphabet ( P waves, PR interval, QRS complexes ,ST segment, T waves, QT interval)

Answer 2

normal= 60-100 tachycardia\> 100 bpm bradycardia \< 60 bpm

Answer 3

10 seconds Rate= total number of R waves x 6

Answer 4

1 sec = 25 mm = 5 large squares 1minute= 60 x 5 = 300 large squares rate = 300 / number of large squares between R waves

Answer 5

Normal looking P wave (indicates SAN) P wave always followed by QRS complex In a regular fashion anything not meeting that criteria is not considered normal

Answer 6

look at the R-R distances are they regular? regularly irregular? Irregularly irregular?

Answer 7

regular rhythm approx 75 bpm P waves present 1 P wave per QRS complex Normal PR interval Normal sinus rhtyhm

Answer 8

1. atrial fibrillation 2. atrial flutter 3. heart block (complete, atrioventricular, first degree, second degree, third) 4. broad complex tachycardia

Answer 9

Very common arrhythmia, risk increasing with age multiple wave fronts across the atria cause a sporadic wave form manifests as an **irregular baseline** with **no clear P waves** because these wave fronts hit the AVN in an irregular fashion, there is irregular electrical action in the ventricles, causing an irregular heartbeat----- **irregulalry irregular QRS complex**

Answer 10

Affects atria. Generally, affects 1 macro circuit (one repeating electrical circuit going through the atria). Presents as a **sawtooth baseline** on the ECG. Can be **regularly irregular** or **irregularly irregular** depending on how long it takes for a wave front to complete a circuit. Tends to go round the atria at 300bpm, AVN can’t conduct at this pace so 1:1 hardly ever seen. **2:1** block means that every other flutter is acted on therefore **150 bpm**. 3:1 block = 100 bpm

Answer 11

Where there is absolute failure of the AVN, SAN still operational Backup, intrinsic pacemaker function of his/ purkinje fibres takes over **30 -40 bpm** **Slower and broader PQRS complex** **P waves** will still be happening at their **original rhythm** but will now be **unrelated to the QRS**, P and QRS out of rhythm together.

Answer 12

when conduction between the atria and ventricles of the heart is impaired

Answer 13

less than 0.2 seconds (5 small squares)

Answer 14

The wife (P wave) is waiting at home. The husband (QRS) comes home late every night, but he always comes home, and it is the same time every night. **(impluse is delayed at AVN**, and **PR interval is greater than 0.2 secs \> 5 small squares**)

Answer 15

2 Mobitz1 (wenkebach) and Mobitz 2

Answer 16

The wife is waiting at home. The husband comes home later and later every night until one night he doesn’t come home at all? (what a wenker!) Note: the husband must come home at least 2 nights in a row first to see this pattern **(PR interval will become greater and greater** until there will be a **dropped QRS complex** and there are **two consecutive P waves**, after which the pattern will restart) can be common in healthy people, like athletes. Just the AVN being under lots of vagal tone

Answer 17

The wife is waiting at home. Sometimes the husband comes home and sometimes he doesn’t. When he does come home, it’s always on time. Note: this unpredictable behaviour is more serious than type 1 second degree heart block and usually requires counselling (pacing). (P to R and R to R intervals will remain consistent, but there will be “missing” QRS complexes.

Answer 18

Wife (P wave) is no longer waiting at home. She and her husband (QRS) are on separate schedules and are no longer talking. Each spouse has a regular, individual schedule. Note: This **requires emergency counselling** (pacing) Atrial activity will continue with **p waves at one rate**. The ventricles (QRS) are depolarising in a slower escape rhythm- both will be **regular, but will be uncoordinated**)

Answer 19

Due to a little bit of scar tissue in the myocardium that causes a mini circuit (**usually greater than 180 bpm**) in the **ventricle**. Because this rate is greater than the SAN, **this becomes the dominant pace**. Regular tachycardia, rate ~150 bpm **Broad QRS complexes** No obvious preceding atrial activity Aka **Ventricular tachycardia**

Answer 20

Axis refers to the overall electrical direction within the heart. Electricity moving towards and electrode is POSITIVE Electricity moving away from an electrode is NEGATIVE If there is a change in the overall direction of the energy, the axis will be described as deviated- left, or right Look at leads I and II If both are positive, the axis is normal ECG: left axis Look at leads I, II and III If lead 1 is positive, II is midlining/ negative, there is left axis deviation The deflection are Leaving each other in the Left axis deviation Right axis: Look at leads I, II and III Lead I is more negative, and III is positive, it is right axis deviation Lead I and lead III are Reaching toward each other in Right axis

Answer 21

infarction pericarditis

Answer 22

flat anmd prolonged

Answer 23

complete third degree heart block

Answer 24

Complete heart block

Answer 25

broad complex tachycardia

Answer 26

atrial flutter

Electrophysiology Flashcards

(52 cards)