Supraventricular Rhythms

Question 1

What is the origin of Sinus Tachycardia?

Answer 1

Sinoatrial (SA) node

Question 2

What is the heart rate associated with Sinus Tachycardia?

Answer 2

> 100 bpm

Question 3

Describe the rhythm of Atrial Fibrillation (AF).

Answer 3

Irregularly irregular

Question 4

What are the features of Atrial Fibrillation?

Answer 4

• Absent P waves
• Presence of fibrillatory waves

Question 5

What is the typical rate of Atrial Flutter?

Answer 5

Typically 250-350 bpm

Question 6

Describe the rhythm of Atrial Flutter.

Answer 6

Regular

Question 7

What are the features of Atrial Flutter?

Answer 7

Sawtooth flutter waves

Question 8

What is the origin of Atrial Tachycardia?

Answer 8

Ectopic atrial focus

Question 9

What is the rhythm of Atrial Tachycardia?

Answer 9

Regular

Question 10

What is the typical heart rate range for Atrial Tachycardia?

Answer 10

Often between 150-250 bpm

Question 11

Describe the rhythm of Multifocal Atrial Tachycardia (MAT).

Answer 11

Irregular

Question 12

What are the features of Multifocal Atrial Tachycardia (MAT)?

Answer 12

At least three different P wave morphologies

Question 13

What is the rhythm of AV Nodal Re-entrant Tachycardia (AVNRT)?

Answer 13

Regular narrow-complex tachycardia

Question 14

What is the cause of AV Nodal Re-entrant Tachycardia (AVNRT)?

Answer 14

Re-entry within the AV node

Question 15

What is the rhythm of AV Re-entrant Tachycardia (AVRT)?

Answer 15

Regular

Question 16

What is involved in AV Re-entrant Tachycardia (AVRT)?

Answer 16

Accessory pathway (e.g., Wolff-Parkinson-White syndrome)

Question 17

Describe the rhythm of Junctional Tachycardia.

Answer 17

Regular

Question 18

What are the features of Junctional Tachycardia?

Answer 18

Often with absent or retrograde P waves

Question 19

What are Premature Atrial Contractions (PACs)?

Answer 19

Early atrial beats with abnormal P wave morphology

Question 20

What are Atrial Escape Beats?

Answer 20

Occur after a long sinus pause, from an ectopic atrial focus

Question 21

What characterizes an Accelerated Atrial Rhythm?

Answer 21

Faster than normal sinus rate but below tachycardia threshold

Question 22

What are the features of a Wandering Atrial Pacemaker?

Answer 22

Multiple atrial foci with different P wave morphologies

Question 23

What characterizes Non-paroxysmal Junctional Tachycardia?

Answer 23

Gradual onset, often seen in digitalis toxicity

Question 24

What is the mechanism of re-entry?

Answer 24

An electrical impulse continuously circulates through a circuit, causing sustained tachycardia

Question 25

What are the mechanisms involved in AVNRT?

Answer 25

* Involves dual AV nodal pathways (slow and fast) * A premature atrial beat triggers re-entry

Question 26

What is the mechanism involved in AVRT?

Answer 26

* Involves an accessory pathway (e.g., WPW syndrome) * Impulse travels down AV node and retrogradely up accessory pathway

Question 27

What characterizes the circuit of Atrial Flutter?

Answer 27

Macro-re-entrant within the atria, typically around the tricuspid valve

Question 28

What is a possible cause of a wide QRS presentation?

Answer 28

* Bundle Branch Block (BBB) * Rate-Related Aberrancy * Accessory Pathway Conduction * Hyperkalemia or Drug Effects

Question 29

What causes Bundle Branch Block (BBB)?

Answer 29

Pre-existing conduction delay in ventricles

Question 30

What causes Rate-Related Aberrancy?

Answer 30

Abnormal ventricular conduction at high heart rates

Question 31

What happens during Accessory Pathway Conduction in AVRT?

Answer 31

Impulses may travel through an accessory pathway, bypassing the AV node

Question 32

What can cause wide QRS due to Hyperkalemia or Drug Effects?

Answer 32

Electrolyte imbalances or medications (e.g., sodium channel blockers) can slow ventricular conduction