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EKG Exam 3

by: Jessica Cox

EKG Exam 3 EP 3613

Jessica Cox

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Dysrhythmias and Risk Stratifications
Exercise Electrocardiograph
Ben Abadie
Study Guide
50 ?




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This 4 page Study Guide was uploaded by Jessica Cox on Sunday April 24, 2016. The Study Guide belongs to EP 3613 at Mississippi State University taught by Ben Abadie in Spring 2016. Since its upload, it has received 15 views. For similar materials see Exercise Electrocardiograph in Kinesiology at Mississippi State University.

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Date Created: 04/24/16
EKG T est 3 04/24/2016 ▯ Normal Rhythm ▯ Premature Beats  An irritable focus spontaneously fires a single stimulus o Premature Atrial Beat o Premature Junctional Beat o Premature Ventricular Beat  Premature Atrial Beat (PAB) o Originates suddenly in an irritable atrial automaticity focus produces a too early depolarization of the atria that depolarizes the SA Node.  Premature Atrial Beat with aberrant ventricular conduction  Non conducted Premature Artial Beat o The AV Node is completely unreceptive to a premature atrial depolarization stimulus b/c it reaches the AV Node prematurely. The AV Node is still in refractory period of its repolarization  Sinus Node pacing interrupted by Sinus Arrest o Sinus Arrest occurs when a very sick SA Node ceases pacemaking completely.  Atrial Escape Beat o Transient Sinus Block of one pacemaking stimulus (SA Node misses one cycle) is a sufficient pause for an atrial automaticity focus to escape overdrive suppression and have a Atrial Escape Beat. Notice that the P wave differs from the Sinus generated P Waves.  Junctional Escape Rhythm o Absent regular pacing stimuli from an automaticity focus in the AV Junction may escape overdrive suppression to become an active pacemaker producing Junctional Escape Rhythm  Inherent rate range: 40 to 60 bpm  Paroxysmal Atrial Tachycardia (PAT) o Caused by the sudden, rapid firing of a very irritable atrial automaticity focus.  150-250 bpm  Wandering Pacemaker o Irregular rhythm o P wave shape varies o Atrial rate less than 100 o Irregular ventricular ▯ ▯ Atrial Bigeminy ▯ Atrial Trigeminy ▯ Mutlifocal Atrial Tachycardia  Irregular rhythm  P wave shape varies  Atrial rate greater than 100  Irregular ventricular rhythm ▯ Atrial Flutter  250-350 bpm  rapid succession of identical back to back atrial depolarization waves “flutter” ▯ Atrial Fibrillation  Irregular rhythm  Continuous chaotic atrial spikes  Irregular ventricular rhythm  Cause by the continuous rapid firing, no single impulse depolarizes the atria completely and only an occasional random atrial depolarization reaches the AV Node to be conducted to the ventricles  This produces an irregular ventricular (QRS) rhythm ▯ Premature Junctional Beat  Occurs when an irritable automaticity focus in the AV Junction suddenly fires a premature stimulus that is conducted to and depolarizes the ventricles and sometimes the atria in retrograde ▯ ▯ AV- Junctional Bigeminy ▯ AV-Junctional Trigeminy  Supraventicular Tachycardia o Produced by Paroxysmal Atrial Tachycardia and Paroxysmal Junctional Tachycardia ▯  Premature Ventricular Contraction (PVC) ▯ Ventricular Bigeminy ▯ Ventricular Trigeminy ▯ Ventricular Quadrigeminy  Paroxysmal Ventricular Tachycardia (PVT) o 150-250 bpm  Multifocal PVC  R on T o When a PVC falls on a T wave  Ventricular Flutter o 250-350 bpm o single ventricular firing at a fast rate o produces ad rapid series of smooth sine waves of a similar amplitude  Ventricular Fibrillation o Rapid rate discharges, rapid twitching of the ventricles o 350-450 bpm ▯ ▯ Risk Stratification of Dysrhythmias  LOW RISK  PAC  Sinus Arrest  Atrial Escape  Atrial Bigeminy  Atrial Trigmeniny  Atrial Quadgeminy  Unifocal Atrial Tachycardia  PNC  Nodal Escape  Nodal Tachycardia  Nodal Bigeminy  Nodal Trigeminy  Nodal Quadgeminy  Unifocal PVC  Less than 6 Unifocal PVC’s ▯  MODERATE RISK  Greater than 5 unifocal PVC’s per minute  Unifocal coupled PVC’s  Unifocal ventricular salvo  Multifocal atrial tachycardia  Unifocal ventricular tachycardia  Atrial flutter  Ventricular flutter ▯  HIGH RISK  Atrial fibrillation  Multifocal coupled PVC’s  Multifocal ventricular salvo  Multifocal ventricular PVC’s  R on T PVC  Ventricular fibrillation  Ventricular standstill  asystole ▯ ▯


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