Dysrhythmias (Including EKG Strips) Latest 2023 Graded A+

Dysrhythmias (Including EKG Strips) Latest 2023 Graded A+ Normal Sinus Rhythm Refers to a rhythm that originates in the SA node @ a rate of 60-100 BPM and follows normal conduction pattern of the cardiac cycle. Sinu ...

Dysrhythmias (Including EKG Strips) Latest 2023 Graded A+ Normal Sinus Rhythm Refers to a rhythm that originates in the SA node @ a rate of 60-100 BPM and follows normal conduction pattern of the cardiac cycle. Sinus Bradycardia The conduction pathway is the same as that in sinus rhythm but the SA node fires @ a rate of less than 60 BPM. May be normal in athletes. Symptomatic Sinus Bradycadia S/S Pale, cool skin, hypotension, weakness, angina, dizziness or syncope, confusion or disorientation, and shortness of breath. Symptomatic Sinus Bradycardia Tx Admin of atropine, or pacemaker therapy. If due to drugs; must be held, discontinued, or dosages reduced. Sinus Tachycardia The conduction pathway is the same as that in sinus rhythm. The discharge rate from the sinus node increases because of vagal inhibition or sympathetic stimulation. the sinus rate is 101-200 BPM. Sinus Tachycardia S/S Dizziness, dyspnea, and hypotension due to decreased CO. Increased O2 consumption due to increased HR. Angina or an increase in infarction size may accompany this disorder in pts with CAD or AMI Sinus Tachycardia Tx The underlying cause determines treatment, eg.) pain management if d/t pain. In stable pts vagal manuevers can be attempted. Beta-adrenergic blockers Atrial Flutter An atrial tachydysrhythmia identified by recurring, regular, sawtooth-shaped flutter waves that originate from a single ectopic focus in the right atrium, less commonly, can occur in left atrium. Atrial Flutter S/S High venticular rate; loss of atrial 'kick'. Decreased CO, HF: esp in pts with underlying heart disease, and increased risk of stroke. Atrial Flutter Tx Coumadin, slow ventricular response by increasing AV block, calcium channel blockers, betaadrenergic blockers, electrical cardioversion, antidysrhythmia meds, and radiofrequency catheter ablation. Atrial Fibrillation Characterized by a total disorganization of atrial electrical activity due to multiple ectopic foci resulting in loss of effective atrial contraction. May be paroxysmal or persistant (+7 days). Most common dysrhythmia. Atrial Fibrillation S/S Usually occur with underlying heart disease. Decreased CO, thrombi form in atria due to blood stasis, causes 20% of all strokes. Atrial Fibrillation Tx Goals include decreased ventricular repsonse (<100 BPM), prevention of cerebral embolic events, conversion to sinus rhythm possible. Calcium channel blockers, beta-adrenergic blockers, digoxin, dronedarone, electrical cardioversion, antidysrhythmics, coumadin, aspirin, radiofrequency catheter ablation, maze procedure or cryoblation. Premature Ventricular Contractions (PVCs) A contraction originating in an ectopic focus in the ventricles. It is the premature occurence of a QRS complex, which is wide and distorted in shape compared with a QRS complex originated from the normal conduction pathway. PVCs S/S Usually benign in the pt with a normal heart. In heart disease: decreased CO, precipitate angina/HF, indicate ventricular irritability in CAD or AMI, and pulse deficit. PVCs Tx Treatment relates to the underlying cause eg.) O2 therapy for hypoxia. Beta-adrenergic blockers, procainamide, amiodarone, and lidocaine. Multifocal PVCs Arise from different foci and appear different in shape from each other. Unifocal PVCs PVCs have the same shape Ventricular Tachycardia A run of 3 or more PVCs. It occurs when an ectopic focus or foci fire repetively and the ventricle takes control as the pacemaker. Ventricular Tachycardia S/S Stable- pt has pulse. Unstable- pt has no pulse. Severe decreased CO, loss of atrial contraction, hypotension, pulmoary edema, decreased cerebral blood flow, and cardiopulmonary arrest. Ventricular Fibrillation A severe derangement of the heart rhythm characterized on ECG by irregular waveforms of varying shapes and amplitude. This represents firing of multiple ectopic foci in the ventricle. Ventricle is just 'quivering' Ventricular Fibrillation S/S Pt is unresponsive, pulseless, and apneic. If not treated rapidly will lead to death. Ventricular Fibrillation Tx Immediate initiation of CPR and ACLS (advanced cardiac life-support), defibrillation, and definitive drug therapy. Paroxysmal Supraventricular Tachycardia (PSVT) A dysrhythmia originating in an ectopic focus anywhere above the bifurcation of the bundle of His. P wave is often hidden in preceding T wave, but if seen may have an abnormal shape. The PR interval may be shortened or normal, and QRS is usually normal.