Clk. Alexander L. Gonzales II December 14, 2010

SINUS RHYTHM  >60bpm and <100bpm  P-wave in front of QRS  QRS is narrow  Rhythm is regular

CARDIAC ARRHYTMIAS BRADYARRHYTHMIAS

SINUS BRADYCARDIA  Slow heart beat (<60bpm)  Normal rhythm, but slow  P wave is present  QRS is narrow

SINUS PAUSE  SA node stops working  Pause in heart beat for 6-8s

CARDIAC ARRHYTHMIAS PREMATURE BEATS

ATRIAL PREMATURE CONTRACTION  QRS is normal  P-wave is present but looks different on the premature beat

AV NODAL PREMATURE CONTRACTION = JUNCTIONAL  No P-wave before premature beat b/c originates in AV node, not atria  QRS is normal

PREMATURE VENTRICULAR CONTRACTION  Every other beat is abnormal (ventricular bigemini)  One QRS complex and P-wave are normal  Next QRS is wide and T-wave is inverted (-)  repolarization is abnormal

CARDIAC ARRHYTMIAS SUPRAVENTRICULAR TACHYCARDIAS

SINUS TACHYCARDIA  >100bpm  Normal P-wave  Narrow QRS

ATRIAL TACHYCARDIA  P-wave is inverted (-)  2 P-waves per every QRS complex

AV NODAL REENTRANT TACHYCARDIA  No P-wave b/c it’s within QRS complex  QRS is narrow, looks normal but is faster  Regular rhythm

PREEXCITATION: WOLFE PARKINSON WHITE SYNDROME  Slurred upslope on QRS and wider complex  PR is shorter   -wave (pts. prone to SVTs)  Tachycardia pathway: AV node  accessory pathway  atrium (  - wave disappears, but will return once  HR)

SVT WITH SHORT RP (REFRACTORY PERIOD)  QRS is narrow  1:1 relationship b/w P- wave and QRS  Can see P-wave before QRS

ATRIAL FLUTTER  Regular and reproducible  QRS is narrow  See (-) complexes  Saw tooth pattern

ATRIAL FIBRILLATION  Disorganized rhythm  Pulse is irregularly irregular/irregular rhythm  QRS is narrow  No P-wave

VENTRICULAR TACHYARRHYTHMIA  Occur in bottom chambers  >3 PVC in a row  V-tach  Nonsustained  stops after a certain time period  No P-waves  Repolarization is abnormal  QRS complexes are wider  More QRS than P-waves

TORSADES DE POINTES  Long QT interval  QRS complexes are all over the place  look abnormal

VENTRICULAR FIBRILLATION  Complete disorganization  No P-waves  No QRS complexes