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Abnormal Sinus Rhythms
Tachycardia means a fast heart rate usually greater than 100 beats /min. Figure 13-1; Guyton & Hall
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Abnormal Sinus Rhythms (cont’d)
Bradycardia means a slow heart rate usually less than 60 beats /min Figure 13-2: Guyton & Hall
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Note: no P waves and slow rate Figure 13-4; Guyton & Hall
Sinoatrial Block In rare instances impulses from S-A node are blocked. New pacemaker is region of heart with the fastest discharge rate, usually the A-V node. Note: no P waves and slow rate Figure 13-4; Guyton & Hall
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First Degree Heart Block
AV Node SA Node H T Delay Prolonged P-R Interval Copyright © 2006 by Elsevier, Inc.
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Second Degree Heart Block
AV Node SA Node H T Intermittent Block Conducted Blocked Copyright © 2006 by Elsevier, Inc.
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Third Degree Complete Block
Total block through the A-V node or A-V bundle P waves are completely dissociated from QRST complexes Ventricles escape and A-V nodal rhythm ensues HR = 37 Figure 13-7; Guyton & Hall
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Premature Atrial Contractions (cont’d)
Figure 13-9; Guyton & Hall
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Premature Ventricular Contractions (PVC’s)
Figure 13-3; Guyton & Hall
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Atrial Paroxysmal Tachycardia
Paroxysmal means a series of rapid heart beats suddenly start and then suddenly stop. Can be stopped with a vagal reflex or quinidine or procainimide P wave is inverted if origin is near A-V node Occurs by re-entrant pathways Figure 13-12; Guyton & Hall
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Ventricular Paroxysmal Tachycardia
Usually does not occur unless there has been ischemic damage Quinidine increases refractory period of cardiac muscle and can eliminate the problem Figure 13-13; Guyton & Hall
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Atrial Fibrillation Figure 13-19; Guyton & Hall
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Atrial Flutter Figure 13-20; Guyton & Hall
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Ventricular Fibrillation
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