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This document discusses different types of junctional dysrhythmias: - Junctional rhythms originate in the atrioventricular (AV) junction and can cause inverted or absent P waves. - A premature junctional complex is a single early impulse from the AV junction. - A junctional escape rhythm arises from the AV junction at a rate of 40-60 beats per minute. - An accelerated junctional rhythm has a rate of 60-100 beats per minute from the AV junction. - Junctional tachycardia is a fast rhythm of 100-180 beats per minute from the bundle of His.
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Atrial dysrhythmias originate outside the SA node and are caused by three mechanisms: increased automaticity, triggered activity, and reentry. Key characteristics include abnormal P waves and P-R intervals with normal QRS complexes. Wandering atrial pacemaker produces changing P waves as the pacemaker site shifts. Premature atrial complexes originate outside the SA node and cause rhythm irregularity with different P wave morphologies. Atrial tachycardia and multifocal atrial tachycardia involve rapid atrial rates while supraventricular tachycardia cannot identify a specific origin. Atrial flutter shows sawtooth waves at 250-350 bpm and atrial fibrillation is chaotic firing with no P waves
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2. Non-conducted complexes where an early P wave is not followed by a QRS and the P wave is often hidden in the T wave.
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1. The document discusses ECG interpretation and analysis. It covers ECG basics, normal sinus rhythm, arrhythmias, and diagnosing myocardial infarction.
2. A key point is that diagnosing a myocardial infarction requires analyzing a 12-lead ECG, not just a rhythm strip, as the 12-lead ECG provides multiple views of the heart.
3. ST elevation in certain leads can help locate the site of a myocardial infarction, with the anterior wall seen in leads V1-V4, the lateral wall in leads I, aVL, V5-V6, and the inferior wall in leads II, III, and aVF.
Cardiac axis
The document discusses the cardiac axis and methods for determining it from an electrocardiogram (ECG). The cardiac axis represents the overall direction of electrical conduction through the heart. It is normally between -30° and +90° but can deviate left or right. Left axis deviation occurs between -30° and -90° and may indicate conduction abnormalities, while right axis deviation is between +90° and +180° and can be caused by right ventricular hypertrophy. The hexaxial reference system and other methods are described for calculating the axis from the ECG readings.
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This document discusses different types of heart block. Sinoatrial block occurs when the impulse from the sinus node is blocked before entering the atrial muscle, causing the atria to stop beating. Atrioventricular block occurs when impulses are blocked from passing from the atria to the ventricles. There are three degrees of atrioventricular block: first degree is a prolonged P-R interval; second degree is intermittent blocking of impulses; third degree is a complete dissociation between the atria and ventricles. Causes of atrioventricular block include ischemia, compression, inflammation, or stimulation of the vagus nerves.
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- The document summarizes the cardiac conduction system, including the sinus node, atrioventricular node, bundle of His, and Purkinje fibers. It describes how electrical impulses are generated in the sinus node and propagated through the conduction system to coordinate atrial and ventricular contractions. It also discusses factors that can influence heart rate such as the parasympathetic and sympathetic nervous systems through the release of acetylcholine and norepinephrine.
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This document provides information about cardiac arrhythmias. It defines arrhythmias as any abnormal heart rate or rhythm and normal sinus rhythm as 60-100 bpm originating from the sinus node. Arrhythmias are classified as sinus, atrial, or ventricular based on origin. Common types include sinus tachycardia/bradycardia, atrial fibrillation, ventricular tachycardia, and heart blocks. Symptoms vary depending on type but can include palpitations, dizziness, and fainting. Diagnosis involves ECG, echocardiogram, and Holter monitoring. Treatment depends on type and may include medications, ablation, pacemakers, or defibrillators.
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The document discusses junctional rhythms, which originate from the atrioventricular (AV) node. The AV node has three main functions: it slows conduction to allow for atrial emptying before ventricular contraction, it acts as a secondary pacemaker with a rate of 40-60 beats per minute (bpm), and it blocks some impulses from being conducted to the ventricles during rapid atrial rates. Premature junctional contractions are early beats originating in the AV junction that can cause slight irregularity. A junctional escape beat occurs late in an underlying rhythm with an inverted, hidden, or late/inverted P wave. A junctional rhythm appears when the sinoatrial node fires at a rate lower
Atrial arrhythmia
This document summarizes various types of atrial arrhythmias:
- Wandering pacemaker involves the pacemaker site transferring between the SA node and other areas of the atria.
- Premature atrial contractions (PACs) are early atrial impulses followed by normal sinus rhythm.
- Atrial tachycardia overrides the SA node impulse with a rapid atrial rate over 150 bpm.
- Atrial flutter involves the AV node conducting impulses to the ventricles at a ratio, with the ventricular rate either controlled or uncontrolled.
- Atrial fibrillation involves rapid discharges from multiple foci in the atria, so no organized depolarization is detectable
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This document discusses various arrhythmias of the atria including atrial ectopic beats, atrial tachycardia, atrial flutter, and atrial fibrillation. It provides details on the characteristic electrocardiogram patterns of each condition, including descriptions of the P waves, QRS rate and rhythm, and QRS width. Atrial ectopic beats involve premature impulses from the atria. Atrial tachycardia has a regular rapid heart rate between 150-200 bpm. Atrial flutter sees sawtooth flutter waves in the baseline at a rate of 300 bpm. Atrial fibrillation is characterized by irregular rapid impulses that prevent effective atrial emptying.
Junctional arrhythmias
This document discusses junctional rhythms, which occur when the atrioventricular (AV) node acts as the backup pacemaker when the sinoatrial (SA) node fails. There are three types of junctional rhythm: junctional rhythm with a rate of 40-60 bpm; accelerated junctional rhythm with a rate of 61-100 bpm; and junctional tachycardia with a rate of 101-180 bpm. All junctional rhythms lack P waves or have inverted, buried, or retrograde P waves and a absent, short, or retrograde PR interval. Causes include SA node disease, increased vagal tone, digitalis use, and inferior wall myocardial infarction. Treatment options are
Premature Atrial complexes
The document discusses three types of atrial premature complexes:
1. Normally conducted complexes which have an early P wave that conducts normally with a PR interval that may be normal, increased, or decreased and a QRS similar to sinus rhythm.
2. Non-conducted complexes where an early P wave is not followed by a QRS and the P wave is often hidden in the T wave.
3. Complexes with aberrant conduction where the early P wave is followed by a QRS with an abnormal conduction pattern most commonly right bundle branch block but sometimes left bundle branch block.
Pseudo infarction
Inferior lead pseudo-infarct Q waves are a common finding in the Wolff-Parkinson-White (WPW) syndrome.The characteristic Q wave-T wave vector discordance results from secondary repolarization changes due to altered ventricular activation. As a corollary, the presence of T wave inversion with inferior lead Q waves and a short PR interval is strongly suggestive, but not pathognomonic of inferior ischemia.
ECG: Toxin induced First degree Heart Block
A 17-year-old female presented with retrosternal and epigastric burning after consuming 50ml of bleach containing sodium hypochlorite. Her initial ECG showed first-degree AV block with a prolonged PR interval of 320ms that normalized to 140ms on a follow up ECG 3 days later, likely after elimination of the toxin. First-degree AV block is defined as a PR interval over 200ms and can be caused by various conditions. It typically has no symptoms but may reduce exercise tolerance and cause syncope in rare cases of infranodal block or left ventricular dysfunction. Treatment involves discontinuing any medications that may cause AV block and permanent pacing may be indicated in severe cases.
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This document discusses determining regularity in ECG rhythms. Regularity is the second step in ECG rhythm analysis, and irregular rhythms are considered abnormal. Regularity can be assessed using methods like calipers, marking a paper with a pen, or counting small squares between intervals. Irregularity may present as occasional, very irregular, or slightly irregular patterns, or as a sudden heart rate acceleration. Patterned or totally irregular rhythms also exist. Irregularity can be caused by conditions that alter conduction ratios.
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Dr. Irwan, SpJP, FIHA. 3rd Pekanbaru Cardiology Update, August 25th, 2013. Pangeran Hotel Pekanbaru. Learn more at PerkiPekanbaru.com
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1) Atrial tachycardias can be focal, triggered, or reentrant and include both macroreentrant circuits and focal mechanisms. Sinus node reentry is considered a specific type of focal atrial tachycardia.
2) AV nodal reentrant tachycardia (AVNRT) is a common form of reentrant tachycardia that involves dual pathways in the AV node - a fast and slow pathway. Typical AVNRT uses the slow pathway anterograde and fast pathway retrograde.
3) Other reentrant tachycardias discussed include atypical AVNRT variants, orthodromic and antidromic AV reentrant
Arrythmias and ek gs 1
This document discusses various types of arrhythmias, their mechanisms, and EKG characteristics. It covers normal sinus rhythm, altered automaticity such as sinus bradycardia and tachycardia, reentry mechanisms including AV nodal reentrant tachycardia and atrial flutter, conduction blocks, and helpful questions for identifying unknown arrhythmias based on rate, rhythm regularity, QRS width, P waves, and relationship between P waves and QRS complexes.
Narrow qrs tachy i.tammi raju
This document discusses approaches to narrow complex tachycardia. It begins by defining narrow QRS tachycardia as having a QRS width of less than 120ms. It then classifies different types of narrow complex tachycardia by site of origin and regularity, including sinus tachycardia, inappropriate sinus tachycardia, sinus node reentrant tachycardia, atrial tachycardia, atrial flutter, atrioventricular nodal reentrant tachycardia (AVNRT), and atrioventricular reentrant tachycardia (AVRT). It provides details on electrocardiogram features and diagnostic approaches for each type.
shadechapter09-150421103043-conversion-gate02.pdf
Atrial dysrhythmias originate outside the SA node and are caused by three mechanisms. Key characteristics include abnormal P waves and P-R intervals with normal QRS complexes. Wandering atrial pacemaker causes shifting P wave morphology. Premature atrial complexes produce irregularity with differently shaped P waves preceding QRS. Atrial tachycardia arises from the atria at 150-250 bpm, overriding the SA node. Atrial flutter has a saw-tooth appearance at 250-350 bpm. Atrial fibrillation is chaotic firing with fibrillatory waves but no P waves.
Cardiac arrhythmia
This document discusses cardiac arrhythmias including their mechanisms and types. It describes the cardiac action potential and how impulses are conducted regularly through the heart. The main types of arrhythmia are defined as bradycardia which is a slow heart rate, and tachycardia which is a fast heart rate. The mechanisms that can generate arrhythmias include accelerated automaticity, triggered activity, and reentry. Specific types of supraventricular tachycardias such as atrial fibrillation, atrial flutter, AV nodal reentrant tachycardia, and AV reentrant tachycardia are then explained in detail.
EKG Lecture 2 Walls Spring 2022.pptx
1. The document discusses rhythm identification and interpretation of electrocardiograms (EKGs). It covers the basics of rate, rhythm, axis, hypertrophy, and infarction.
2. Key rhythms discussed include normal sinus rhythm, wandering pacemaker, multifocal atrial tachycardia, and atrial fibrillation. Characteristics of each rhythm like rate, P wave morphology, and regularity are examined.
3. The document provides an overview of the PQRST waveform and reviews concepts like axis, intervals, and rhythm identification. Common arrhythmias are categorized including irregular rhythms, escape beats/rhythms, premature beats, tachyarrhythmias, and heart blocks.
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- The conduction system of the heart and action potentials across cardiac tissues.
- Causes of tachyarrhythmias including increased automaticity, triggered activity, and reentry.
- Algorithm for evaluating and treating stable vs. unstable tachyarrhythmias.
- Characteristics and management of common tachyarrhythmias like atrial fibrillation, atrial flutter, AV nodal reentrant tachycardia, and ventricular tachycardia.
- Use of synchronized cardioversion for unstable rhythms
Prof.-Randa-Cardiac-Arrhythmias.ppt
This document discusses various types of cardiac arrhythmias including their mechanisms, ECG features, and treatment approaches. It covers basics of the cardiac action potential and mechanisms that can generate arrhythmias such as accelerated automaticity, triggered activity, and reentry. Specific arrhythmias summarized include:
- Supraventricular tachycardias like sinus tachycardia, AV nodal reentrant tachycardia, AV reciprocating tachycardia, atrial fibrillation, and atrial flutter.
- Ventricular arrhythmias including ventricular tachycardia, ventricular fibrillation, and torsades de pointes.
- Causes, diagnostic ECG patterns,
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This document provides an overview of electrocardiogram (ECG) interpretation. It discusses the location of the heart, the components of a normal sinus rhythm on an ECG, and describes various types of atrial and ventricular arrhythmias including their characteristics and presentations on an ECG. The objectives are to discuss ECG pattern recognition for arrhythmias like atrial fibrillation, ventricular tachycardia, and heart blocks. Placement of ECG leads and components of the ECG paper are also outlined.
Ecg step y step 2015 hashem
This document provides an overview of electrocardiogram (ECG) basics and interpretation. It discusses the normal conduction pathways in the heart and the components of the ECG waveform. Examples are provided to demonstrate how to analyze rhythm, identify normal sinus rhythm, and diagnose various arrhythmias including premature beats, supraventricular arrhythmias, ventricular arrhythmias, and AV blocks based on heart rate, regularity, P waves, PR interval and QRS duration. Potential causes are outlined for each type of arrhythmia.
ECG [Compatibility Mode].pdf
This document provides an overview of cardiac arrhythmias that may be seen in the surgical intensive care unit (SICU). It begins with definitions of normal sinus rhythm and mechanisms of arrhythmias including automaticity, ectopic foci, and reentry. Common arrhythmias are then described in more detail such as sinus bradycardia, atrial fibrillation, ventricular tachycardia, and various forms of heart block. Causes and management of arrhythmias are discussed with a focus on the relevant medical literature. Antiarrhythmic drug classes and their uses and side effects are also reviewed.
ARRYTHMIAS- narrow complex tachycardia’s .pptx
1. Sinus arrhythmia is a normal variation in heart rate due to changes in vagal tone during respiration, causing the P-P interval to vary more than 120 ms in a cyclical fashion.
2. Atrial fibrillation is an irregularly irregular rhythm with no discernible P waves and a variable ventricular rate.
3. Ventricular tachycardia is 3 or more ventricular ectopic beats at a rate over 130 bpm, which can be either monomorphic or polymorphic.
ECG changes, changes in intraventricular conduction
This document provides an overview of common ECG changes seen in various cardiac conditions including:
- Intraventricular conduction abnormalities, arrhythmias, injury, infarction, electrolyte imbalances, and atrial and ventricular enlargement.
It describes sinus rhythm and arrhythmias, different types of dysrhythmias categorized by heart rate, and characteristics of junctional and ventricular dysrhythmias. Specific arrhythmias like atrial fibrillation, bundle branch blocks, AV blocks, and Wolff-Parkinson-White syndrome are outlined. Finally, ECG patterns of ischemia, injury and infarction in different areas of the heart are identified.
ecg.pptx
This document provides a summary of basics of ECG interpretation including:
1. It describes the normal conduction system and the 12 leads of an EKG including limb and precordial leads.
2. It explains how to determine heart rate using the Rule of 300 and 10 Second Rule and summarizes common rhythms like sinus, atrial, junctional and ventricular.
3. It outlines criteria for identifying conditions like chamber enlargements, bundle branch blocks, ischemia, infarction and provides examples of how these appear on EKGs.
Management of peri arrest arrhythmias
This document provides an overview of peri-arrest arrhythmias including objectives, ECG interpretation, bradycardia, tachycardia, treatment approaches, and specific arrhythmias like atrial fibrillation, ventricular tachycardia, supraventricular tachycardia, and electrolyte abnormalities. The objectives are ECG interpretation in context of patient assessment, concepts of symptomatic and unstable arrhythmias, basic ECG reading, and treatments for tachycardias and bradycardias. Evaluation of stability and symptoms is emphasized over rhythm alone for treatment decisions.
Aritm eng
The patient, a 43-year-old female, presented with palpitations, dyspnea, and chest pain after physical exertion. She has a history of rheumatism and mitral stenosis but had been stable until now. Her symptoms suggest new onset atrial fibrillation precipitated by exertion in the setting of underlying heart valve disease.
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- 1. Q I A 10 Fast & Easy ECGs – A Self-Paced Learning Program Junctional Dysrhythmias
- 2. Junctional Dysrhythmias • Originate in AV junction (area around AV node and bundle of His)
- 3. Junctional Dysrhythmias • Key characteristics – P’ waves may be inverted with a short P’R interval, absent (as they are buried by the QRS complex), or follow QRS complexes – QRS complexes usually normal unless there is an intraventricular conduction defect, aberrancy or preexcitation I
- 4. Premature Junctional Complex (PJC) • Single early electrical impulse that arises from the AV junction Q I
- 7. Junctional Escape Rhythm • Arises from AV junction at rate of 40 to 60 BPM I
- 10. Accelerated Junctional Rhythm • Arises from AV junction at rate of 60 to 100 BPM I
- 13. Junctional Tachycardia • Fast ectopic rhythm that arises from bundle of His at rate of 100 to 180 BPM I
- 16. Practice Makes Perfect • Determine the type of dysrhythmia I
- 17. Practice Makes Perfect • Determine the type of dysrhythmia I
- 18. Practice Makes Perfect • Determine the type of dysrhythmia I
- 19. Practice Makes Perfect • Determine the type of dysrhythmia I
- 20. Practice Makes Perfect • Determine the type of dysrhythmia I
- 21. Practice Makes Perfect • Determine the type of dysrhythmia I
- 22. Practice Makes Perfect • Determine the type of dysrhythmia I
- 23. Practice Makes Perfect • Determine the type of dysrhythmia I
- 24. Practice Makes Perfect • Determine the type of dysrhythmia I
- 25. Practice Makes Perfect • Determine the type of dysrhythmia I
- 26. Summary • Junctional rhythms originate in the AV junction. • Impulses originating in the AV junction travel upward and cause backward or retrograde depolarization of the atria resulting in inverted P’ waves in lead II with a short P’R interval, absent P waves or P waves that follow the QRS complexes. • With junctional dysrhythmias the QRS complexes are usually normal unless there is an intraventricular conduction defect, aberrancy or preexcitation.
- 27. Summary • A premature junctional complex (PJC) is a single early electrical impulse that arises from the AV junction. • Junctional escape rhythm arises from the AV junction at a rate of 40 to 60 beats per minute. • Accelerated junctional rhythm arises from the AV junction at a rate of 60 to 100 beats per minute. • Junctional tachycardia is a fast ectopic rhythm that arises from the bundle of His at a rate of between 100 and 180 beats per minute.