![]() ![]() Alcohol, cigarettes, caffeine, anxiety, fever, fatigueĢ. Characterized by beats occurring earlier than the next expected beat in the underlying rhythmġ. The impulse is from the atria, outside the SA nodeī. Treatment – Treated only if accompanied by symptoms of hypoperfusion, treat as symptomatic bradycardiaĪ. Clinical Presentation – not usually significantį. Interpretation: Wandering Atrial PacemakerĮ. P wave: only one precedes each QRS, but vary is size, shape, and deflectionĦ. Rate: usually 60 - 100, but may be slowerĤ. Rhythm: usually irregular, but may be regularĢ. May be associated with Digitalis administrationġ. Mostly from an inhibitory vagal responseģ. May be normal in very young, very old, or athletesĢ. Characterized by varying size, shape and direction of the P wavesġ. The pacemaker shifts from the SA node to ectopic atrial sitesī. Nonconducted premature atrial contractionsĪ. These rhythms, especially if very rapid, can affect ventricular filling time and diminish the strength of atrial kick that normally provides 30% of cardiac outputģ. P waves will have different configuration that sinus P wavesĬ. Result from ectopic stimuli– that is, they arise from outside the SA node in either the left atrium or right atriumī. Interpretation: Underlying rhythm with Sinus Exit BlockĪ. Rhythm: irregular – the underlying rhythm resumes on time following the pause, with the length of the pause being a multiple of the underlying R-R intervalĦ. The length of the pause will be a multiple of the underlying R-R intervalġ. Because the regularity of the sinus node discharge is not interrupted (just blocked), the underlying rhythm will resume on time following the pauseģ. An electrical impulse is generated by the SA node, but is blocked as it exits the sinus nodeĢ. Characterized by a regular pause in a regular rhythmġ. ![]() If pauses are long or frequent, patient may not tolerate and have symptoms of hypotension, dizziness, syncopeĮ. If pauses are short, there may be no symptomsĢ. Interpretation: Underlying rhythm with Sinus Arrestġ. Heart rate: can be normal, 60 - 100 or slow, 40 - 60Ħ. Rhythm: irregular – the underlying rhythm does not resume on time following the pauseĢ. Upsets the timing of the sinus node discharge, and the underlying rhythm will not resume on time following the pauseġ. Failure of the SA node to discharge an impulseĢ. ![]() Characterized by an irregular pause in the regular rhythmġ. Clinical Presentation – no problems associated with rhythmĪ. Seen most often in children and young adultsĢ. Inspiration causes slight increase in rate and exhalation causes a slight decrease in rate due to vagal tone during the different phases of respirationģ. Characterized by slightly irregular rhythmĢ. Medical treatment may include atropine or pacemakerĪ. Treated only if accompanied by symptoms of hypoperfusion, such as dizziness, chest pain, changes in LOCĢ. Clinical Presentation – dependent on the rate and patient tolerance of the rateġ. Characterized by heart rate less than 60Ĭ. Treatment – directed at the underlying causeĪ. Clinical Presentation – dependent on the rate and patient tolerance of the rateĮ. Causes: fever, any type of hypovolemia such as dehydration or blood lossĭ. Characterized by heart rate greater than 100ī. Treatment – no treatment generally associated with this rhythmĪ. Clinical Presentation – no problems typically associated with rhythmĭ. P wave: only one precedes each QRS, all have same size, shape and deflectionĬ. Is the standard against which all other rhythms are comparedĤ. Records the impulse originating from the sinus node and follows the path to the atria, AV junction, and through the bundle of His, to the bundle branches and on to the Purkinje fibersĪ. ![]()
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