Cardiac Dysrhythmia

Atrial Dysrhythmias

100

Originates in the SA node, regular, every P has a QRS, less than 60 BPM, PR interval 0.12-0.20 seconds and QRS interval 0.08 to 0.12 seconds  

What is sinus bradycardia 

200

A normal appearing beat on the monitor that occurs earlier than expected.

What is a PAC (premature atrial contraction)?

300

This atrial dysrhythmia has a characteristic "saw tooth" pattern that has F waves in varying ratios such as 3:1 or 4:1

What is atrial flutter?

400

This atrial dysrhythmia is irregular and can have many or no P waves. The QRS complexes occur at irregular intervals. If it is a new dysrhythmia for the patient, the major concern is the formation of blood clots that can cause an MI, stroke or pulmonary embolus.

What is atrial fibrillation?

500

This atrial dysrhythmia occurs when there is an abnormal electrical conduction pathway called the "Bundle of Kent." If the QRS complex is wide, >.12 a delta wave is present.

What is WPW (Wolff-Parkinson-White syndrome?

Ventricular Dysrhythmias

100

This dysrhythmia can occur as a single event, or as every 4th beat (quadrigeminy) 3rd beat (trigeminy) every other beat (bigeminy). The shape can be the same (unifocal) or can differ (multifocal). More frequent and/or multifocal are of greater concern.

What is a PVC (premature ventricular contraction)?

200

This life-threatening dysrhythmia has wide, bizarre, identical QRS complexes that occur at a rate of 101-250 impulses/minute. If it is sustained (>30 seconds) & the patient is unresponsive and without a pulse, it must be treated with CPR and defibrillation shocks between 200-360 joules.

What is VT (ventricular tachycardia)?

300

This dysrhythmia may look similar to VT, but the fast (>150) wide, bizarre complexes start close to the baseline, increase in size and then decrease in size in a twisting pattern. The treatment of choice is 1-2 grams of magnesium sulfate given over 5-20 minutes.

What is Torsades de Pointes?

400

This ventricular dysrhythmia is always lethal if not treated. It appears as a wavy line that can be fine or coarse.

What is Vfib (ventricular fibrillation)?

500

When the ventricles stop for a prolonged period, there are no waveforms/complexes seen on the monitor. Shocks from the defibrillator will have no effect so CPR must be started immediately.

What is asystole?

AV Blocks

100

This "block" is really not a block, but a delay in conduction from the atria to the bundle of His. The only difference between this "block" and sinus rhythm is a PR interval that is >.20

What is a first degree AV block?

200

This AV block has a repeating pattern of a PR interval that is long, then longer until a beat (QRS complex) is dropped. It has two names, one of them is German.

What is Wenckebach or Mobitz I?

300

In this AV block, the PR interval can be normal or prolonged. It usually remains the same (.32, .32, .32 or .12, .12, .12) It is caused by an intermittent interruption in the electrical conduction system near or below the AV junction. It occurs suddenly and without warning. QRS complexes are dropped.

What is a 2nd degree AV block type II (Mobitz II)?

400

This block is caused by a delay in conduction of the electrical impulse down one of the bundle branches that results in a wide QRS complex (>.12) that may have the appearance of "rabbit ears"

What is a bundle branch block?

500

This life-threatening AV block is caused when the electrical impulse is completely blocked between the atria and the ventricles. The P-P intervals & R-R intervals are regular. It is considered a medical emergency and is treated with temporary pacing until a permanent pacemaker can be placed.

What is a 3rd degree (complete) heart block?

Pacemakers

100

This term means that the pacemaker is successfully causing the cardiac cells to depolarize in response to the electrical impulse generated by the pacemaker. A pacer spike is seen immediately followed by a P wave or QRS complex depending upon where the lead wires are placed.

What is capture?

200

This term means that the cardiac muscle actually contracts after the electrical impulse is generated by the pacemaker.

What is mechanical capture?

300

When this occurs, there is no P wave (with an atrial pacemaker) or QRS complex (with a ventricular pacemaker) seen after the pacer spike.

What is loss of capture?

400

This is one of the most common types of pacemaker with an electrode and lead wire placed in an atrium and ventricle.

What is a sequential or AV pacemaker?

500

This term refers to the percentage of complexes generated by the artificial pacemaker.

What is pacing?

Medications

100

This medication is given as quickly as possible as a 6 mg dose IV push. It is used to treat narrow, complex tachycardias such as SVT, PAT or PSVT. Lifting the extremity in which the drug is given will hasten the delivery of the drug to the heart.

What is adenosine?

200

This drug is often used to treat symptomatic bradycardia. The usual dose is 0.5 mg every 3-5 minutes not to exceed a total of 3 mg. Any single dose less than 0.5 mg may CAUSE bradycardia.

What is atropine?

300

This medication comes in a 1:10,000 dilution and is given in 1 mg doses every 3-5 minutes for cardiac arrest, Vfib, pulseless VT, asytole, PEA and refractory bradycardia or hypotension. It can also be given for severe allergic reactions.

What is epinephrine?

400

This medication Selectively inhibits beta receptors of the heart blocking the Sympathetic Nervous system, decrease workload of the heart, Decreased contractility, decrease BP and Heart rate 

What is Metoprolol?

500

This calcium channel blocker slows the conduction of the AV node and increases the refractory period so that the heart rate is slowed down. It is given to treat narrow, complex tachycardia, Afib & Aflutter with RVR (rapid ventricular response). The initial bolus is 0.25 mg/kg (average dose 15-20 mg) over 2 minutes. If the bolus works, then a drip of the same drug is hung.

What is diltiazem?