-Uses accessory pathways – MOST COMMON ACCESSORY pathway syndrome-Usually through the Bundle of Kent-Genetic (born with it)-Impulses arrive in ventricles through accessory pathways-Represented by a “D” wave for the r wave-Wide QRS-PR interval is less than .12 seconds-Can conduct impulses either ANTEROGRADE (toward the ventricles), RETROGRADE (away from the ventricles) or in bothdirectionsPersons Max HR – 220-Age = Max HRAberrant Conduction-Not an arrhythmia, but rather a condition imposed upon impulses traveling through damaged or blocked bundle branches-QRS is wide and measures .12 or greater (AT EVERY QRS)-Indicates a Bundle Branch block – mainly due to hypoxia or AMIAtrial RhythmsPremature Atrial Contraction (PAC)-Regularity – single/multiple ectopic beats interrupt the regularity of the underlying rhythm-P wave will be morphology (different from normal beats)-PRI between .12-.20-Ectopic, irritability when the atria fires prematurely-Found in Pts with cardiovascular diseases-Sympathetic response to stimulants-P wave usually has different shape but isupright (peaked) because T wave is hidden under it – if in T may not be ableto saydefinite P-QRS – normal (less than .12 or 3 small boxes)-NO PREMATURE BEATS/CONTRACTIONS FROM THE SA NODESinus Arrhythmia VS. Sinus with a PAC-In Sinus Arrhythmia, nothing comes early (rate changes gradual)-In Sinus Arrhythmia,ALL P Waves look ALIKENARROW QRS TACHYCARDIASSinus Tachycardia (Worse than PSVT)-R-R Constant-SYMPATHETIC Stimulation-Rate – 100-200 bpm-P wave can be lost in the T Wave-PRI .12-.20 seconds-QRS – less than .12-FEVER- HR increases 10 bpm for every degree of feverTREAT itsunderlying physical or psychological causeand rate will slow/return to normalAtrial Flutter-Usually regular rhythm-SAW TOOTH type pattern-Rate – 220-350 bpm; 1:1 Conduction-Unable to determine PRI59
-QRS – less than .12-One cell caught in re-entryAtrial Fibrilation – MOST COMMON SUSTAINEDrhythm disturbance-Chaotic baseline-RR is Irregular -ALWAYS-Rate – exceeds 350 bpm-If Ventricular Rate is above 100 – Uncontrolled-If Ventricular Rate is below 100 – Controlled-No P wave present because atria is fibrillating-PRI – immeasurable-QRS – less than .12-Usually seen if older population with CHF-Chaotic baseline-Many cells caught in re-entry-AV node blocks some impulses but not all-Usually present in older population-CHF-Can cause blood clots (thrombus) because of the pooling blood in the atria-Decreased cardiac output-Controlled AFIB VS. Uncontrolled AFIB-AFIB with a ventricular response in the normal range – 100 bpm or less – is called AFIB with controlledventricular response-AFIB with ventricular rates greater than 100 bpm is called AFIB with rapid ventricular response or A-Fibwith rvr.-3 Categories of Atrial Fibrillation-Paroxysmal-Begins and stops on its own-Symptoms can be mild or severe and can last seconds, minutes, hours or days-Persistent-Continues until it is stopped with a treatment-Permanent-Normal rhythm cannot be restored with the usual treatment; patients then live in permanently-Both Paroxysmal and Persistent AFib may progress to permanentPSVT-It is a regular rhythm-Electrical Problem in the heartS/S-Comes on all of a sudden with no sympathetic stimulation-Sudden onset-Need to determine Pt’s max HR-Attacks usually occurs at rest-1 cell is caught in re-entry-Rate is usually 150-250 bpm
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Term
Spring
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professor_unknown
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