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cardiopulmonary
ECG
132
Medical
Undergraduate 4
10/01/2013

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Term
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Definition

SA Node

Normal Sinus Rhythm

Term
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Definition
SA Node
Sick Sinus Syndrome
Term
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[image]
Definition
SA Node
Sinus Tachycardia
Term
[image]
[image]
Definition
SA Node
Sinus Bradycardia
Term
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Definition
SA Node
Sinus Arrhythmia
Term
SA Node
Normal Sinus Rhythm

Rate
Definition
Rate
Atria: Between 60 and 100 contractions per minute
Ventricle: Same as atrial rate
Term
SA Node
Normal Sinus Rhythm

Rhythm
Definition
Rhythm: atria and ventricles are both regular
Term
SA Node
Normal Sinus Rhythm

Wave Configuration
Definition
Wave Configuration
P-Wave: follow each QRS complex with normal unchanging contour
QRS Complex: Married to P-Waves
T-Wave: normal
Term
SA Node
Normal Sinus Rhythm

Intervals
Definition
Intervals:
both the PR interval and QRS duration are normal
Term
SA Node
Normal Sinus Rhythm

Clinical Observation
Definition
Clinical Observation:
The sinus rate is higher in infants and children than in adults
Term
SA Node
Sinus Arrhythmia

Rate
Definition
Rate
Atrial: Variable, Usually 60-100 contractions per minute, maybe slower or faster
Ventricles: same as atrial
Term
SA Node
Sinus Arrhythmia

Rhythm
Definition
Rhythm
Atrial: Irregular; varies with respiration (increases with inspiration, decreases with expiration)
Ventricle: Irregular; same as atria
Term
SA Node
Sinus Arrhythmia

Wave configuration
Definition
wave configuration
P-Wave, QRS complex, and T-Wave follow normal pattern
Term
SA Node
Sinus Arrhythmia

Intervals
Definition
Intervals:
Both PR Interval and QRS duration are normal
Term
SA Node
Sinus Arrhythmia

Clinical Observation
Definition
Clinical Observation
Harmless, Seen in children or young adults
Term
SA Node
Sinus Bradycardia

Rate
Definition
Rate
Atrial: Less than 60 bpm
Ventricles: Less than 60 bpm
Term
SA Node
Sinus Bradycardia

Rhythm
Definition
Rhythm:
Atrial and Ventricles are regular
Term
SA Node
Sinus Bradycardia

Wave Configuration
Definition
Wave Configuration:
P-Wave, QRS complex, and T-Wave is normal pattern
Term
SA Node
Sinus Bradycardia

Intervals
Definition
Intervals
PR Interval: As the Sinus rate slows, PR interval lengthens
QRS Duration: normal
Term
SA Node
Sinus Bradycardia

Clinical Observation
Definition
Clinical Observation
harmless; seen in young children or young adults
Term
SA Node
Sinus Tachycardia

Rate
Definition
Rate
Atria: 100-160 contractions per minute
Ventricle: 100-160 contractions per minute
Term
SA Node
Sinus Tachycardia

Rhythm
Definition
Rhythm
Atria and Ventricle rhythm is regular
Term
SA Node
Sinus Tachycardia

Wave configuration
Definition
wave configuration
P-Wave, QRS, and T-wave, follows normal pattern
Term
SA Node
Sinus Tachycardia

Intervals
Definition
Intervals:
PR interval: Normal to slightly shortened
QRS duration: Normal to slightly shortened
Term
SA Node
Sinus Tachycardia

Clinical Observation
Definition
Clinical Observation
rapid heart rate may increase cardiac output. can precipitate congestive heart failure in the damaged heart
Term
SA Node
Sick Sinus Syndrome

Rate
Definition
Rate:
Atria: Irregular; alternating bradycardia (<60) and tachycardia (>100)
Ventricles: not always same as atria
Term
SA Node
Sick Sinus Syndrome

Rhythm
Definition
Rhythm:
Atria: irregularly irregular
Ventricle: irregularly irregular
Term
SA Node
Sick Sinus Syndrome

Wave Configuration
Definition
Wave configuration:
PWave: sometimes absent
QRS Complex and TWave are normal
Term
SA Node
Sick Sinus Syndrome

Intervals
Definition
Intervals:
PR Interval: Normal-Prolonged or absent
QRS duration: Normal
Term
SA Node
Sick Sinus Syndrome

clinical observation
Definition
clinical Observation
Can bee seen with ischemia and other heart diseases. associated with severe myocardial infarction
Term
[image][image]
Definition

Atria:

Premature Atrial Contractions

Term
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Definition

Atria:

Paraxysmal Atrial Tachycardia

Term
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Definition

Atria: 

Wandering Atrial Pacemaker

Term
[image][image]
Definition

Atria:

Atrial Flutter

Term
[image][image][image]
Definition

Atria:

Atria Fibrillation

Term
Atria
Premature Atrial Contraction

Rate
Definition
Rate
Atria: depends on number of PCA's
Ventricle: same as atria
Term
Atria
Premature Atrial Contraction

Rhythm
Definition
Rhythm
Atrial: Irregular
Ventricle: same as atrial
Term
Atria
Premature Atrial Contraction

Wave configuration
Definition
Wave Configuration
Pwave: could be hidden in the perceeding twave
QRS: normal but maybe aberrantly conducted
TWave: higher if it includes pwave
Term
Atria
Premature Atrial Contraction

Intervals
Definition
Intervals
PR interval: normal, prolonged, or completely blocked
QRS duration: normal
Term
Atria
Premature Atrial Contraction

Clinical observation
Definition
Clinical Observation
May go into tacchycardia
Term
Atria
Paroxysmal Atrial Tachycardia

Rate
Definition
Rate:
Atria: 140-250 contractions per minute
Ventricle: same as atria
Term
Atria
Paroxysmal Atrial Tachycardia

Rhythm
Definition
Rhythm
Atria and ventricles are regular
Term
Atria
Paroxysmal Atrial Tachycardia

Wave Configuration
Definition
Wave configuration
Pwave: often hard to discern; hidden in twave
QRS: normal
Twave: normal
Term
Atria
Paroxysmal Atrial Tachycardia

Intervals
Definition
Intervals
PR Interval: short <.12 if pwave present
QRS Duration: normal
Term
Atria
Paroxysmal Atrial Tachycardia

Wave configuration
Definition
clinical observation
a run of 3 or more PACS- underlying cause is digitalis toxicity
Term
Atria
Wandering Atrial Pacemaker

Rate
Definition
Rate
Atria: usually slow 58-62
Ventricle: same as atria
Term
Atria
Wandering Atrial Pacemaker

Rhythm
Definition
Rhythm
Atria:cyclic slowing and speeding as in sinus arrhythmia
Ventricle: same as atria
Term
Atria
Wandering Atrial Pacemaker

Wave Configuration
Definition
Wave configuration
Pwave: change in height, contour and direction in each cycle- retrograde
QRS: Complex; normal
Twave: normal
Term
Atria
Wandering Atrial Pacemaker

Intervals
Definition
Intervals:
PR: vary
QRS: normal
Term
Atria
Wandering Atrial Pacemaker

Clinical observation
Definition
Clinical observation
attributed to acute rheumatic fever
Term
Atria
Atrial Flutter

Rate
Definition
Rate:
Atria:250-350
Ventricle:125-175
Term
Atria
Atrial Flutter

Rhythm
Definition
Rhythm
Atrial: regular
Ventricle: often 2:1. AV conduction maybe irregular with 3:1 or AV Block
Term
Atria
Atrial Flutter

Wave Configuration
Definition
Wave configuration
Pwave: sawtooth pattern
QRS: normal
Twave: Normal
Term
Atria
Atrial Flutter

Intervals
Definition
Interval:
PR: not measured
QRS: normal but may be widened if flutter waves are buried in QRS complex
Term
Atria
Atrial Flutter

Clinical Observation
Definition
Clinical Observation
Organic heart disease; occur in alcohol toxication
Term
Atria
Atrial Fibrillation

Rate
Definition
Rate
Atria: 350-600
Ventricle: 100
Term
Atria
Atrial Fibrillation

Rhythm
Definition
Rhythm
both atria and ventricle are irregularly irregular
Term
Atria
Atrial Fibrillation

Wave Configuration
Definition
Wave configuration
Pwave: not discernable
QRS: normal
Twave: normal
Term
Atria
Atrial Fibrillation

Intervals
Definition
Intervals:
PR: not measurable
QRS: normal
Term
Atria
Atrial Fibrillation

Clinical Observation
Definition
clinical observation
Seen with heart attack and can lead to ventricle problems
Term
[image][image]
Definition

AV Node 

Premature Nodal Contraction

Term
[image]
Definition

AV Node

Nodal or Junctional Rhythm

Term
[image][image][image]
Definition

AV Node: 

First Degree AV Block

Term
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Definition

AV Node

Second Degree AV Block- Wenckebach

Term
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Definition

AV Node

Second Degree AV Block- Wenckebach (type 2)

Term
[image][image]
Definition

AV Node

Third Degree AV Block

Term
[image][image]
Definition

AV Node

Wolff-Parkinson White Syndrome

Term
AV Node
Premature Nodal Contraction

Rate
Definition
Rate:
Atria: determined by the number of premature beats
Ventricle: same
Term
AV Node
Premature Nodal Contraction

Rhythm
Definition
rhythm
Both atria and ventricle rhythm is irregular due to premature beats
Term
AV Node
Premature Nodal Contraction

Wave Configuration
Definition
Wave configuration
Pwave: inverted if visible, in lead 2, 3, and avF, may occur before, after, or during QRS
QRS: Normal
Twave: normal
Term
AV Node
Premature Nodal Contraction

Intervals
Definition
Interval:
PR: <.12 seconds if pwave present
QRS: normal
Term
AV Node
Premature Nodal Contraction

Clinical observation
Definition
Clincal Observation
isolated PNC's occur in normal individuals. may indicate organic heart disease. (supra-ventricular tachycardia)
Term
AV Node
Nodal or junctional Rhythm

Rate
Definition
Rate:
Atria: 40-80
Ventricle: same as atria
Term
AV Node
Nodal or junctional Rhythm

Rhythm
Definition
Rhythm
Both atria and ventricle are regular
Term
AV Node
Nodal or junctional Rhythm

Wave configuration
Definition
Wave configuration
PWave: absent or inverted if present or when the rhythm returns to NSR, the pwave is nomal
QRS: normal
Twave: normal
Term
AV Node
Nodal or junctional Rhythm

intervals
Definition
Interval:
PR: shortened, usually .08-.12
QRS: normal
Term
AV Node
Nodal or junctional Rhythm

clinical observation
Definition
Clinical Observation
Most commonly occurs with digitalis toxicity. seen with heart attacks and inflammatory disease of the heart
Term
AV Node
First Degree AV Block

Rate
Definition
Rate:
Artia: usually within normal range, depends on underlying rhythm
Ventricle: same
Term
AV Node
First Degree AV Block

Rhythm
Definition
Rhythm:
atria and ventricles are regular
Term
AV Node
First Degree AV Block

Wave Configuration
Definition
Wave configuration
Pwave: precede each QRS complex
QRS: normal
twave: normal
Term
AV Node
First Degree AV Block

Intervals
Definition
Intervals:
PR intervals: prolonged to greater than .20 seconds but at a constant level
QRS: Normal and present
Term
AV Node
First Degree AV Block

Clinical Observation
Definition
Clinical Observation:
warning of more advanced forms of AV block and acute MI. due to digitalis excess
Term
AV Node
Second Degree AV Block: Wenckebach

Rate
Definition
Rate:
Atrial: normal, about 100 contractions per minute
Ventricle: about 80 contractions per minute
Term
AV Node
Second Degree AV Block: Wenckebach

Rhythm
Definition
Rhythm
Atria: regular
Ventricle Irregular; depending on degree of block
Term
AV Node
Second Degree AV Block: Wenckebach

Wave configuration
Definition
Wave Configuration
PWave: more numerous that QRS
QRS: normal but not always present
Term
AV Node
Second Degree AV Block: Wenckebach

Interval
Definition
Interval
PR: becomes progressively longer until the action potential is not confucted and no QRS results. sequence starts over
QRS: normal
Term
AV Node
Second Degree AV Block: Wenckebach

Clinical Observation
Definition
serious; common in patients with acute inferior myocardial infarction. produced by excess digitalis
Term
AV Node
Second Degree AV Block- Type 2

Rate
Definition
Rate:
Atrial:Normal
Ventricular:Depends on the degree of the block
Term
AV Node
Second Degree AV Block- Type 2

Rhythm
Definition
Rhythm
Atrial: Regular
Ventricular: Irregular, depending on degree of AV block
Term
AV Node
Second Degree AV Block- Type 2

Wave configuration
Definition
Waves Configuration
P waves: P waves are consistently related to the ventricular contractions, but P waves are more numerous than the QRS complexes.
QRS complex: Normal
Term
AV Node
Second Degree AV Block- Type 2

Interval
Definition
Intervals
PR interval: For conducted contractions, the PR interval is prolonged at a constant rate or value. May be normal but likely prolonged but prolonged at constant rate or value. Sudden block of one or more P waves will occur without preceding PR prolongation.
QRS duration: Usually normal but can be wide – can be 0.10 sec or greater, periodically absent after P waves
Term
AV Node
Second Degree AV Block- Type 2

Wave Configuration
Definition
Clinical Observaition:
occurs in large anterior myocardial infractions and forerunner to complete AV block
Term
AV Node
Third Degree AV Block

Rate
Definition
Rate
Atrial: Normal, greater than
Ventricular: 30-40 contractions per min
Term
AV Node
Third Degree AV Block

Rhythm
Definition
Rhythm
Atrial: Regular
Ventricular: Regular

There is no relationship between the atrial and ventricular rhythms
Term
AV Node
Third Degree AV Block

Wave Configuration
Definition
Waves Configuration
P waves: Normal shape
QRS complex: Normal
Term
AV Node
Third Degree AV Block

Intervals
Definition
Intervals
PR interval: PR interval completely variable and unrelated to the QRS complex.
QRS duration: Normal if the escape focus is above the bifurcation of the bundle of His, but widened and greater than 0.12 seconds if the escape focus is below this point.
Term
AV Node
Third Degree AV Block

Clinical Observation
Definition
Clinical Observation:
Ventricle rate can be so slow that circulation can not be maintained; causing congestive heart failure and angina
Term
AV Node
Wolff-Parkinson-White Syndrome

Rate
Definition
Rate
Atrial: Normal, usually between 60-100 contractions per min
Ventricular: Same
Term
AV Node
Wolff-Parkinson-White Syndrome

Rhythm
Definition
Rhythm
Atrial: Regular
Ventricular: Regular
Term
AV Node
Wolff-Parkinson-White Syndrome

Wave Configuration
Definition
Waves Configuration
P waves: Normal, precede each QRS complex
QRS complex: Slurred upstroke of the QRS complex (Delta wave) may be seen in on or more leads.
Term
AV Node
Wolff-Parkinson-White Syndrome

intervals
Definition
Intervals
PR interval: Shortened, less than 0.12 sec, due to acessory pathway and premature ventricular excitation.
QRS duration: Prolonged, usually greater than 0.12 sec.
Term
AV Node
Wolff-Parkinson-White Syndrome

Clinical Observation
Definition
Clinical Observation
pre-excitation syndrome. Uncommon. can lead to paroxysmal atrial or ventricular tachycardia
Term
[image][image]
Definition

Ventricle

Premature Ventricular Contraction

Term
[image]
Definition

Ventricle 

Ventricular Tachycardia

Term
[image]
Definition

Ventricle

Paraoxysmal Ventricular Tachycardia

Term
[image][image]
Definition

Ventricle

Ventricular Flutter

Term
[image][image][image]
Definition

Ventricle

Ventriclar Fibrillation

Term
Ventricle
Premature Ventricular Contraction

Rate
Definition
Rate
Atrial: Variable
Ventricular: Determined by the underlying ventricular contractions and number of PVCs.
Term
Ventricle
Premature Ventricular Contraction

Rhythm
Definition
Rhythm
Atrial: Irregular because of PVCs
Ventricular: Irregular because of PVCs
Term
Ventricle
Premature Ventricular Contraction

wave configuration
Definition
Waves Configuration
P waves: Not seen and often lost in the QRS or T wave of PVC
QRS complex: Normal shape for normal contraction
Term
Ventricle
Premature Ventricular Contraction

Intervals
Definition
Intervals
PR interval: Not applicable
QRS duration: Wide and bizarre and greater than 0.12 seconds.
T wave: Usually opposite-directed
Term
Ventricle
Premature Ventricular Contraction

Clinical Observation
Definition
Clinical Observation
Reflect myocardial irritability and precipitate lethal disrhytmias
Term
Ventricle
Ventricular Tachycardia

Rate
Definition
Rate
Atrial: Undeterminable
Ventricular: 100-250 bpm
Term
Ventricle
Ventricular Tachycardia

rhythm
Definition
Rhythm
Atrial: Undeterminable
Ventricular: Generally regular but maybe irregular
Term
Ventricle
Ventricular Tachycardia

Wave configuration
Definition
Waves Configuration
P waves: Often lost in the QRS complex
QRS complex: Wide and bizarre
T wave: Usually opposite-directed
Term
Ventricle
Ventricular Tachycardia

intervals
Definition
Intervals
PR interval: Not measurable
QRS duration: Greater than 0.12 seconds
T wave: Usually opposite-directed
Term
Ventricle
Ventricular Tachycardia

clinical observation
Definition
Clinical Observation
serious and dangerous; precursor to ventricular fibrillation
Term
Ventricle
Paraoxysmal Ventricular Tachycardia

Rate
Definition
Rate
Atrial: Difficult to determine
Ventricular: 150-250 bpm
Term
Ventricle
Paraoxysmal Ventricular Tachycardia

rhythm
Definition
Rhythm
Atrial: ?
Ventricular:Variable
Term
Ventricle
Paraoxysmal Ventricular Tachycardia

Wave configuration
Definition
Waves Configuration
P waves: Not always seen and often lost in the QRS complex
QRS complex: Normal shape
Term
Ventricle
Paraoxysmal Ventricular Tachycardia

Intervals
Definition
Intervals
PR interval: Not discernible
QRS duration: Wide and bizarre and greater than 0.12 seconds
Term
Ventricle
Paraoxysmal Ventricular Tachycardia

Clinical observation
Definition
Clinical Observation
Indicates coronary artery disease. precursor to ventricular fibrillation and if continues, cardiac output decreases
Term
Ventricle
Ventricular Flutter

Rate
Definition
Rate
Atrial: Undeterminable
Ventricular: 250-350 bpm
Term
Ventricle
Ventricular Flutter

rhythm
Definition
Rhythm
Atrial: Undeterminable
Ventricular: Regular
Term
Ventricle
Ventricular Flutter

Wave configuration
Definition
Waves Configuration
P waves: Not discernible
QRS complex: Smooth like in appearance
Term
Ventricle
Ventricular Flutter

interval
Definition
Intervals
PR interval: Not measurable
QRS duration: Wide and bizarre and greater than 0.12 seconds; Often difficult to differentiate between QRS and T wave.
Term
Ventricle
Ventricular Flutter

clinical observation
Definition
Clinical Observation:
Ventricles cannot fill- ineffective cardiac output. Lethal
Term
Ventricle
Ventricular Fibrillation

Rate
Definition
Rate
Atrial: Same as Ventricular
Ventricular: 350-450 bpm, Rapid, disorganized
Term
Ventricle
Ventricular Fibrillation

rhythm
Definition
Rhythm
Atrial: Totally Irregular
Ventricular: Totally Irregular
Term
Ventricle
Ventricular Fibrillation

Wave Configuration
Definition
Waves Configuration
P waves: Not discernible
QRS complex: Bizarre in appearance
Term
Ventricle
Ventricular Fibrillation

Intervals
Definition
Intervals
PR interval: Not measurable. There is no pattern to the QRS complex
QRS duration: Undeterminable
Term
Ventricle
Ventricular Fibrillation

Clinical Observation
Definition
Clinical Observation:
Clinically dead without effective cardiac output. normal rhythm must be restored within a few minutes. Lethal
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