What is the difference between 2nd degree type 1 blocks versus 3rd degree block?

2nd type 1 is irregular (PRI gets longer and longer)and 3rd is reg from P to P and R to R

Saw tooth?

Atrial flutter

Length of PR Interval (PRI)

.12 to .20

length of QRS complex

.04 to .12 secs

What type of QRS complex for impulse above intiating above the ventricle?

Narrow, below ventricle is widened

**junctional counts as above

How long (time) is one big square?

one big square is .20 secs (the max normal PRI)

Normal except for below 60 rate

Siunus Bradycardia

Normal except rate above 100

Sinus tachycardia

faster during inspiration and slower during expiration?

Sinus Dysrythmia (same as arythmia)

Sinus dysrythmia

irregular, rate is 60 to 100 but there are delayed beats

Sinus Arrest

Like sinus dysrhythmia but slower- delayed beats, irregular rhythm, rate is below 60, delayed beats

Wandering Pacemaker

Rate is nromal and there is a P for every QRS but rate is slightly irregular and morphology of Pwave and length of PRI will vary as impulse "wanders"

Premature Atrial Contraction (PAC)

a single premature ectopic beat, the ectopic beat will have a P wave but it might be hidden

Atrial Tachycardia

 Rate is 150 to 250 bpm and P waves differ

Atrial Flutter

atrial rate of 250 to 350! but ventricular will  be less- looks like a saw tooth

Atrial Fibrillation

Irregular Irregular! Can't ID P wave, atrial rate over 350 but ventricular rate varies

Atrial Fibrillation

Atrial Fibrillation

Atrial Flutter

Atrial Tachycardia

Premature Atrial Contraction

Wandering Atrial Pacemaker

Sinus Dysrythmia

Sinus Tachycardia

Sinus Bradycardia

Premature Junctional Contraction

(junction= AV junction)

PJC intreupts underlying rhythm with a single ectopic beat, for that beat the P wave will be inverted or hidden

Premature Junctional Contraction

Junctional Escape Rhythm

The SA node has failed and AV is taking over, rate is 40-60 and the P wave is retrograde so will be inverted or hidden

Junctional Escape Rhythm

Accelerated Junctional Rhythm

AV node speeds up and displaces SA node so ventricle conduction is normal and atrial conduction is retrograde, regular rhythm, rate is 60-100, P wave is either inverted or hidden

Accelerated Junctional Rhythm

Junctional Tachycardia

Regular rhythm but rate is 100 to 180, P wave is retrgade so inverted or hidden

Junctional Tachycardia

Premature Ventricular Contraction (PVC)

 Wave interupted with ectopic beat that is crazy looking (can't recognize anything). QRS is wide and bizzare.

Superventricular Tachycardia

When the exact wave cannot be identified because P waves are hidden and rate is such that it could be a few things, rhythm is regular.

Sinus Tachy 100-160, Atrial Tachy 150-250, Atrial Flutter 150-250, Junctional Tachy 100-180 

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Superventricular Tachycardia

Unifocal PVC vs multifocal PVC

Unifocal is weird beats in just one direction (positive or negative), multi has beats in both

Premature Ventricular Contraction (PVC)

Ventricular Tachycardia

Pretty regular, ventricular rate is 100-25 and there are NO P WAVES

Ventricular Tachycardia

Slow Vtach vs. Ventricular flutter

Slow vtach is vtcah under 150 bpm, ventricular flutter is vtach above 250 bpm

Torsades de Pointes/ Polymorphic Ventricular Tachycardia

waves from small to big and back (no notes on this)

Polymorphic Ventricular Tachycardia

Ventricular Fibrilation

multpl sites firing in the ventricles, totally chaotic- no true contractions happening

Ventricular Fibrilation

Idioventricular Rhythm

the higher pacemakers have stopped working, rate is 20 to 40 bpm, rhythm is regular, no P wave, QRS is wide and bizzare

Ideoventricular Rhythm

asystole

straight line- heart has lost its electrical activity...

First Degree Heart Block

not a true heart block, P for every QRS but P is out infront (there is a delay, long PRI). QRS is narrow.

First Degree AV Heart Block

Second Degree AV Heart Block, type 2

The P waves are equally spaced but not every P has a QRS, there are extra Ps thrown in

2nd Degree AV Block, type 2

2nd Degree Type 1 AV Block/ Wenckebach

PRI gets longer and longer until conduction is blocked all together and P wave stands alone, then stats over. Thus irregular, R to R is is different (gets longer).

2nd Degree Type 1 AV Block/ Wenckebach

3rd Degree Heart Block

A complete heart block such that atria and ventricleas are totally disassocitated, 20- 60 bpm. P wave are totally out of sync with QRS. BUT P too P is regular and QRS to QRS is regular. note- QRS can be wide or narrow.

3rd Degree Heart Block

 What is the difference between a 2nd degree type 1 (Wenckebach) and a 3rd degree heart block?

The wenckebach is irregular and the 3rd degree is regular P to P and R to R

When assessing a wave, what do you look at?

Regularity (ectopic beats?

QRS complex (wide or narrow?)

Rate (is atrial the same as ventricular?)

P Waves (regular, alike, upright?)

PRI (constant, w/in range?)