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EKG Basics
Echo school
| Term | Definition |
|---|---|
| PRI | PR interval. Time from the start of the onset of the P wave to the start of the QRS complex. Reflects conduction through AV node. |
| Duration of PRI | .12-.20 sec (three to five small squares) |
| Atrial dysrhythmia | Dysrhythmia that orginates outside of the SA node. Impulse generates in atrial tissue or internodal pathways |
| Accessory pathway | An irregular muscle connection between the atria and ventricles that bypasses the AV node |
| WAP | Wandering atrial pacemaker rhythms. When pacemaker sites wander from the SA node to other pacemaker sites in the atria, internodal pathways or AV node |
| MAT | Multifocal atrial tachycardia, a variation of WAP, in which the rate of the WAP rhythm exceeds 100 bpm |
| PAC | Premature atrial complex/contraction. A single impulse that originates outside the SA node in the atria |
| Noncompensatory pause | Often follows a PAC |
| PAC pair | two sequential PAC's |
| Atrial bigeminy | every other beat is a PAC |
| Atrial trigeminy | every third beat is a PAC |
| Frequent dysrhythmia | When any premature beat occurs more than 6 times per min |
| Reentry | The reactivation of myocardial tissue for a second or subsequent time by the same electrical impulse. Considered a "short-circuit" |
| Atrial flutter | Regular atrial activity with a sawtooth or picket fence pattern. Occurs when a single irritable site in the atria initiates many electrical impulses at a rapid rate. |
| AV node gatekeeper role | In afib when the AV node conducts the atrial impulse. Ratios can vary from 2:1 to 4:1. |
| SA node | Primary pacemaker of the heart; creates the "p" wave |
| AV node | Secondary pacemaker of the heart; creates the "qrs" complex |
| Junctional rhythms | Rhythms that are initiated in the area of the AV junction; not life-threatening |
| Retrograde conduction's | When the AV node is the dominant pacemaker, the electrical impulses must travel backward to stimulate the atria |
| Premature junctional contractions (PJC's) | Are initiated from a single site in the AV junction or bundle of HIS/Purkinje system and arise earlier than the next anticipated complex of the underlying rhythm. (Less common than PAC's) |
| PJC 5 Q's | Rate of the underlying rhythm plus the PJC Regular rhythm P wave is either absent or inverted and may appear after QRS PR interval less than 0.12 or absent QRS complexes are alike and less than 0.12 |
| Junctional escape rhythms | When the SA node fails to generate an impulse or if the rate of impulse falls below the AV node, then the AV node becomes pacemaker |
| Junctional bradycardia | When the rate of a junctional escape rhythm falls below 40 |
| Causes of junctional escape beats/rhythms | SA node disease, hypoxia, increased parasympathetic (vagal) tone, certain cardiac drugs, and a complete heart block |
| Causes of PJC's | Fever, anxiety, exercise, drug effects, electrolyte imbalance, congestive heart failure, stimulants, hyoxia or myocardial ischemia |
| Accelerated junctional rhythms | Increased automticity in the AV junction causing the junction to discharge impulses at a rate (60-100) faster than its intrinsic rate, resulting in dysrhythmia |
| Automaticity | The capability of the pacemaker cells of the heart to self-depolarize |
| Junctional tachycardia | When the junctional firing rate of the AV node is between 100 and 160; rare, can also be called PSVT (paroxysmal supraventricular tachycardia) |
| Causes of accelerated junctional rhythms | Ischemia of the AV junction, hypoxia, digitalis intoxication, inferior wall myocardial infarction, and rheumatic fever |
| Accelerated junctional rhythm 5 Q's | Rate btw 60-100 Regular rhythm Inverted or absent p waves, may appear after the QRS PRI less than 0.12 or absent QRS complexes alike and less than 0.12 secs |
| Paroxysmal rhythm | A rhythm that starts or ends abruptly |
| Causes of junctional tachycardia | Underlying ischemic heart disease, frequent ingestion of stimulants, anxiety, hypoxia, medications such as digitalis, rheumatic heart disease or idiopathic |
| Junctional tachycardia 5 Q's | 100-180 bpms Regular rhythm Inverted or not visible, may appear after the QRS PRI less than 0.12 or absent QRS complexes alike and less than 0.12 |
| Angina | Heart pain or SOB when the heart doesn't get enough oxygen rich blood |
| Ischemia | Diminished blood supply to any tissue or organ in the body |
| Myocardial infarction | Heart attack |
| PCI | Percutaneous coronary intervention (used to treat a heart attack) |
| Ventricular rhythms | The least efficient of the heart's different pacemakers |
| PVC | Premature Ventricular Complexes A single ectopic beat that occurs earlier than expected due to an irritable sight in the ventricles |
| Patterns of PVC | Ventricular bigeminy: occurs when every other beat is a PVC Ventricular trigeminy: occurs when every third beat is a PVC Ventricular quadrigeminy: occurs when every 4th beat is a PVC |
| Couplet | Two PVC's occuring together without a normal complex in between |
| V-tach | Three or more PVC's in a row |
| PVC 5 Q's | Rate depends on underlying rhythm and number of PVC's Occassionally irregular; regular if interpolated PVC No P waves before PVC; P waves of underlying rhythm may be present QRS complex of PVC is wide and bizarre |
| Unifocal PVC's | Look alike |
| Multifocal PVC's | Look different; are more serious than unifocal PVC's |
| Idioventricular rhythms | Ventricular escape rhythms; the heart's last ditch effort; indicates that both the SA and the AV nodes have failed; rate is less than 40 bpm's |
| Causes of V-tach | Myocardial ischemia, hypoxia, electrolyte imbalances, increased anxiety or physical exertion and underlying heart disease |
| V-tach 5 Q's | Rate 100-250 Regular ventricular rhythm No PRI All QRS complexes look alike and are greater than 0.12 |
| Torsades de pointes | Similar to V-tach, but morphology of QRS complexes shows variations in width and shape; looks like a twisty helix |
| Causes of Torsades | Hypokalemia, hypomagnesemia, tricyclic antidepressant drug overdose, use of antidysrhythmic drugs or combination of these |
| Ventricular Fibrillation | FATAL; no pulse; most common rhythm in cardiac arrest; occurs as a result of multiple weak ectopic foci |
| Fine V Fib | Waves less than 3 mm's in height |
| Coarse V Fib | Waves greater than 3 mm's in height; generally more irregular than fine V fib |
| V fib 5 Q's | No discernible rate; rapid unorganized rhythm; no p waves; no PRI; no QRS complexes |
Created by:
gillybruursema
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