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    Ecg Notes

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    Aszhi
    This document describes several cardiac arrhythmias including sinus bradycardia, sinus tachycardia, sinus arrhythmia, first-degree AV block, second-degree AV block types 1 and 2, third-degree AV block, atrial flutter, atrial fibrillation, premature ventricular contractions, ventricular tachycardia, ventricular fibrillation, pulseless electrical activity, and asystole. For each arrhythmia, the rhythm, rate, P wave, PR interval, and QRS complex are defined, as well as common causes and recommended treatments.

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    Ecg Notes

    Uploaded by

    Aszhi
    103 views16 pages
    This document describes several cardiac arrhythmias including sinus bradycardia, sinus tachycardia, sinus arrhythmia, first-degree AV block, second-degree AV block types 1 and 2, third-degree AV block, atrial flutter, atrial fibrillation, premature ventricular contractions, ventricular tachycardia, ventricular fibrillation, pulseless electrical activity, and asystole. For each arrhythmia, the rhythm, rate, P wave, PR interval, and QRS complex are defined, as well as common causes and recommended treatments.

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    ECG NOTES

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    This document describes several cardiac arrhythmias including sinus bradycardia, sinus tachycardia, sinus arrhythmia, first-degree AV block, second-degree AV block types 1 and 2, third-degree AV block, atrial flutter, atrial fibrillation, premature ventricular contractions, ventricular tachycardia, ventricular fibrillation, pulseless electrical activity, and asystole. For each arrhythmia, the rhythm, rate, P wave, PR interval, and QRS complex are defined, as well as common causes and recommended treatments.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    103 views16 pages

    Ecg Notes

    Uploaded by

    Aszhi
    This document describes several cardiac arrhythmias including sinus bradycardia, sinus tachycardia, sinus arrhythmia, first-degree AV block, second-degree AV block types 1 and 2, third-degree AV block, atrial flutter, atrial fibrillation, premature ventricular contractions, ventricular tachycardia, ventricular fibrillation, pulseless electrical activity, and asystole. For each arrhythmia, the rhythm, rate, P wave, PR interval, and QRS complex are defined, as well as common causes and recommended treatments.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 16

    SINUS BRADYCARDIA

    RHYTHM: Regular
    RATE: less than60 bpm
    P WAVE: Normal
    PR INTERVAL: Normal
    QRS COMPLEX: Normal
    CUASE: weakened or damaged sinoatrial (SA) node, severe or
    chronic hypoxemia, increased intracranial pressure,
    obstructive sleep apnea, and certain drugs (most
    notably the beta-blockers).
    TREATMENT: Correction of the underlying cause
    Atropine or epinephrine to maintain heart rate
    Dopamine for hypotension
    SINUS TACHYCARDIA

    RHYTHM: Regular
    RATE: >100/ <160 bpm
    P WAVE: Normal
    PR INTERVAL: Normal
    QRS COMPLEX: Normal
    CAUSE: hypoxemia, severe anemia, hyperthermia, massive
    hemorrhage, pain, fear, anxiety, hyperthyroidism,
    and sympathomimetic or parasympatholytic drug
    administration.
    TREATMENT: eliminating the underlying cause, such as pain
    relievers, fever reducers (antipyretics),
    fluids, or oxygen
    SINUS ARRHYTHMIA

    RHYTHM: Regularly Irregular


    RATE: Normal
    P WAVE: Normal
    PR INTERVAL: Normal
    QRS COMPLEX: Usually narrow <0.12
    CAUSE: may occur with the effects of breathing on the
    heart or as a side effect of medications such as
    digoxin.
    TREATMENT: do not need treatment
    FIRST-DEGREE AV BLOCK

    RHYTHM: Regular
    RATE: Usually Normal
    P WAVE: Normal
    PR INTERVAL: Prolongation (>0.20)
    QRS COMPLEX: Usually Normal
    CAUSE: common after an MI that damages the AV node, or it
    may be a complication of certain medications, such
    as digoxin or beta blockers.
    TREATMENT: not needed for 1st-degree AV block if the
    patient is able to maintain an adequate blood
    pressure
    SECOND-DEGREE AV BLOCK TYPE 1

    RHYTHM: Regularly Irregular


    RATE:
    P WAVE: (Normal P wave) Extra P waves
    PR INTERVAL: No discernable P wave
    QRS COMPLEX: Usually Normal
    CAUSE: After Cardiac surgery, Myocarditis, Drugs (CA
    blockers)
    TREATMENT: not needed because it usually does not impair
    cardiac output or cause symptoms
    SECOND-DEGREE AV BLOCK TYPE 2

    RHYTHM: Atrial (regular); Ventricular (irregular)


    RATE: Typically bradycardic
    P WAVE: (Normal P wave) Extra P waves
    PR INTERVAL: Constant
    QRS COMPLEX: Usually Normal
    CAUSE: Cardiac Surgery, MI, Hyperkalemia
    TREATMENT: Atropine, dopamine, or epinephrine
    administration, for symptomatic bradycardia
    (Atropine may worsen ischemia with MI.)
    Temporary or permanent pacemaker
    THIRD-DEGREE AV BLOCK

    RHYTHM: Usually Regular


    RATE: 40-60/<40 bpm
    P WAVE: (Normal P wave) Extra P waves
    PR INTERVAL: Variable (not measurable)
    QRS COMPLEX: Usually Normal
    CUASE: MI or drug toxicity (especially digitalis)
    TREATMENT: medication to speed up the ventricles and
    possibly a temporary external pacemaker until
    a permanent one can be placed
    ATRIAL FLUTTER

    RHYTHM: Regular
    RATE: 250 to 350 bpm
    P WAVE: “Saw tooth”
    PR INTERVAL: Normal constant
    QRS COMPLEX: Normal
    CAUSE: rheumatic heart disease, coronary heart disease,
    pulmonary embolism, stress, renal failure, and
    hypoxemia.
    TREATMENT: Digoxin, β blockers, or calcium channel
    blockers
    Synchronized cardioversion immediately if
    patient is unstable
    ATRIAL FIBRILLATION

    RHYTHM: Regularly Irregular


    RATE: 400 to 700 bpm
    P WAVE: None
    PR INTERVAL: No discernable P wave
    QRS COMPLEX: Normal
    CAUSE: Similar to the causes of atrial flutter
    Can lead to a significant reduction in cardiac output
    resulting from the loss of the atrial kick
    TREATMENT: anticoagulant medications, beta blockers and
    calcium channel blockers, synchronized
    cardioversion
    PREMATURE VENTRICULAR
    CONTRACTION

    RHYTHM: Irregular during PVC; underlying rhythm may be


    regular
    RATE: Patterned after underlying rhythm
    P WAVE: No P wave
    PR INTERVAL: Unmeasurable
    QRS COMPLEX: Unique and bizarre, much wider than normal
    CAUSE: stress, caffeine intake, nicotine use, or electrolyte
    imbalance
    TREATMENT: If warranted, procainamide, lidocaine, or
    amiodarone administration
    Treatment of underlying cause
    Potassium chloride I.V. if induced by
    hypokalemia
    VENTRICULAR TACHYCARDIA

    RHYTHM: Usually Regular


    RATE: 100 to 250 bpm
    P WAVE: None
    PR INTERVAL: None
    QRS COMPLEX: .0.12
    CAUSE: MI, coronary artery disease, and hypertensive heart
    disease
    TREATMENT: Monomorphic VT with pulse: Give amiodarone,
    using Advanced Cardiac Life Support (ACLS)
    protocol; if unsuccessful, synchronized
    cardioversion
    Polymorphic VT with normal QT interval: Amiodarone or
    sotalol using ACLS protocol; if unsuccessful, synchronized
    cardio version
    Polymorphic ventricular tachycardia with prolonged QT
    interval: Stop drugs that may prolong QT interval and treat
    electrolyte imbalances
    Pulselessness: Initiate cardiopulmonary resuscitation (CPR)
    and follow treatment for ventricular fibrillation
    VENTRICULAR FIBRILLATION

    RHYTHM: Chaotic; Fine/Coarse


    RATE: None
    P WAVE: None/Absent
    PR INTERVAL: None/Absent
    QRS COMPLEX: No discernable
    CAUSE: Previous Heart attack, Sepsis and insufficient blood
    flow to the heart muscle.
    TREATMENT: Rapid defibrillation, cardiopulmonary
    resuscitation, and administration of O2 and
    antiarrhythmic medications
    PULSELESS ELECTRICAL ACTIVITY

    Electrical activity is present on ECG but heart muscle can’t


    contract
    Result is no palpable pulse or blood pressure and cardiac
    arrest

    CAUSE: Generally does not occur without a precipitating


    event, such as a tension pneumothorax, MI, drug
    overdose, or severe electrolyte or acid-base
    disturbance
    TREATMENT: Emergency life support, and the immediate
    reversal of the underlying cause.
    ACLS protocols: Initiation of CPR, Epinephrine,
    Atropine for bradycardia
    ASYSTOLE

    RHYTHM: None
    RATE: None
    P WAVE: No discernible
    PR INTERVAL: No discernible
    QRS COMPLEX: No discernable
    CAUSE: Anything that causes inadequate blood flow to the
    heart
    TREATMENT: CPR, following ACLS protocol
    Endotracheal intubation
    Transcutaneous pacemaker
    Treatment of underlying cause
    Repeated doses of epinephrine and atropine,
    as ordered

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