ECG Arrhythmia Section review

Impulses down on the side of the branches are delayed therefore one of the ventricles will contract a fraction of a second slower than the other is called

Bundle Branch Block

What to include when Reporting results for an ECG

Include pt. name, date, ID number, doctor, cardiac history and any relevant medication that the pt. is on. Make sure any changes in paper speed or amplitude are noted Also note any special positioning of pt. or electrodes

Stress testing when is it used

Indicated for pt. with symptoms such as pain or fatigue, that show no abnormalities on resting EKG Noninvasive Need informed consent

What is a pacemaker

Small battery operated pulse generator. The permanent pacemakers are self contained and last 3 -12 years

Describe AC interference & what causes it

Standard electrical current from the wall socket, shows up as regular peaks of spiked lines Always use 3 pronged plug, wires not crossed keep away from metal tables and x-ray equipment

Exercise electrocardiograph

Stress test Noninvasive continuous EKG with blood pressure monitoring, this is done during increasingly demanding exercise. Consent needed due to increased risk of MI or stroke

Heart block is

conditions in which the electrical impulse is delayed or blocked in the AV node this is electrical not in arteries

2nd degree Heart block occurs in

cycles of delayed impulses until SA node fails to conduct the AV node Then heart rhythm returns to normal

Ventricular Tachycardia

fast heart beat that starts in the ventricles. It usually requires prompt intervention

What is a PAC and where does Rhythm originate

premature atrial contractions - cause atria to contract ahead of anticipated time originating from the atria

What is a PVC and where does Rhythm originate

premature ventricular contractions -start in the ventricles, Extra beat sooner than normal, a pause and then the next beat is more forceful

If PVC if every 4th beat

quadieminal rhythm

What is Atrial Flutter and where does Rhythm originate

rapidly fired signals cause the muscles in atria to contract quickly leads to a very steady fast heartbeat originating from the atria

Rhythms usually originate in

the SA node

If PVC if every third beat

trigeminal rhythm

Cardiac event monitoring - Infrequent Intermittent symptoms when symptoms occur

turn on recorder and transmit signals over the phone to a monitoring center

Ventricular fibrillation

ventricles contract in a rapid, unsynchronized, uncoordinated fashion. Little or no blood is pumped out. Immediate treatment is needed, often defibullation

Normal heart rate is

60 - 100

Types of Artifacts 4

AC interference Wandering baseline Somatic tremors Baseline Interruption

What is Holter monitor

Ambulatory EKG machine with 24 hour reading

Asystole

An abnormal heart rhythm characterized by the absence of electrical activity, because there is no electrical activity there is no heartbeat. The outcome is death if not immediately reversed

Describe Wandering baseline & what causes it

Baseline not level Electrodes too tight or loose Electrodes pulling away from the pt. skin. Tape wires if needed

what is an Arrhythmia

Any deviation from the normal electrical rhythm of the heart

What is Atrial Fibrillation and where does Rhythm originate

Atria emits uncoordinated electrical signals. Pumps too fast, unevenly does not fully contract serious heart abnormality originating from the atria

Procedure for stress testing

Pt. to arrive in comfortable clothes Attach pt. to cardiac monitor Pt. exercises EKG used to monitor closely during exercise session

3rd degree heart block

Complete heart block, no impulses from SA node. Very slow rate, Pt. weak and fainting. Will be transferred immediately to hospital for pacemaker

Used to discharge strong electrical current into a pt.'s heart , interferes with uncoordinated action & allows the SA node to resume control

Defibullators

When is Holter monitor used

For intermittent symptoms

when performing a Pediatric ECG follow this procedure

If pt. is under 10 yrs. Of age, some facilities doing ECGs want the V3 electrode placed on the Right side of the chest, (at same position as if it were on the left) Carefully count the ICS

What is Sinus tachycardia

Impulse originates in the SA node heart rate above 100 bpm

what is Sinus bradycardia

Impulse originates in the SA node heart rate less than 60 bpm

What is Sinus arrhythmia

Impulse originates in the SA node rate between 60 and 100 Rhythm is irregular heart rate increases with inspiration decreases with expiration

Instruction for PT. when using a Holter Monitor

Instruct pt. no baths, showers or electric blankets Pt. must journal all activities ex: eat, sleep & bowel movements (include emotions)

The inability of the left side of the heart to pump into the systemic circulation. Back-up behind the left ventricle causes accumulation of fluid in the lungs.

Left Heart Failure

what is Mounting the ECG

Means preparing it to be read Single channel - a section from each lead is cut & applied with a special sticky backing include any arrhythmias, label as needed Multi channel - does not need to be mounted

The inability of the right side of the heart to adequately pump venous blood into the pulmonary circulation. This causes a back-up of fluid in the body, resulting in swelling and edema.

Right Heart Failure

Pacemakers Needed when

SA node fails to maintain a normal heart rate or if drug therapy designed to cause effective regular beats fails to correct the situation.

Cessation of sinus node activity marked by absence of normal P waves is called

Sinus arrest

Describe Somatic tremors & what causes them

Unnatural baseline deflection caused by muscle tension or talking, it is also caused by and physical problem that causes tremors Make pt. warm and comfortable. If necessary palms facing flat under the buttocks

Describe Baseline interruption & what causes it

When the pt. moves around or there is a break in the connection, if it only happens on some of the leads it is probably due to a loose connection

A PVC can be ,_______or ______ may require immediate medical intervention to decrease irritability

benign or deadly

If PVC every other beat

bigeminal rhythm