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atrial rhythms Flashcards

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1
Q

Where do atrial rhythms originate?

A

Atrial tissues or internodal pathways

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2
Q

What are the main atrial rhythms?

A

Atrial Flutter, Atrial Fibrillation, Supraventricular Tachycardia, Premature Atrial Complexes (PACs – ectopic beats)

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3
Q

Rate of Atrial Flutter?

A

250–400 BPM

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4
Q

Rate of Atrial Fibrillation?

A

350–400 BPM

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5
Q

Rate of Supraventricular Tachycardia (SVT)?

A

150–250 BPM (ventricular), up to 150–250 BPM (atrial)

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6
Q

Rhythm of Atrial Flutter?

A

Regular (ventricular may be irregular)

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7
Q

Rhythm of Atrial Fibrillation?

A

Irregularly irregular

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8
Q

Rhythm of SVT?

A

Regular

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9
Q

Are there P waves before QRS in Atrial Flutter?

A

No (sawtooth flutter waves instead)

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10
Q

Are there P waves before QRS in Atrial Fibrillation?

A

No (no discernible P waves)

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11
Q

Are there P waves before QRS in SVT?

A

Hidden in QRS

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12
Q

Are P waves uniform in Atrial Flutter?

A

No (sawtooth pattern)

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13
Q

Are P waves uniform in Atrial Fibrillation?

A

No

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14
Q

Are P waves uniform in SVT?

A

Hidden in QRS (not visible)

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15
Q

PR interval in Atrial Flutter?

A

Cannot measure

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16
Q

PR interval in Atrial Fibrillation?

A

Cannot measure

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17
Q

PR interval in SVT?

A

Cannot measure

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18
Q

QRS complex in all atrial rhythms?

A

Yes, 0.06–0.12 sec (1.5–3 boxes), unless affected by conduction abnormality

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19
Q

What is the hallmark ECG pattern of Atrial Flutter?

A

Sawtooth pattern, often 3:1, 4:1, or 6:1 conduction

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20
Q

Symptoms of Atrial Flutter?

A

Syncope, palpitations, SOB, anxiety, weakness, angina

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21
Q

Causes of Atrial Flutter?

A

Age >60, valve disorder (mitral), cardiomyopathy, COPD/emphysema

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22
Q

Treatments for Atrial Flutter?

A

Antiarrhythmics (amiodarone), rate control (beta blockers, calcium channel blockers), cardioversion, anticoagulation (heparin)

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23
Q

When might no treatment be needed in Atrial Flutter?

A

If HR is 60–100 BPM and patient is asymptomatic

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24
Q

Treatment for atrial flutter when asymptomatic but the BPM is over 100

A

Give something to slow down the HR- slow ventricular rate with BB or CCB

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25
Treatment for atrial flutter if symptomatic and stable
Antiarrythmics (amiodarone), can give when starting to have aymptoms
26
Treatment for atrial flutter when unstable and symptomatic
Cardioversion
27
Risks of Atrial Flutter?
Clot formation (CVA/PE), dramatic drop in cardiac output
28
Nursing interventions for Atrial Flutter?
Assess symptoms, O2/SPO2, BP/HR, IV, notify provider, prep for cardioversion if unstable
29
ECG hallmark of Atrial Fibrillation?
Irregularly irregular rhythm, no P waves, wavy baseline
30
Symptoms of Atrial Fibrillation?
Syncope, dizziness, irregular pulse, confusion, fatigue, SOB (esp. lying down), chest tightness
31
Causes of Atrial Fibrillation?
Hypoxia, hypertension, hyperthyroid, CHF, CAD, sinus node dysfunction, rheumatic heart disease, pericarditis, alcohol, caffeine
32
Target HR in Afib treatment?
<100 BPM
33
Treatments for Atrial Fibrillation?
Digoxin, beta blockers, calcium channel blockers, amiodarone, anticoagulation, cardioversion (chem/electrical)
34
When to do nothing for Atrial Fibrillation?
If HR <100 and patient is asymptomatic
35
Why are anticoagulants important in Afib?
To reduce risk of clots (CVA/PE)
36
Risks of Atrial Fibrillation?
Stroke (CVA), pulmonary embolism, decreased cardiac output
37
Nursing interventions for Atrial Fibrillation?
O2/SPO2, BP/HR, IV access, notify provider, prep for cardioversion if unstable
38
What is Rapid Ventricular Response (RVR) in Afib?
HR >100, requires rate control (diltiazem drip commonly used)
39
Stable Afib with RVR treatment?
Diltiazem or beta blocker for rate control
40
Unstable Afib with RVR treatment?
Cardioversion (sedation if possible)
41
Typical HR in SVT?
>150 BPM
42
Symptoms of SVT?
Syncope, dizziness, chest pain, SOB, pounding pulse, throat tightness, fatigue, sweating, polyuria
43
Causes of SVT?
Stimulants, hypoxia, hypokalemia, stress, atherosclerosis
44
Treatments for SVT (stable)?
Vagal maneuvers, adenosine (6 mg → 12 mg), cardioversion if unsuccessful
45
Treatments for SVT (unstable)?
Immediate cardioversion (with or without sedation)
46
Risks of SVT?
Heart failure if prolonged
47
Nursing interventions for SVT?
Assess stability, O2/SPO2, BP/HR, IV access, vagal maneuvers, notify provider, prep for cardioversion
48
What is considered a normal ventricular rate in A-fib?
60–100 bpm
49
If a patient with A-fib has a HR within 60–100 bpm and no symptoms, what is the intervention?
May not do anything
50
What is the treatment for a symptomatic but stable A-flutter patient?
Antiarrhythmics (e.g., amiodarone)
51
When can antiarrhythmics like amiodarone be given?
When patient is symptomatic and starting to have symptoms, but stable
52
If a patient is asymptomatic but has HR > 100 bpm, what is the treatment goal?
Slow down the heart rate
53
Which drugs are used to slow ventricular rate in A-fib?
Beta blockers or calcium channel blockers
54
What is the intervention for a symptomatic and unstable A-fib patient?
Cardioversion
55
What does “Rapid Ventricular Response (RVR)” mean in A-fib?
HR > 100 bpm
56
Why does RVR in A-fib need intervention?
Need to control the ventricular rate
57
How is stable, symptomatic A-fib with RVR treated?
Rate control (diltiazem drip/Cartiazem drip)
58
How is stable, asymptomatic A-fib with RVR treated?
Still treat the heart rate (commonly with diltiazem/Cartiazem drip)
59
How is unstable, symptomatic A-fib with RVR treated?
Prepare for cardioversion
60
Is sedation always required for cardioversion?
Not always; depends on the physician and situation (preferred if possible since it’s painful)
61
If a patient remains in A-fib but HR is controlled (<100 bpm), what is the management approach?
It is considered acceptable; no need for cardioversion again
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