Atrial Rhythms

Question 1

What is the key characteristic of wandering pacemaker?

Answer 1

Caused when pacemaker role switches from beat to beat between the SA node to the atria and back again

Question 2

What will help you identify a wandering pacemaker?

Answer 2

The morphology of the p wave changes based upon the pacemaker site. There is a p wave for every QRS, but it may be more difficult to see depending upon the pacemaker site

Question 3

What are the rules for PAC’s?

Answer 3

1. ) regularity will be interrupted by PAC
2. ) rate depends on underlying rhythm
3. ) p wave of PVC WILL DIFFER from underlying p waves; may be flattened or notched
4. ) PRI 0.12-0.20
5. ) QRS less than 0.12

Question 4

What are the rules for atrial tachycardia?

Answer 4

1. ) regular
2. ) 150-250
3. ) will have atrial p waves, can be lost in T wave
4. ) PRI 0.12-0.20
5. ) QRS less than 0.12

Question 5

What are the rules for Afib?

Answer 5

1. ) grossly irregular
2. ) atrial rate above 350, ventricular varies
3. ) p waves are discernible/fibrillatory
4. ) PRI is unable to measure
5. ) QRS is less than 0.12

Question 6

What are the rules for Aflutter?

Answer 6

1. ) atrial rate is regular
2. ) atrial rate 250-350
3. ) p waves are sawtooth
4. ) PRI is unable to determine
5. ) QRS is less than 0.12