Exam (elaborations)
Arrhythmias and Conduction Blocks.
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- MedSurg Notes Nurse’s Clinical Pocket Guide
Arrhythmias and Conduction Blocks.
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Arrhythmias and Conduction Blocksatrial fibrillation - ANS-rapid, random, ineffective contractions of the atrium
Atrial Flutter - ANS-· Regular, rapid atrial rhythm (rate = 220-330bpm)
Atrioventricular Heart Block - First Degree - ANS-prolonged P-R (or P-Q) interval (goes
from normal 0.16 of P-R to 0.2 for prolonged P-R/first-degree incomplete heart block).
Atrioventricular Heart Block - Second Degree Mobitz Type 1 (Wenchebach) -
ANS-Progressive prolongation of the PR interval until a ventricular beat is dropped, rest
of the PR, cycle repeats. Caused: abnormality of the A-V node.
Atrioventricular Heart Block - Second Degree Mobitz Type 2 - ANS-fixed number of
non-conducted P waves for every QRS complex. Caused: abnormality of the bundle of
His-Purkinje system
Atrioventricular Heart Block - Third Degree - ANS-Severe condition causing poor
conduction in the AV node or AV bundle means complete block of the impulse form the
atria into the ventricles. Ventricles spontaneously establish own signals in AV
node/bundle.
Left Bundle Block - ANS-Rarely seen in a healthy heart, often associated with CAD,
hypertensive heart disease, aortic valvular diseases, and others).
· Wide QRS
· Absence of initial (septal) R wave
. Abnormal ST and T waves
premature ventricular contraction - ANS-irritable focus within ventricle fires prematurely,
bypassing the His-Purkinje conduction system.
Right Bundle Block - ANS-Septal depolarization is normal (as LBB is intact);
Left ventricular depolarization normal; right ventricular depolarization delayed
- common, not diagnostic of heart disease
Sinoatrial Block - ANS-impulse from the sinus node is blocked before entering the atrial
muscle. Ventricles pick up new rhythm from spontaneous atrioventricular node
activation.
- no P waves, rate of QRS-T slowed
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