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ECG Module 4 Atrial Dysrhythmias Exam Questions and Complete Solutions Graded A+
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ECG Module 4 Atrial Dysrhythmias Exam Questions and Complete Solutions Graded A+
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ECG Module 4 AtrialDysrrhythmias Exam
Questions and Complete
Solutions Graded A+
Denning [Date] [Course title]
, Atrial rhythms - Answer: Atrial rhythms originate in tissue other than the sinus node, (therefore, these
rhythms are not sinus rhythms). The origin for these rhythms can not always be pinpointed, but we
know that they originate somewhere in the atrial tissue. They are generally the result of irritable tissue
in the atria known as irritable foci
Atrial Tissue - Answer: The atrial tissue is an interesting area of the myocardium. The atrium is not
considered a pacemaker of the heart, but it has the ability to usurp the normal sinus rhythm with its
irritability (especially when ischemic) and produce very rapid heart rates. This is often the issue with
atrial rhythms, they are rapid and compromise cardiac output quickly.
• *Enhanced automaticity from ischemia*
• So atrial dysrrhythmias tend to be tachycardic
Premature Atrial Complexes - Answer: These are beats that escape from the atrial tissue despite an
adequate normal sinus rhythm. They arrive early and are therefore, called premature. Because they are
early beats, and because they come from the atrial tissue as opposed to the sinus node, they are timed
differently and they look differently. So the patient may be pumping along at a
normal rate and rhythm and suddenly have a premature atrial complex. It will look like the picture.
There are two premature atrial complexes in this strip. The third complex is early and the sixth complex
is early.
• Notice that the remainder of the strip reflects a normal sinus rhythm with a normal and consistent P
wave and PR interval.
• Notice that the QRS complex looks similar to the usual complex and is of the same width.
• Often times the premature P wave will come so early that it falls on top of or on the down slope of the
T wave and may be buried there and not noticed until someone checks the R to R intervals and finds
that they are inconsistent.
• This is easy to see if the rhythm is 60 - 80, however, when the rhythm is 90 -
100, it is less obvious.
Criteria for Premature Atrial Contractions (PACs) - Answer: • The strip looks like a NSR with a slight
interruption in regularity. This will be obvious based on the R - R intervals.
• The rate can be bradycardic, tachycardic or normal. *(but is usually tachycardic or normal)*
• P Waves are similar for normal beats, but have a differing morphology for the premature complex.
*Remember that P waves can be "hidden" in the T wave, so look for differences in the way the T wave
looks*
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