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Atrial Dysrhythmias
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Atrial Fibrillation
Description
Atrial Fibrillation occurs when multiple electrical impulses occur within within the atria. This chaotic electrical activity results in a chaotic wave form between the QRS complexes. P waves are absent. They are replaced by lower case "f" waves. No P waves means there is no PR interval measurement.
This rapid electrical activity overwhelms the AV node causing impulses to enter the ventricular conduction system at irregular points. This results in irregular R to R intervals.
Analysis
Not all fibrillatory waves are created equal. The "f" waves can be coarse (majority measure 3 mm or more) or can be fine (majority of waveforms measure less than 3 mm) to almost absent. Regardless always report your observations. Many times when a patient has "new onset" Atrial Fibrillation the patient will report with a heart rate of 160 bpm or more.
Mechanisms
When a patient experiences A-fib, the atria are not contracting as they normally would. They are just quivering. This absence of contraction of the atria can result in a loss of cardiac output anywhere from 15 - 30% due to the absence of "atrial kick". This is why the heart rate is so high. The body is trying to maintain homeostasis.
It will be impossible to determine the atrial rate. You will only be able to analyze and report the ventricular rate.
Atrial Fibrillation with a ventricular response in excess of 100 bpm is commonly referred to as Atrial Fibrillation with “rapid ventricular response” or "uncontrolled A-fib".
Practice Strip
Atrial Fibrillation - Practice Strip
Analyze this tracing using the five steps of rhythm analysis.
Compare your answers with the answers on the next slide.
Answers
Atrial Fibrillation - Practice Strip - Answers
Rhythm: Irregular
Rate: Ventricles - 90, Atria - Unable to determine (UTD)
P wave: "f" waves
PR interval: absent
QRS: 0.08
Interpretation: Atrial Fibrillation
Lessons
Overview
Rhythm Analysis Method
Interpretation
Premature Atrial Complex
Wandering Atrial Pacemaker
Multifocal Atrial Tachycardia
Atrial Flutter
Atrial Fibrillation
Test Questions 1-5
Test Questions 6-9
Test Questions 10-14
Test Questions 15-18
Test Questions 19-22
EKG Self Test
Next Lesson »
Description
Atrial Fibrillation occurs when multiple electrical impulses occur within within the atria. This chaotic electrical activity results in a chaotic wave form between the QRS complexes. P waves are absent. They are replaced by lower case "f" waves. No P waves means there is no PR interval measurement.
This rapid electrical activity overwhelms the AV node causing impulses to enter the ventricular conduction system at irregular points. This results in irregular R to R intervals.
Analysis
Not all fibrillatory waves are created equal. The "f" waves can be coarse (majority measure 3 mm or more) or can be fine (majority of waveforms measure less than 3 mm) to almost absent. Regardless always report your observations. Many times when a patient has "new onset" Atrial Fibrillation the patient will report with a heart rate of 160 bpm or more.
Mechanisms
When a patient experiences A-fib, the atria are not contracting as they normally would. They are just quivering. This absence of contraction of the atria can result in a loss of cardiac output anywhere from 15 - 30% due to the absence of "atrial kick". This is why the heart rate is so high. The body is trying to maintain homeostasis.
It will be impossible to determine the atrial rate. You will only be able to analyze and report the ventricular rate.
Atrial Fibrillation with a ventricular response in excess of 100 bpm is commonly referred to as Atrial Fibrillation with “rapid ventricular response” or "uncontrolled A-fib".
Practice Strip
Atrial Fibrillation - Practice Strip
Analyze this tracing using the five steps of rhythm analysis.
Compare your answers with the answers on the next slide.
Answers
Atrial Fibrillation - Practice Strip - Answers
Rhythm: Irregular
Rate: Ventricles - 90, Atria - Unable to determine (UTD)
P wave: "f" waves
PR interval: absent
QRS: 0.08
Interpretation: Atrial Fibrillation
Next Lesson »
Table of Contents
Overview
Rhythm Analysis Method
Interpretation
Premature Atrial Complex
Wandering Atrial Pacemaker
Multifocal Atrial Tachycardia
Atrial Flutter
Atrial Fibrillation
Test Questions 1-5
Test Questions 6-9
Test Questions 10-14
Test Questions 15-18
Test Questions 19-22
EKG Self Test