Conduction
↳
electrical
activity
coronary perfusion
atrial depolar
Pa
-makers
ventrepolar
In
to stimulate
mechanical act CONTRACTION
↳ electrical first, then mechanical and
=
↳ records
↳
on
④
-
2) signal
to
sent
3) right atrium
↳ Bundle of His
no more than
3 b0xeS
vent.depolar
↳
Purkinje Fibers
·
TWAVE
(repolar of
resetting
=
-320x20 1 sec
↳ tie mark-tie mark
=
60 100
-
2) determine rhythm (R R)
#wave
-
·
↳ diastolic deflection
L should go back to isoelectric
line
upright U "normal"
more prominent w/hypo
-
Kalemia
3
6 second strip
=
regular irregular
evaluate "p"waves
p to QRS ratio
(measure/evaluate intervals
PR 0.12-0.2
=
①T 0.36
QRS 0.06 -0.10
=
=
-
greater than
0.4L)-ifhypokalemia
-
complex
-
↳ 5x5 0.2 secs
1) determine HR
QRS
15 40
res
#thod
&
Bundle Branches
Info .kG-Paper
#Basic
-
(AV)
↳
·
SIMUTANEOUSLY
1
PR
Interval
-
-
4) AV node delayed vent. fill time
5) after delay PR interval
triggers ventri.contract.
↳
-
-
AV
A.
deporalizes first
60 100
-
of the G
SA Node- pacemaker
(SA)
pwave/pace M!
In Atmoventricular
40 60
depolarization (contractonequickly
S
-quence
1)
-
EKG
spreads to all
Sinoatrial Node
also depends
on HR
vent)
e
DaCeMaher"SRe
Conduct
Atr.
↳ Bundle of HIS
penetrates
·
↳ Athoventricular values
Avalve (bridge)
↳ LOR Bundle Branches
surround ventricles
-
onlypathway
·
PurKingle Fibers
-
-
thIS
fast moving Nations
for depolarization
Uses
Automaticity
Lo
is
it?
bunch
of
-
SicK
Location?
·
·
·
AU Node
-
-
Internodal Tracts
Middle & Distal
·
Ventricular foci
[Lb AV node solepathwaythru
-
In
for depolarization
AU values
SA node
-
-
to AUnode
brief pause (for vent. filling
meds that slow AV node
BetaBlocker LnCalclum
-
·
ISA node pacing
I rate conduct/contract
·
·
of focci
-
DIgOXI
Calcium
long
Channel
Amiorodone
make deporalization ster
sodium ions
↳sympathetic #Node
cholinergic
↳
receptors
·
Atria Focci
the ventri. from the atria
adrenergic
pirritability
ventlatua
ELECTRICALLY INSULATES
-
pacemaker cells
node suppress other foci
SA
becomes
fails when the
·
-mpathetic
↳ Cardiac B,
#
↳ What
from atria-rent
both made up of
at
prevent backflow
·
·
-
AU JUNCTION
Purkinje Fibers
SA
node pacing
↓rate conduct/contract
·
irritability
atrial/junctionand
i)
I
delays
for
ventr.filling time
controls the # of impulses
-
prevents irregular atria rhythms
3) back up pacemaker
4) retrograde (backwards)
-
-
atria falls it
can
backwards
takes longer
send
pulse
Arodycardia
↳
CaUse?
meds
·
·
->
[beta blockers]
athletes
·brain injury
symptomatic?
hypotension
-
-
-
-
-
ALOC
chest discomfort
SOB
shOcKSIS
#becausedby.sAatracellAvventricalI
ATROPINE Δ
Q3-5 mins
MAX:3mg
Transcutaneous
Pacing
-RAMINE
INin
A
INF
EPINEPHRINE
-
2-10mcglmin
e
Procainamide IVI
EX: VTACH
20-50mglmin until
L only
-
narrow
complex
~
IV
& Amiodarone
1st:
Maintenance:Img. min
Sotalol IVevoid
100mg/5mins
if
-
-
->
prolonged
QRT
(1.5mg/kg)
* Adenosine
1st-Omg
2nd -12mg
IV rapid
push
PE
Chronic I) Failure
symptomatic?
hypotension
-
-
-
-
-
⑤
drug
(GHRS)
dehydration
-
ALOC
chest discomfort
SOB
shOcKSIS
↳ Yes?
IS
-
a
150mg/10min
anxiety
-
ensures
MAG
PaIn
-
QRS duvi. 450%
MAX of ImglIg
maintenance:1.4mglmin
medsatropine
bronchodilators
fevers
-
rhythmia supp
hypotens
-
QRS-DEX: AFib
#row
Synchronized Cardioversion
adenosine
CaUSeS:
-
Q RT
SUT, A Flutter
&UT
LD
avoid if prolonged
-
1st dose:Img Bolus
↳ HR:101-150
w/pulse Tach]DE
=
↳ Treatment
Echycardia
see
-
synchronized
cardiovers.
If narrow-adenosine
No?
QRS2
#E
↳
Yes?
-
-
adenosine/regular &
No?
-
-
-
monomorph.
antiarrhythmic infusions
vagal
maneuvers
Adenosine
BB or CCB
-
regular
.
FlUtterircular
course in atria
↳
regular
or
irregular
↳ no P/F waves
↳ normal QRS
F waves:sawtooth appear
↳
Cause?
↳
C7dZ, PE, lung dz
Treatment?
Anticoagulants
Betablockers
↳ premature atrial contraction
↳ can fire from
a
L event, not
a
foci
Digoxin
↳
↳
HR:151-250
pwares diff. to
SETS IPPRIntevale
rhythm
EN
A7
-
·
identify
Vagal maneuvers
bearing down
stimu.parasymp
MEDS
-
-
-
·
*
&pranoversiorn hythmias1
W/10.20mL same e
ENOSINE
Fib
I
Trial
Caloum Channel
-
&Iventri
origin above
↳
↑
↳
-
HAC
o v
If
Lo
V-metroRam
pathways
IRREGULAR
always
↳ Chaotic random
I
waves
nopwares/f
↳normal QRS
↳y
cause?
·
MI, lung dz, valuul.Ddz,
hyperthyroidism
I2mgIV PUSHW/10.20mL
saline
cardioversion (50 -100 Joules)
& Ist if unstable
·
↑ risk for STROKE
↑-
Anticoagulants
Betablockers
Cardioversion
If unstable
Caloum Channel
-
Digoxin
irregular
fantast
Injector]
#Fib
Treatment
Treatment in Detail
↳
Chemical Cardioversion
EX:AMIODARONE
-
oral
vers used
for
longterm
Rate Control
Ex:Calcium, digoxin, beta block
-11
Imbalayan]
regular
-
amiodarone
·monitor for
-
TRANSESOPHAGEAL
·
postdysrhytmic
effects
Identifies thrombi
atria
·
management
↳
#ib/AFlutter
Echocardiogram
in
fibrillating
I
NO THROMBI?
↳n
screening tool before cardioversion
Trial
Arrhythmias
⑭
sedated, then
cardioverted
#JC
HACs
La
--
premature atrial
contraction
L premature
LP
·
pwares
present/upright
normal QRS
Lp caused by caffeine
Beatsinverted
#
Early
normal QRS
oo
Beats
o
#G
↳ premature
ventricular contraction
LP Caused?
↳
·Cfdz, hypokalemia, hypoxia
symptomatic?
AMIODARONE
↳ classification
early beat
nopware
Wide QRS
DIGOXIN TOXICITY
In classification
earlybeattested absent
If frequent
Early
multiple--UTACH
O
·
O
o
nopwave
wide QRS
⑧
hidden
O
O
inverted P
⑧
O
·
·
junctional
CaUse?
-
·
·
We
contraction
L classification?
early beat
·
multison.
**