The document describes 13 different types of atrial arrhythmias, providing the identifying electrocardiogram (ECG) features of each. For each type of arrhythmia, the summary includes the rhythm, rates of the atria and ventricles, characteristics of the P waves, PR interval, and QRS complex duration. The arrhythmias described include wandering atrial pacemaker, premature atrial contractions, sinus bradycardia/tachycardia, paroxysmal atrial tachycardia, atrial flutter, and atrial fibrillation.
The document describes 13 different types of atrial arrhythmias, providing the identifying electrocardiogram (ECG) features of each. For each type of arrhythmia, the summary includes the rhythm, rates of the atria and ventricles, characteristics of the P waves, PR interval, and QRS complex duration. The arrhythmias described include wandering atrial pacemaker, premature atrial contractions, sinus bradycardia/tachycardia, paroxysmal atrial tachycardia, atrial flutter, and atrial fibrillation.
The document describes 13 different types of atrial arrhythmias, providing the identifying electrocardiogram (ECG) features of each. For each type of arrhythmia, the summary includes the rhythm, rates of the atria and ventricles, characteristics of the P waves, PR interval, and QRS complex duration. The arrhythmias described include wandering atrial pacemaker, premature atrial contractions, sinus bradycardia/tachycardia, paroxysmal atrial tachycardia, atrial flutter, and atrial fibrillation.
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Wandering atrial pacemaker
Identifying ECG features Rhythm: Regular or irregular Rate: Normal (60 to 100 beats/minute) or slow (less than 60 beats/minute) P waves: Vary in size, shape, direction across rhythm strip; one P wave precedes each QRS complex PR interval: Usually normal duration, but may be abnormal depending on changing pacemaker locations QRS complex: Normal (0.10 second or less)
Wandering atrial pacemaker
Identifying ECG features Rhythm: Regular or irregular Rate: Normal (60 to 100 beats/minute) or slow (less than 60 beats/minute) P waves: Vary in size, shape, direction across rhythm strip; one P wave precedes each QRS complex PR interval: Usually normal duration, but may be abnormal depending on changing pacemaker locations QRS complex: Normal (0.10 second or less)
Normal sinus rhythm with two PACs
Identifying ECG features Rhythm: Underlying rhythm usually regular; irregular with premature beat Rate: That of underlying rhythm P waves: P wave associated with PAC is premature, abnormal (commonly appears small, upright, and pointed, but may be inverted or a squiggle); abnormal P wave is often found hidden in preceding T wave, distorting T-wave contour PR interval: Usually normal but may be abnormal QRS complex: Premature, normal duration QRS (0.10 second or less); followed by a pause
Sinus bradycardia with one PAC (abnormal P wave associated with
PAC is hidden in preceding T wave, distorting T-wave contour) Identifying ECG features Rhythm: Underlying rhythm usually regular; irregular with premature beat Rate: That of underlying rhythm P waves: P wave associated with PAC is premature, abnormal (commonly appears small, upright, and pointed, but may be inverted or a squiggle); abnormal P wave is often found hidden in preceding T wave, distorting T-wave contour PR interval: Usually normal, but may be abnormal QRS complex: Premature, normal duration QRS (0.10 second or less); followed by a pause 4
Sinus tachycardia with two nonconducted PACs
Identifying ECG features Rhythm: Underlying rhythm usually regular; irregular with nonconducted PACs Rate: That of underlying rhythm P waves: Premature and abnormal; often found hidden in preceding T wave, distorting T-wave contour; a pause follows the nonconducted P wave PR interval: Absent with nonconducted PAC QRS complex: Absent with nonconducted PAC
Normal sinus rhythm with one nonconducted PAC (abnormal P wave
associated with PAC is hidden in preceding T wave, distorting T-wave contour) Identifying ECG features Rhythm: Underlying rhythm usually regular; irregular with nonconducted PACs Rate: That of underlying rhythm P waves: Premature and abnormal; often found hidden in preceding T wave, distorting T-wave contour; a pause follows the nonconducted P wave PR interval: Absent with nonconducted PAC QRS complex: Absent with nonconducted PAC
Paroxysmal atrial tachycardia
Identifying ECG features Rhythm: Regular Rate: 140 to 250 beats/minute P waves: Abnormal (commonly pointed); usually hidden in preceding T wave so that T wave and P wave appear as one wave defection (T-P wave); one P wave to each QRS unless AV block is present PR interval: Usually not measurable QRS complex: Normal (0.10 second or less)
Paroxysmal atrial tachycardia
Identifying ECG features Rhythm: Regular Rate: 140 to 250 beats/minute P waves: Abnormal (commonly pointed); usually hidden in preceding T wave so that T wave and P wave appear as one wave defection (T-P wave); one P wave to each QRS unless AV block is present PR interval: Usually not measurable QRS complex: Normal (0.10 second or less)
Atrial flutter with variable AV conduction
Identifying ECG features Rhythm: Regular or irregular (depends on AV conduction ratios) Rate: Atrial: 250 to 400 beats/minute Ventricular: Varies with number of impulses conducted through AV node; will be less than that of the atrial rate P waves: Sawtooth-wave deflections affecting the entire baseline PR interval: Not measurable QRS complex: Normal (0.10 second or less)
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Atrial flutter with 4:1 AV conduction
Identifying ECG features Rhythm: Regular or irregular (depends on AV conduction ratios) Rate: Atrial: 250 to 400 beats/minute Ventricular: Varies with number of impulses conducted through AV node; will be less than that of the atrial rate P waves: Sawtooth-wave deflections affecting the entire baseline PR interval: Not measurable QRS complex: Normal (0.10 second or less)
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Atrial flutter with 2:1 AV conduction
Identifying ECG features Rhythm: Regular or irregular (depends on AV conduction ratios) Rate: Atrial: 250 to 400 beats/minute Ventricular: Varies with number of impulses conducted through AV node; will be less than that of the atrial rate P waves: Sawtooth-wave deflections affecting the entire baseline PR interval: Not measurable QRS complex: Normal (0.10 second or less)
Identifying ECG features Rhythm: Grossly irregular (unless ventricular rate is rapid, in which case the rhythm becomes more regular) Rate: Atrial: 400 beats/minute or more; not measurable due to wavy baseline Ventricular: Varies with number of impulses conducted through AV node to ventricles; ventricular rate is controlled if rate is less than 100 beats/minute; ventricular rate is uncontrolled if rate is greater than 100 beats/minute P waves: Wavy deflections that affect the entire baseline PR interval: Not measurable QRS complex: Normal (0.10 second or less) 12
Identifying ECG features Rhythm: Grossly irregular (unless ventricular rate is rapid, in which case the rhythm becomes more regular) Rate: Atrial: 400 beats/minute or more; not measurable due to wavy baseline Ventricular: Varies with number of impulses conducted through AV node to ventricles; ventricular rate is controlled if rate is less than 100 beats/minute; ventricular rate is uncontrolled if rate is greater than 100 beats/minute P waves: Wavy deflections that affect the entire baseline PR interval: Not measurable QRS complex: Normal (0.10 second or less) 13