1. Chapter 5 Atrial Rhythms
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

2. Wandering Pacemaker
Pacemaker site wanders between sinus node, atria, and AV junction. Rate is usually normal; impulses are conducted normally to the ventricles.
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

3. Wandering Pacemaker Regularity: Slightly irregular
Rate: Usually normal, 60–100 beats/minute
P Wave: Morphology changes from beat to beat
PRI: Less than .20 seconds; may vary
QRS: Less than .12 seconds
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

4. Wandering Pacemaker
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

5. Premature Atrial Contraction
Pacemaker is an irritable focus within the atrium that fires prematurely and produces a single ectopic beat. Impulses are conducted normally to the ventricles.
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

6. Premature Atrial Contraction
Regularity: Depends on underlying rhythm; usually regular except for PAC
Rate: Usually normal; depends on underlying rhythm
P Wave: P wave of early beat differs from sinus P Waves; can be flattened or notched; may be lost in preceding T wave
PRI: .12–.20 seconds; can be greater than .20 seconds
QRS: Less than .12 seconds
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

7. Premature Atrial Contraction
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

8. Atrial Tachycardia
Pacemaker is a single irritable site within the atria that fires repetitively at a very high rate. Impulses are then conducted normally to the ventricles.
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

9. Atrial Tachycardia Regularity: Regular Rate: 150–250 beats per minute
P Wave: Atrial P wave; differs from sinus P wave; can be lost in preceding T wave
PRI: .12–.20 seconds
QRS: Less than .12 seconds
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

10. Atrial Tachycardia
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

11. Atrial Flutter
Single irritable focus within the atria initiates rapid, repetitive impulses. AV node protects the ventricles by blocking conduction of some impulses.
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

12. Atrial Flutter
Regularity: Atrial Rhythm regular; ventricular rhythm usually regular but can be irregular if there is variable block
Rate: Atrial rate 250–350 beats per minute; ventricular rate varies
P Wave: Characteristic sawtooth pattern (F waves)
PRI: Unable to determine
QRS: Less than .12 seconds
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

13. Atrial Flutter
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

14. Atrial Fibrillation
Many irritable sites within atria fire repetitively, causing ineffective atrial depolarization. AV node blocks most impulses, so ventricular rate is usually slower than atrial.
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

15. Atrial Fibrillation Regularity: Grossly irregular
Rate: Atrial greater than 350 beats per minute; ventricular rate varies greatly
P Wave: No discernible P waves; atrial activity is referred to as fibrillatory waves (f waves)
PRI: Unable to measure
QRS: Less than .12 seconds
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

16. Atrial Fibrillation
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

17. Chapter 5 Practice Strips
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

18. 5.1
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

19. 5.2
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

20. 5.3
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

21. 5.4
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

22. 5.5
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

23. 5.6
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

24. 5.7
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

25. 5.8
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

26. 5.9
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

27. 5.10
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

28. 5.11
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

29. 5.12
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

30. 5.13
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

31. 5.14
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

32. 5.15
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

33. 5.16
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

34. 5.17
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

35. 5.18
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

36. 5.19
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

37. 5.20
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

38. 5.21
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

39. 5.22
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

40. 5.23
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

41. 5.24
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

42. 5.25
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

43. 5.26
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

44. 5.27
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

45. 5.28
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

46. 5.29
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

47. 5.30
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

48. 5.31
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

49. 5.32
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

50. 5.33
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

51. 5.34
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

52. 5.35
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

53. 5.36
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

54. 5.37
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

55. 5.38
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

56. 5.39
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

57. 5.40
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

58. 5.41
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

59. 5.42
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

60. 5.43
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

61. 5.44
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

62. 5.45
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

63. 5.46
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

64. 5.47
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

65. 5.48
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

66. 5.49
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

67. 5.50
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

68. 5.51
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

69. 5.52
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

70. 5.53
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

71. 5.54
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

72. 5.55
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

73. 5.56
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

74. 5.57
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ