ECG P wave

• is there a clear single P present and normal?

  • junctional/nodal rhythm describes an abnormal rhythm coming from the atrioventricular node
  • this is due to issues in the sinoatrial node, the impulse is generated from the atrioventricular node instead
  • will have a bradycardia presentation, so of the rate is low, it can be treated by a pacemaker - can be caused by sick sinus syndrome or myocardial ischemia

  
• Treatment of atrial fibrillation and atrial flutter:

  • risk of patient experiencing a mural thrombus, where blood collects due to loss of contraction of the atrial kick which contributes to 20% of the cardiac output
  • this can lead to a stroke
  • patients are usually treated with anticoagulants and beta blockers
• • bottom ECG shows atrial fibrillation
  • no clear P wave due to the atria fibrillating, so contracting at around 400 to 600 bpm, but the atrioventricular node is smart enough to not conduct all of those impulses
  • irregular heart beat/ventricular rate, as seen by the difference in size between each QRS complex
  • top ECG shows atrial flutter
  • irregular heart beat, with the atria contracting at around 240 to 340 bpm, but the atrioventricular node is smart enough to not conduct all of those impulses

  
• Sinus Arrhythmia:

  • seen more in younger individuals
  • where the rate/heat beat is different between inspiration and expiration
  • usually quicker heart rate during inspiration
  • usually slower heart rate during expiration

  A) sinus arrythmia