A premature atrial contraction occurs when a focus in the atrium (not the sinoatrial node) generates an action potential before the next scheduled SA node action potential. Show
There are four main characteristics of PACs:
When every other QRS complex is a premature atrial contraction, then the rhythm is referred to as “atrial bigeminy” as seen in this strip above. If a PAC occurs when the AV node has not yet recovered from the refractory period, it will fail to conduct to the ventricles; this means there will not be a QRS complex following, or the ectopic PR interval will be prolonged. The ECG will show a premature, ectopic P wave and then no QRS complex afterward. When this occurs in a pattern of bigeminy, the interpreter may be fooled into thinking that sinus bradycardia is present, because every other beat is a nonconducted PAC, and the QRS rate is quite slow. Ashman’s Phenomenon, also known as the Ashman Beat, occurs when a PAC or supraventricular beat occurs before the right bundle branch has recovered from its refractory period. This results in the premature beat displaying a right bundle branch block pattern and can be confused with a premature ventricular contraction. Although rarely fatal, disorders of sinus node function and atrial arrhythmias are causes of much morbidity. They are the most common causes of clinical bradyarrhythmias and tachyarrhythmias, respectively. Sinus node dysfunction accounts for over half of permanent pacemaker implants worldwide [1], while atrial fibrillation occurs secondary to the progression of most cardiac conditions [2]. The sinus node and the atrium are closely related, both anatomically and functionally, and disorders of one interfere with the functioning of the other. This fact is of particular relevance to the electrocardiographic study of sinus and atrial activity. The electrocardiographic diagnosis both of sinus disorders and atrial arrhythmias depends on the P wave as evidence of atrial activation, since sinus node activity itself is not recorded on the surface ECG. The presence or absence of P waves, their morphology and timing, including their relation to ventricular activation as... Keywords
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Rights and permissionsReprints and Permissions Copyright information© 2010 Springer-Verlag London Ltd. About this entryCite this entryQuinn, F.R., McGavigan, A.D., Rankin, A.C. (2010). 26 Sinus and Atrial Arrhythmias. In: Macfarlane, P.W., van Oosterom, A., Pahlm, O., Kligfield, P., Janse, M., Camm, J. (eds) Comprehensive Electrocardiology. Springer, London. https://doi.org/10.1007/978-1-84882-046-3_26 How does sinus arrhythmia differ from wandering atrial pacemaker?WAP is differentiated from sinus arrhythmia by the fact that heart rate variability occurs from beat-to-beat, and is not phasic. Also, in sinus arrhythmia, the P-wave morphology and the P-R interval are constant [7]. Most of the arrhythmias occur soon after electric shock and are short-lived.
What is the distinguishing characteristic of the wandering atrial pacemaker rhythm quizlet?What is the distinguishing characteristic of the wandering atrial pacemaker rhythm? Wandering atrial pacemaker is a: normal finding in children, older adults, and well-conditioned athletes and does not usually cause clinical signs and symptoms.
What are the characteristics of sinus arrhythmia quizlet?Sinus arrhythmia that is associated with the phases of breathing and changes in intrathoracic pressure is called respiratory sinus arrhythmia. The rhythm is irregular; the heart rate increases gradually during inspiration (R-R intervals shorten) and decreases with expiration (R-R intervals lengthen).
What is the difference between sinus arrhythmia and sinus tachycardia?The rate in NSR is generally regular but will vary depending on autonomic inputs into the sinus node. When there is irregularity in the sinus rate, it is termed "sinus arrhythmia." A sinus rhythm faster than the normal range is called a sinus tachycardia, while a slower rate is called a sinus bradycardia.
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