Heart Blocks and Pacemakers

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  1. Where to put EKG pads
    • Smoke over Fire (LEFT)
    • Clouds over Grass (RIGHT)
    • Brown anywhere
  2. Heart Block indicates a problem with the ____
    AV node
  3. Least Serious Degree of Heart Block
    1st degree
  4. Slightly Injured/Ischemic AV node, Longer PR interval, Anything >.20
    First degree heart block
  5. When do you treat first degree heart block
    when there are s/s of decreased cardiac output (bradycardia) but otherwise leave untreated
  6. EKG changes in 1st Degree Heart block
    Upright P wave followed by QRS complex, PRI greater than .20 seconds (constantly)
  7. 1st type of Second Degree Heart Block
  8. EKG changes for Wenckebach (1st type of 2nd degree Heart Block)
    Upright, some P waves not followed by QRS, PRI progressively lengthens until a P wave is not conducted anymore
  9. Second Type of 2nd Degree Heart Block
    "Classical"... "Mobitz II"
  10. Any time you see an extra P wave, measure :
  11. When the AV node is injured, it does not let every impulse get through...sometimes it takes 2 P waves (or more) before QRS is created
    Mobitz II (2nd degree)
  12. How will you tell Mobitz II or Classical Second Degree Heart Block apart from others
    • Every PR interval is exactly the same
    • Too many P waves without QRS complex
  13. A patient with Classical Second Degree Heart Block with Prolonged PRI is likely to have what kind of HR
    Bradycardic (40s)
  14. Like a cement wall, NOTHING goes from atria to ventricles (2 pacemaker sites)
    Complete Heart Block
  15. EKG characteristics of a complete heart block
    Rate of 60-100, more P waves than QRS, no relationship between P waves and QRS, QRS >.12 if ventricular, <.12 if junctional

    *Every PR interval you measure will be different
  16. PR Intervals for types of Heart Blocks
    1st-     Greater than .20 seconds constant

    Wen-    Increas. longer until one P is blocked

    2nd-     Constant on conducted beats, can be > .20 sec

    3rd- PRI not constant no relation of Ps to QRSs (Ps march through)
  17. Rate/Rhythm of Heart Blocks
    • 1st-    Usually Regular
    • Wen-  Irregular
    • 2nd-   Usually Regular
    • 3rd-    Regular
  18. Conduction in Heart Blocks
    • 1st-     One P for every QRS
    • Wen-   More than one P for some QRSs
    • 2nd-    More than one P for every QRS
    • 3rd-     More Ps than QRS
Card Set:
Heart Blocks and Pacemakers
2014-09-20 03:29:39
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