Conduction Disorders

Conduction Disorders

Atrial Fib

-irregularly, irregular rhythm 

-Fibrillation is caused by rapid discharges from numerous ectopic foci

-The rate is 350-450 per minute of atrial discharges

-Goal INR is between 2.0-3.0

-Rate control is key.  Cardizem, Beta Blockers and Digoxin are helpful

-If patient not anti-coagulated, risk for cerebral vascular event

-IV Cardizem good for A-Fib with RVR

Atrial Flutter

-Characterized by saw tooth pattern at baseline

-Atrial rate fires at rate of 250-350 per minute

-Can have a 2:1 to 4:1 conduction delay

-Treated just like A-Fib

First Degree AV Block

-Characterized by lengthened PR interval greater than 0.2 seconds

-Something blocking the conduction through the AV node

-No dropped QRS complexes

-No treatment necessary

2nd Degree Type I  AV Block

-Also called Wenckebach/Mobitz Type I

-Characterized by lengthening PR interval until the QRS complex drops

-This rhythm usually does not cause symptoms

-Usually just observe

Second Degree Type II   AV Block

-Characterized by normal PR interval and a dropped QRS Complex

-Also called Mobitz Type II

-Usually symptomatic and can be associated with syncope or pre syncope

-May progress to 3rd Degree Block

-It may be present because of ischemia or infarction

-Can be caused by medications that slow heart

3rd Degree AV Block

-Also called complete heart block

-None of the atrial impulses conduct to the ventricles

-Key characteristics is the P waves are equal distance and QRS complex are equal distance       They are dissociated. 

-Can be caused from congenital abnormality, infection,post op problem, or structural problem

-Needs a pacer