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Premature Atrial Complexes: Feature Description Duration

The document discusses several types of cardiac arrhythmias and features seen on electrocardiograms (ECGs). It describes premature atrial complexes as having a normal or prolonged PR interval. Atrial fibrillation is characterized by an irregularly irregular ventricular response that can be fast, moderate, or slow. Atrial flutter typically has an atrial rate of around 300 beats per minute. Multifocal atrial tachycardia is defined as having an atrial rate less than 100 beats per minute. The document also provides descriptions of other ECG intervals and features such as P waves, QRS complexes, ST segments, and T waves.

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Ricky Marion Manalo
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76 views3 pages

Premature Atrial Complexes: Feature Description Duration

The document discusses several types of cardiac arrhythmias and features seen on electrocardiograms (ECGs). It describes premature atrial complexes as having a normal or prolonged PR interval. Atrial fibrillation is characterized by an irregularly irregular ventricular response that can be fast, moderate, or slow. Atrial flutter typically has an atrial rate of around 300 beats per minute. Multifocal atrial tachycardia is defined as having an atrial rate less than 100 beats per minute. The document also provides descriptions of other ECG intervals and features such as P waves, QRS complexes, ST segments, and T waves.

Uploaded by

Ricky Marion Manalo
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Premature atrial complexes

 The PR interval is normal or prolonged because the AV junction is often


partially refractory when the premature impulse enters it.

Atrial Fibrillation (A-fib)


Ventricular response is irregularly irregular and may be fast (HR >100
bpm, indicates inadequate rate control), moderate (HR = 60-100 bpm),
or slow (HR <60 bpm, indicates excessive rate control, AV node disease,
or drug toxicity). 

Atrial Flutter (A-flutter):


The atrial rate is usually about 300/min, but may be as slow as 150-
200/min or as fast as 400-450/min. 
In this ECG rhythm strip, arrows point to atrial flutter waves @ 280bpm with ventricular rate
@ 140bpm

Multifocal Atrial Tachycardia (MAT) and rhythm


If atrial rate is <100 bpm, call it multifocal atrial rhythm

Feature Description Duration

RR The interval between an R wave and the next R wave is the inverse of the heart
0.6 to 1.2s
interval rate. Normal resting heart rate is between 50 and 100 bpm

During normal atrial depolarization, the main electrical vector is directed from
P wave the SA node towards the AV node, and spreads from the right atrium to the 80ms
left atrium. This turns into the P wave on the ECG.

The PR interval is measured from the beginning of the P wave to the beginning
PR of the QRS complex. The PR interval reflects the time the electrical impulse
120 to 200ms
interval takes to travel from the sinus node through the AV node and entering the
ventricles. The PR interval is therefore a good estimate of AV node function.

PR The PR segment connects the P wave and the QRS complex. This coincides 50 to 120ms
segment with the electrical conduction from the AV node to the bundle of His to the
bundle branches and then to the Purkinje Fibers. This electrical activity does
not produce a contraction directly and is merely traveling down towards the
ventricles and this shows up flat on the ECG. The PR interval is more clinically
relevant.

The QRS complex reflects the rapid depolarization of the right and left
QRS
ventricles. They have a large muscle mass compared to the atria and so the 80 to 120ms
complex
QRS complex usually has a much larger amplitude than the P-wave.

The point at which the QRS complex finishes and the ST segment begins. Used
J-point N/A
to measure the degree of ST elevation or depression present.

ST The ST segment connects the QRS complex and the T wave. The ST segment
80 to 120ms
segment represents the period when the ventricles are depolarized. It is isoelectric.

The T wave represents the repolarization (or recovery) of the ventricles. The
interval from the beginning of the QRS complex to the apex of the T wave is
T wave 160ms
referred to as the absolute refractory period. The last half of the T wave is
referred to as the relative refractory period (or vulnerable period).

ST
The ST interval is measured from the J point to the end of the T wave. 320ms
interval

The QT interval is measured from the beginning of the QRS complex to the
300 to
QT end of the T wave. A prolonged QT interval is a risk factor for ventricular
430ms[citation
interval tachyarrhythmias and sudden death. It varies with heart rate and for clinical needed]
relevance requires a correction for this, giving the QTc.

The U wave is not always seen. It is typically low amplitude, and, by


U wave
definition, follows the T wave.

The J wave, elevated J-Point or Osborn Wave appears as a late delta wave
J wave following the QRS or as a small secondary R wave . It is considered
pathognomic of hypothermia or hypocalcemia.[24]

Shortened QT interval Hypercalcemia, some drugs, certain genetic


abnormalities.

Hypocalcemia, some drugs, certain genetic


Prolonged QT interval
abnormalities.

Coronary ischemia, left ventricular


Flattened or inverted T waves
hypertrophy, digoxin effect, some drugs.

Possibly the first manifestation of acute myocardial


Hyperacute T waves
infarction.

Prominent U waves Hypokalemia

Normal Results
1. P wave that doesn’t exceed 2.5 mm (0.25 mV) in height or last longer than 0.12 second.
2. PR interval (includes the P wave plus the PR segment) persisting for 0.12 to 0.2 second for heart
rates above 60 beats/min.
3. QT interval that varies with the heart rate and lasts 0.4 to 0.52 second for heart rates above 60
beats/min.
4. Voltage of the R wave leads V1 through V6 that doesn’t exceed 27 mm.
5. Total QRS complex lasting 0.06 to 0.1 second

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