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NR-291 Pharmacology I Chamberlain University

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Chamberlain University

NR-291 Pharmacology I Chamberlain University

Arrhythmias Description Causes Treatment
Sinus Arrhythmia
 Irregular atrial and ventricular rhythms.  Normal P wave preceding each QRS complex.
 Normal variation of normal sinus rhythm in athletes, children, and the elderly.  Can be seen in digoxin toxicity and inferior wall MI.
 Atropine if rate decreases below 40bpm.
Sinus Tachycardia
 Atrial and ventricular rhythms are regular.  Rate > 100 bpm.  Normal P wave preceding each QRS complex.
 Normal physiologic response to fever, exercise, anxiety, dehydration, or pain.  May accompany shock, left-sided heart failure, cardiac tamponade, hyperthyroidism, and anemia.  Atropine, epinephrine, quinidine, caffeine, nicotine, and alcohol use.
 Correction of underlying cause.  Beta-adrenergic blockers or calcium channel blockers for symptomatic patients.
Sinus Bradycardia
 Regular atrial and ventricular rhythms.  Rate < 60 bpm.  Normal P wave preceding each QRS complex.
 Normal in a wellconditioned heart (e.g., athletes).  Increased intracranial pressure; increased vagal tone due to straining during defecation, vomiting, intubation, mechanical ventilation.
 Follow ACLS protocol for administration of atropine for symptoms of low cardiac output, dizziness, weakness, altered LOC, or low blood pressure.  Pacemaker
Sinoatrial (SA) arrest or block
 Atrial and ventricular rhythms normal except for missing complex.  Normal P wave preceding each QRS complex.  Pause not equal to multiple of the previous rhythm.
 Infection  Coronary artery disease, degenerative heart disease, acute inferior wall MI.  Vagal stimulation, Valsalva’s aeuver, carotid sinus massage.
 Treat symptoms with atropine I.V.  Temporary pacemaker or permanent pacemaker if considered for repeated episodes.
Wandering atrial pacemaker
 Atrial and ventricular rhythms vary slightly.  Irregular PR interval.
 Rheumatic carditis due to inflammation involving the SA node.  Digoxin toxicity

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NR-291 Pharmacology I Chamberlain University

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