AF or AFL or Artifact

Nursing Students Student Assist

Published

Here is an example of what? AF or AFL or Artifact. Note QRS complexes clearly defined. Looks to be SR but possible slightly irregularly irregular? Also PACs and PVCs in ECG.

Thanks for feedback!

Shutterfly

Up Vote Up Vote ×
Specializes in Nephrology, Cardiology, ER, ICU.

Moved to nursing student assistance

Up Vote Up Vote ×
Specializes in SICU, trauma, neuro.

I see between some of the QRS's definite artifact... right now I'm on my phone and my aging eyes are straining to see if P waves are there or not...the pic is tiny. With afib you won't see them. With a-flutter you see a clear saw-tooth pattern between QRSs, so that one is out

Up Vote Up Vote ×

Agree on AFL assessment. Does there appear to be any irregularity to rhythm? I see ni P waves.

Up Vote Up Vote ×
Specializes in Public Health, TB.

I don't see p or flutter waves. Kinda of weird to see such deep q waves on all leads. Looking at the rate, I might think this is a junctional rhythm.

Up Vote Up Vote ×

My error. This is single lead event monitor. 32 second continous read . 25mm/sec.

Up Vote Up Vote ×
Specializes in 15 years in ICU, 22 years in PACU.

top line: NSR with 1 PVC (5th beat)

2nd line: NSR with artifact

3rd line: artifact, NSR, 1 PAC (5th beat)

bottom line: NSR. Rate approximately 70.

Rhythm is essentially regular except for PVC and PAC. P waves not that distinct but regular and can be due to electrode position. (More common in 1 lead situation rather than official EKG electrode positioning.)

Up Vote Up Vote ×
top line: NSR with 1 PVC (5th beat)

2nd line: NSR with artifact

3rd line: artifact, NSR, 1 PAC (5th beat)

bottom line: NSR. Rate approximately 70.

Rhythm is essentially regular except for PVC and PAC. P waves not that distinct but regular and can be due to electrode position. (More common in 1 lead situation rather than official EKG electrode positioning.)

Thank you.

Question: Given the QRS complexes have no artifact to them, could these waves be F-waves with (5-1, 6-1 conduction ) resulting in NSR? I cant make out P waves but I trust your read.

Up Vote Up Vote ×
Specializes in 15 years in ICU, 22 years in PACU.

What is an "f-wave"? What does the "S" stand for in NSR?

Which line/complexes do you see "f-waves"?

Up Vote Up Vote ×
What is an "f-wave"? What does the "S" stand for in NSR?

Which line/complexes do you see "f-waves"?

Fibrillatory waves ( AFIB) line 2. Fine amplitude. This is my question.

S is Sinus

Thanks.

Up Vote Up Vote ×
Specializes in 15 years in ICU, 22 years in PACU.

"f-waves" originate at random in the atria at a very rapid rate (200-350/min).The ventricles respond at varying intervals depending on when the cells have repolarized and are ready to accept a new stimuli. That response (heart rate) in irregularly irregular.

The sinus node is specialized tissue that produces a very strong electrical signal ("p wave") at regular intervals (60-100). Measuring the distance between QRS complexes (ventricular response) is usually pretty regular with slight variation for respiration.

These are different sources of stimulation. "f waves" don't turn into "p waves"

"f waves" don't come and go as quickly as artifact does.

Up Vote Up Vote ×

Paroxysmal AFib. Is a sudden onset and termination from seconds to days according to Cleveland Clinic.

Up Vote Up Vote ×
+ Add a Comment