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Discussion

Dysrhythmias

One of the assigned chapters for reading before starting the semester is "Dysrhythmia", ECG etc. While studying various types of dysrhythmia, I was making sure I understood the normal physio before studying the pathophysio of it. But I have come to a point where I'm really confused and feel there is something I'm not doing right. I would really appreciate if anyone has pointers/tips on how to study these concepts.

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  • Experts

you must learn the normal electrical pathway first. all arrhythmias are a result of disruptions in the sa node, the av node and of this pathway--no exceptions. another important concept is that the heartbeat is not innervated by the nervous system but by its own ability to generate these electrical impulses. that is why if the sa node (the pacemaker) fails, other cells of the atrium will begin to compensate and start firing off electrical impulses which will continue making their way to the av node. that is one way atrial fib and atrial flutter start.

if you cannot find the physiology of the conduction system of the heart in a physiology book, it should be discussed in several of the sites listed on post #39 of this sticky thread: https://allnurses.com/nursing-student-assistance/any-good-iv-127657.html - any good iv therapy or nursing procedure web sites

Like daytonite said:

1. Learn the basic electrical pathway of the heart, and how a NORMAL heart rhythm travels. Learn NORMAL SINUS RHYTHM.

2. Learn your sinus rhythms, normal sinus, sinus brady, sinus tachy, sinus arrhythmia, sinus arrest, sinus block. Learn what each rhythm is actually doing electrically, the correlation between electrical and mechanical, the criteria you look for to diagnose a rhythm, and then study what to do about it.

3. After you have mastered sinus rhythms, move on to other atrial rhythms. A-fib, A-flutter, PACs, SVT, PAT. Same as above: Learn what each rhythm is actually doing electrically, the correlation between electrical and mechanical, the criteria you look for to diagnose a rhythm, and then study what to do about it.

4. Then move further down the electrical pathway of the heart. Learn the junctional rhythms, and info associated with each rhythm. PJCs, junctional rhythm, accelerated junctional, junctional tachycardia.

5. Then move further down the electrical pathway of the heart. Learn the ventricular rhythms, and info associated with each rhythm. PVCs (lots of terms to know here), V fib, Vtach (stable, unstable, pulseless), idioventricular, accelerated idioventricular, etc.

Don't bite off more than you can chew. Work through these rhythms slowly, and don't move on to the next rhythm until you have mastered the previous group. It will not help you in the least of you can KIND of recognize a rhythm, but aren't sure if maybe it is afib or maybe it isn't.

Don't even start looking at 12 lead ECGs until you master the dysrhythmias.

  • Author

Thanks Daytonite and S.T.A.C.E.Y for your suggestions. You are right S.T.A.C.E.Y, I think I was biting more than I could chew. Though I was following the same sequence I was moving on too fast. Thanks a lot for the advice.

:chair: Stupid question, but... dysrhythmia = arrhythmia?

  • Experts

An arrhythmia is the general term for resulting ectopic electrical activity. Dysrhythmia is a serious disturbance is heart rhythm.

I was taught that technically arrhythmia = asystole (flat lining) and dysrythmia is any type of irregular rhythm. Typically, they are used interchangeably in the clinical setting.

I was taught that technically arrhythmia = asystole (flat lining) and dysrythmia is any type of irregular rhythm. Typically, they are used interchangeably in the clinical setting.

a = without

rrhythmia = rhythm.

Without rhythm doesn't necessarily mean without QRS complexes-- just that they are not in any rhythm (irregular).

They are indeed used interchangeably for the most part, however, sinus arrhythmia is a specific phenomenon.

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