Mystery Rhythm: Marching to a different beat

$3.95 		Nursing Made Incredibly Easy!
April 2004 
Volume 2  Number 2
Pages 8 - 11
 
  PDF Version Available!

ABSTRACT
Outline

  • Rhythm of the heart

  • Making waves

  • That fabulous filter

  • Barely measurable

  • Feel the pulse

  • What can you do?

  • Turn the beat around

  • Getting in sync

  • Setting the pace

  • Risk of restoring sinus rhythm

  • Recognizing atrial fibrillation



    Graphics

  • Figure. No caption a...

  • Figure. Atrial fibri...

  • Figure. No caption a...

    MUCH LIKE A DRUMMER sets the pace in a band, the sinoatrial (SA) node sets the pace for the heart to beat in a steady rhythm to circulate blood throughout the body. But in some cases, the heart's rhythm may change and throw everything out of sync.

    One such change in the heart rhythm is atrial fibrillation, a chaotic, asynchronous, electrical activity that occurs in the heart's atrial tissue. Atrial fibrillation can result from either multiple ectopic (abnormal) pacemakers or rapid reentry circuits in the atria.

    Rhythm of the heart

    As with atrial flutter, atrial fibrillation results in a loss of atrial kick. Atrial kick refers to the complete filling of the ventricles as the atria contract during the last part of ventricular diastole (just before the ventricles contract). Loss of the kick can reduce the patient's cardiac output by 20% to 30%, which is especially significant in patients with underlying heart disease. The ectopic pacemakers may fire at a rate of 400 to 600 times/minute. Small sections of the atria are activated individually, preventing contraction of the atria as a whole. During atrial fibrillation, three factors can affect hemodynamic function: loss of synchronous atrial mechanical activity, irregular ventricular response, and inappropriately rapid heart rate.

    The loss of atrial kick, combined with decreased filling ...

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