### Lectures

by Carlo Raj, MD
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So with arrythmias, well we said there was two major categories. One was one in which it was conduction system diseases and then the vascular component. Now what we will first discuss would be the conduction system disease category first, and our first topic under this would be bradyarrhythmia. So what is brady? I told you earlier that if you find your beats per minute, which is normally 60 to 100 to be less than 60 and trust me you will know if your patient has decreased heart rate. Fifty is the actual technical definition of bradycardia. Bradycardia and what does that mean to you? It means that R wave, when you compare one R wave to another are further apart and earlier told you about "what sounds like a telephone number" which is your "300, 150, 100". So what exactly does that mean? Well when we look at that EKG, if there is one line separating an Rwave from each other, that is 300 beats per minute. What if there's two lines separating an Rwave? 150. Three lines, 100. You group those together 300, 150, 100. Just like a phone number, divide that into whatever numbers so that you can remember this easily. The other three numbers were 75, 60 and 50. So 50 brings you to six lines separating an R wave from one another, and that is 50 beats per minute. Welcome to bradycardia. And sinus means what to you? Sinoatrial wave representing the existence of a P wave. Is that clear? It can be seen in competitive athletes. It is perfectly normal and that you can expect. So if you take a look at the R waves that the upper deflection here and you find a number of lines in between them or you are in...

The lecture Bradyarrhythmia by Carlo Raj, MD is from the course Arrythmias. It contains the following chapters:

• First Degree Heart Block
• Second Degree Heart Block
• Third Degree Heart Block

### Included Quiz Questions

1. Six lines
2. One line
3. Four lines
4. Two lines
5. Three lines
1. All of the above
2. Increased cardiac output
3. S3 heart sound
5. Left ventricular enlargement
1. 250 milliseconds
2. 0.12 seconds
3. 0.15 seconds
4. 200 milliseconds
5. 0.2 seconds
1. Syncope
2. Dyspnea
3. Hypertension
5. Chest pain
1. Asymptomatic
2. Syncope
3. Chest pain
4. Dyspnea
5. Hypotension
1. PR interval > 200 ms
2. Progressively prolonging PR interval
3. Dropped QRS complex every few cycles
4. Complete disassociation between atria and ventricles
5. Normal PR interval
1. QRS complex dropped every few cycles
2. PR interval > 0.2 s
3. All of the above
4. Typically asymptomatic
5. PR interval progressively prolonged in a cyclical fashion
1. 30 bpm
2. 60 bpm
3. 80 bpm
4. 40 bpm
5. 100 bpm
1. Normal QRS wave
2. Heart rate determined by ectopic pacemaker foci
3. Patient requires pacemaker placement
4. Patients have severely decreased cardiac output
5. No correlation between P wave and QRS complex