2015 EKG REVIEW - @myCME

EKG REVIEW for Rutgers PANCE/PANRE Review Course

Presented by Carol J. Sadley, M.Ed., PA-C

June 4, 2015

Rutgers, The State University of New Jersey

Rutgers, The State University of New Jersey

PANCE/PANRE Review Course

Conduction Pathway

? Sino atrial (SA) node (in RA) fires ? Signal travels across atria to AV node ? Slight pause, then signal travels down Bundle of

His ? His Bundle branches into Right & Left bundles

(and further into fasicles) ? Ending at the Purkinje fibers ? Slight pause, then repolarization occurs

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Rutgers, The State University of New Jersey

PANCE/PANRE Review Course

Normal 12-lead EKG

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Rutgers, The State University of New Jersey

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PANCE/PANRE Review Course

Six Second Strip (aka 30 big blocks)

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Rutgers, The State University of New Jersey

PANCE/PANRE Review Course

Rate of Impulse Formation

? S-A Node = 60-100 bpm ? A-V Node = 40-60 bpm ? Ventricle = 20-40 bpm

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Rutgers, The State University of New Jersey

Rutgers, The State University of New Jersey

PANCE/PANRE Review Course

Sinus Bradycardia

? NSR criteria, but heart rate is < 60 ? Can be normal especially in well-trained

athletes or people taking B-blockers ? Most common rhythm disturbance seen in

early stages of AMI ? If symptomatic, treat with Atropine,

consider pacing (TransCutaneous Pacing/TCP)

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PANCE/PANRE Review Course

Sick Sinus Syndrome

? Associated w/ sinus arrest, s-a exit block, or persistent sinus bradycardia < 45 bpm

? Seen in elderly, @ w/ atrial fibrillation, but often asymptomatic

? Patchy fibrosis of SA node and conduction ? May be caused by drug therapy, sarcoid,

amyloidosis, cardiomyopathies ? Treat with pacemaker if symptomatic

Rutgers, The State University of New Jersey

PANCE/PANRE Review Course

Sinus Tachycardia

? NSR criteria, but HR is >100 ................
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