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Heart Rhythms and Arrhythmias

Jun 30, 2025

Overview

This lecture covers normal and abnormal heart rhythms, focusing on cardiac arrhythmias, their causes, and how they affect heart function.

Normal Heart Rhythm and EKG Waves

  • Normal heart rhythm means the heart's electrical impulses follow the expected pattern.
  • The P-wave on an EKG shows atrial depolarization (sodium ions rushing in).
  • The QRS complex shows ventricular depolarization.
  • The T-wave shows ventricular repolarization (potassium ions rushing in).
  • Depolarization is when the heart muscle becomes more positive; repolarization brings it back to negative.

Types of Cardiac Arrhythmias

  • Arrhythmia is when the heart's normal rhythm is disrupted, affecting the efficiency of heartbeats.
  • Common arrhythmias include ectopic focus, extrasystole, bradycardia, tachycardia, fibrillation, and heart block.

Arrhythmia Types and Characteristics

  • Ectopic Focus: An area outside the SA node takes over pacing, often because it's depolarizing faster.
  • Extrasystole: An extra heartbeat occurs when another site fires after the SA node; usually harmless.
  • Bradycardia: Heart rate less than 60 bpm; normal in athletes but may indicate disease or hypothyroidism.
  • Tachycardia: Heart rate over 100 bpm; can be caused by stress, caffeine, nicotine, drugs, potassium deficiency, anemia, or hyperthyroidism; dangerous if persistent.
  • Fibrillation: Uncoordinated, rapid twitching of heart muscle, usually the ventricles; life-threatening if not corrected.
  • Heart Block (AV block): Damage to the AV node prevents signals from reaching the ventricles, causing life-threatening loss of coordinated pumping.

Key Terms & Definitions

  • Arrhythmia — Abnormal heart rhythm.
  • Depolarization — Process where sodium ions enter heart cells, making them more positive.
  • Repolarization — Process where potassium ions re-enter, restoring cells to a negative state.
  • Ectopic Focus — Non-SA node area that sets the heart's pace.
  • Extrasystole — Premature or extra heartbeat.
  • Bradycardia — Abnormally slow heart rate (<60 bpm).
  • Tachycardia — Abnormally fast heart rate (>100 bpm).
  • Fibrillation — Disorganized electrical activity causing ineffective heart contractions.
  • Heart Block — Failure in conduction between atria and ventricles, often at the AV node.

Action Items / Next Steps

  • Review EKG waveforms and correlate with electrical events in the heart.
  • Study causes and effects of different arrhythmias.