Impaired Impulse Formation

Pelter, Michele M.; Kozik, Teri M.; Al-Zaiti, Salah S.; Carey, Mary G.

doi:10.4037/ajcc2012380

Article navigation

ECG Puzzler| July 01 2012

Impaired Impulse Formation

Michele M. Pelter, RN, PhD;

Michele M. Pelter, RN, PhD

Michele M. Pelter is an assistant professor at the Orvis School of Nursing, University of Nevada, Reno. Teri Kozik is supervisor of cardiac research at St. Joseph’s Medical Center, Stockton, California. Salah S. Al-Zaiti is a doctoral student and Mary G. Carey is an associate professor at the School of Nursing at the State University of New York at Buffalo

Search for other works by this author on:

This Site

PubMed

Google Scholar

Teri M. Kozik, RN, PhD, CNS, CCRN;

Teri M. Kozik, RN, PhD, CNS, CCRN

Michele M. Pelter is an assistant professor at the Orvis School of Nursing, University of Nevada, Reno. Teri Kozik is supervisor of cardiac research at St. Joseph’s Medical Center, Stockton, California. Salah S. Al-Zaiti is a doctoral student and Mary G. Carey is an associate professor at the School of Nursing at the State University of New York at Buffalo

Search for other works by this author on:

This Site

PubMed

Google Scholar

Salah S. Al-Zaiti, RN, MS, ANP-BC;

Salah S. Al-Zaiti, RN, MS, ANP-BC

Michele M. Pelter is an assistant professor at the Orvis School of Nursing, University of Nevada, Reno. Teri Kozik is supervisor of cardiac research at St. Joseph’s Medical Center, Stockton, California. Salah S. Al-Zaiti is a doctoral student and Mary G. Carey is an associate professor at the School of Nursing at the State University of New York at Buffalo

Search for other works by this author on:

This Site

PubMed

Google Scholar

Mary G. Carey, RN, PhD

Michele M. Pelter is an assistant professor at the Orvis School of Nursing, University of Nevada, Reno. Teri Kozik is supervisor of cardiac research at St. Joseph’s Medical Center, Stockton, California. Salah S. Al-Zaiti is a doctoral student and Mary G. Carey is an associate professor at the School of Nursing at the State University of New York at Buffalo

Search for other works by this author on:

This Site

PubMed

Google Scholar

Am J Crit Care (2012) 21 (4): 293–294.

https://doi.org/10.4037/ajcc2012380

Scenario: This ECG (V₁ top and lead II bottom) was obtained from a 78-year-old female patient admitted to the cardiac intensive care unit 3 weeks earlier. She was admitted with respiratory distress and is currently intubated via a tracheal tube, on phenylephrine hydrochloride for blood pressure control, is in septic shock, and requiring dialysis every other day. She has an extensive clinical history including: hypertension (HTN), coronary artery disease (CAD), prior myocardial infarction (MI), heart failure (HF), chronic obstructive pulmonary disease, type II diabetes, hypothyroidism, and chronic kidney disease. The patient is nonresponsive so subjective symptoms could not be ascertained. Her blood pressure dropped from 108/60 to 85/43 during this rhythm.

Sick sinus syndrome (SSS) is characterized by: (1) impairment of impulse formation in the sinoatrial node, (2) failure of the lower pacemaker cells (AV junction, bundle branches, and Purkinje) to generate an escape rhythm, and (3) susceptibility to...

You do not currently have access to this content.

Don't already have an account? Register

Impaired Impulse Formation

Cited By

Email alerts

JOURNALS

Impaired Impulse Formation

Sign in

AACN Account

Sign in via your Institution

Subscribe

Short-term Access

Cited By

Email alerts

JOURNALS

This Feature Is Available To Subscribers Only