Bradycardia Flashcards

A patient with an inferior STEMI develops bradycardia. What is the most likely underlying conduction abnormality?

Answer: AV block at the level of the AV node

Inferior MI commonly causes AV nodal ischemia (right coronary artery supplies the AV node in most people), leading to nodal-level AV block.

During transcutaneous pacing, the patient is conscious and experiencing significant discomfort. What should the provider do?

Answer: Administer IV analgesia and sedation

Analgesics and sedatives should be administered to manage pain and anxiety during transcutaneous pacing in conscious patients.

Which ECG feature distinguishes a junctional escape rhythm from a ventricular escape rhythm in complete heart block?

Answer: Width of the QRS complex

Junctional escape beats produce narrow QRS complexes (≤0.12 sec), while ventricular escape beats produce wide QRS complexes (>0.12 sec).

A patient with symptomatic bradycardia has a known transplanted heart. Why might atropine be ineffective?

Answer: The donor heart is denervated and lacks vagal innervation

The transplanted heart is denervated and does not respond to atropine because there is no vagal innervation to block.

What pacing rate is typically used as an initial setting when starting transcutaneous pacing for bradycardia?

Answer: 60–80 bpm

An initial pacing rate of 60–80 bpm is typically selected to achieve hemodynamic stability in bradycardic patients.

Which of the following is TRUE about Wenckebach (Mobitz type I) second-degree AV block?

Answer: It often resolves without treatment and rarely progresses to complete block

Wenckebach block is usually benign, occurs at the AV node, and rarely progresses to complete heart block.

When using the ACLS Bradycardia Algorithm, which finding would prompt IMMEDIATE intervention rather than watchful waiting?

Answer: Heart rate of 48 bpm with acute altered mental status

Altered mental status is a sign of inadequate perfusion from bradycardia and requires immediate ACLS intervention.