SCCM Resource Library-Atrial EKGs After Cardiac Surgery

Pdf Summary

Atrial electrocardiograms (EKGs) are recommended for post-cardiac surgery patients who develop unknown or uncertain tachyarrhythmia, according to the American Heart Association. These EKGs can help identify rhythm disturbances that may be obscured by small amplitude atrial signals, which can lead to delayed or inappropriate care. Postoperative arrhythmias can cause complications and increase the cost of care. Temporary epicardial atrial pacing wires are often used to enhance atrial electrical activity and improve the detection of atrial signals. These wires can be connected to a standard EKG machine or used with telemetry or rhythm strips. Atrial EKGs can help identify P-waves buried within QRS-T complexes, distinguish between supraventricular and ventricular rhythms, accentuate fibrillatory or flutter waves, and determine the type and degree of bradycardia or heart block. It is important to ensure proper technique when performing atrial EKGs, including wearing gloves, comparing the signals to standard surface electrode rhythms, and correctly attaching the atrial lead to the electrode. However, there are risks involved, and it is recommended to use a predefined protocol accepted by the provider's institution and/or unit. Providers should also take precautions to avoid damaging the atrial lead, double-check that they are using the atrial lead and not the ventricular lead, and prevent accidental wire removal or bleeding. Overall, atrial EKGs can be a useful tool for diagnosing atrial activity when it is difficult to detect, as long as they are performed correctly and with caution.

Asset Subtitle

Procedures, Cardiovascular, 2024, 0:10:00

Keywords

atrial electrocardiograms

post-cardiac surgery patients

tachyarrhythmia

rhythm disturbances

atrial signals

postoperative arrhythmias

temporary epicardial atrial pacing wires

standard EKG machine

telemetry

rhythm strips

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