Really basic question

[Josh1]

Hi,

I'm a med student and have a pretty basic question and couldn't find an answer when I searched: what is meant by irregular irregular in Afib?

I understand all the ECG findings and how to detect Afib, what I don't understand is this terminology. What is the first irregular referring to and what is the second one referring to? I know their is an irregular rate of P waves, and the ventricular response is irregular (not all P waves are conducted), is this what is being referred to? If so, which comes first (the P wave rate or the ventricular response?)

For example if I say

Regular Irregular: Does this mean a regular rate of P waves and an irregular ventricular response (would bundle branch blocks fall under this?)

What if I say irregular regular- Is this just atrial flutter with 1:1 response: irregular rate of P waves with regular ventricular response?

I've also heard of pulses being described as 'irregularly irregular' and that without an ECG you have to think of PVCs and PACs besides Afib, which makes the description 'irregularly irregular' more confusing for me as I thought it was an ECG description

Thanks for your help with my learning!

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[Instatewaiter]

Hi,

I'm a med student and have a pretty basic question and couldn't find an answer when I searched: what is meant by irregular irregular in Afib?

I understand all the ECG findings and how to detect Afib, what I don't understand is this terminology. What is the first irregular referring to and what is the second one referring to? I know their is an irregular rate of P waves, and the ventricular response is irregular (not all P waves are conducted), is this what is being referred to? If so, which comes first (the P wave rate or the ventricular response?)

For example if I say

Regular Irregular: Does this mean a regular rate of P waves and an irregular ventricular response (would bundle branch blocks fall under this?)

What if I say irregular regular- Is this just atrial flutter with 1:1 response: irregular rate of P waves with regular ventricular response?

I've also heard of pulses being described as 'irregularly irregular' and that without an ECG you have to think of PVCs and PACs besides Afib, which makes the description 'irregularly irregular' more confusing for me as I thought it was an ECG description

Thanks for your help with my learning!

Regular/irregular has to do with QRS (ie the beat or pulse) not the P waves. It is often used to describe a physical exam, where P waves can't really be determined. It can be used while listening to the heart or feeling a pulse.

Irregularly irregular means that the irregularity is irregualar.

The top is regular. There are regular intervals between each QRS (or if you prefer, between each pulse beat) and they are all the same.

The second is regularly irregular. It is in a common pattern that can be determined (thus the first term is regular). It is irregular because the distance between each qrs is not always the same. So it is regularly irregular because it comes in a common pattern but not every beat has the same interval: There are 3 beats that have regular R-R intervals followed by a longer one. Then the same R-R intervals, followed by the same longer one.

The 3rd is irregularly irregular. There is difference between each QRS so it is not regularly regular (ie it is irregular) and there is no common pattern between QRS complexes so it is irregularly irregular.

 

[Josh1]

Thanks! I appreciate the help