# The patient's ECG shows a ______ rhythm with no discernible P waves and an irregularly irregular QRS pattern, suggesting atrial fibrillation.

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=168377  
> language: ko  
> subject: Diseases of the circulatory system

## 문제

The patient's ECG shows a ______ rhythm with no discernible P waves and an irregularly irregular QRS pattern, suggesting atrial fibrillation.

House M.D. Season 3 Episode 15

## 보기

1. chaotic **✔ 정답**
2. regular
3. sinus
4. normal
5. stable

**정답: 1**

## 해설

A chaotic rhythm is characteristic of atrial fibrillation, where the atria quiver instead of contracting in a coordinated way. This results in an irregularly irregular pattern on ECG with no visible P waves.

## 임상 시나리오

ECG Characteristics of Atrial Fibrillation:
- No discernible P waves
- Irregular RR intervals
- QRS complexes < 120ms unless aberrant conduction
- Fibrillatory waves may be present
- Heart rate typically 110-160 bpm
- Baseline oscillation between 350-600 beats/minute

Clinical Features:
- Palpitations
- Dyspnea
- Fatigue
- Dizziness
- Risk of thromboembolism

Risk Factors:
- Advanced age
- Hypertension
- Heart failure
- Valvular heart disease
- Obesity
- Sleep apnea

Treatment Options:
- Rate control medications
- Rhythm control medications
- Anticoagulation
- Cardioversion
- Ablation procedures

Monitoring Parameters:
- Heart rate control
- INR levels
- Signs of bleeding
- Stroke symptoms
- Medication compliance

## 핵심 개념

- **chaotic** — Describes a disorganized, unpredictable pattern without regular order or structure in cardiac rhythm
- **regular** — Describes a cardiac rhythm that follows a consistent, uniform pattern with equal intervals between beats
- **sinus** — Refers to the normal heart rhythm originating from the sinoatrial node with identifiable P waves
- **normal** — Describes the standard, expected cardiac rhythm without any abnormalities or irregularities
- **stable** — Describes a cardiac rhythm that maintains consistent characteristics without significant changes over time

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