Rhythm interpretations

NSR

present P wave, upright, regular, 60–100

Sinus bradycardia

present P wave, upright, regular, <60

Sinus tachycardia

present P wave, upright, regular, 101–160

Sinus arrhythmia

present P wave, irregular, varies with inspiration

Sinus arrest

normal P wave before pause, regular but interrupted

Premature atrial complex

abnormal premature beats, regular but interrupted

Wandering atrial pacemaker

3 different P waves, irregular, 60–100

Atrial tachycardia

sudden start, PRI not measurable, regular, 100–250

Multifocal atrial tachycardia

3 different P waves, irregular, 101–150

Supraventricular tachycardia

can’t see P waves, narrow QRS, regular, 150–200

Atrial flutter

no P waves, sawtooth waves

Atrial fibrillation

chaotic rhythm, R-R irregular, wavy baseline

Premature ventricular complexes

regular except where PVCs are, wide QRS

Ventricular escape beat

present P waves, regular but interrupted, wide QRS, late beat

Idioventricular rhythm

no P wave, regular, wide QRS

Accelerated idioventricular rhythm

no P waves, usually regular but can be irregular, wide QRS

Ventricular tachycardia

tombstone-shaped wide QRS

Ventricular fibrillation

wavy static-like baseline, chaotic, resembles torsades

Asystole

straight flat line

Agonal rhythm

dying heart rhythm, <20 bpm

Premature junctional complex

inverted or hidden P waves, regular but interrupted

Junctional escape rhythm

inverted or hidden P waves, regular, 40–60

Accelerated junctional rhythm

inverted or hidden P waves, regular, 60–100

Junctional tachycardia

inverted or hidden P waves, regular, >100

Junctional bradycardia

inverted or hidden P waves, regular, <40

1st degree heart block

PR interval prolonged; “if the R is far from the P…”

2nd degree heart block type I (Wenckebach)

longer, longer, longer, drop

2nd degree heart block type II (Mobitz)

constant PRI, then dropped beat

3rd degree heart block

no relationship between P waves and QRS