Ventricular Rhythms

Normal Sinus Rhythm

HR: 60-100bpm

QRS Complex: Normal

T wave: normal

R-R: normal

QRS Duration: Normal

Premature Ventricular Complex

HR:depends

QRS Complex: wide

T wave: opposite of QRS

R-R: irregular

QRS Duration:>120 ms

early beat, different morphologies, no p-wave

Uniform PVC

HR:

QRS Complex: wide

T wave: opposite of QRS

R-R: irregular

QRS Duration: >120ms

Look similar/ same ectopic focus

Multiform PVC

HR:

QRS Complex: wide

T wave: opposite of QRS

R-R: irregular

QRS Duration: >120ms

different appearance in same lead

Compensatory Pause

HR:>300

QRS Complex: wide

T wave: opposite of QRS

R-R: irregular

QRS Duration: >120ms

followed by a pause, due to next R wave coming

“on time” based upon initial background rhythm

Interpolated PVC

HR:60-100

QRS Complex: wide

T wave: opposite of QRS

R-R: regular

QRS Duration: >120ms

if OVC falls directly in between 2 R waves. R waves continue on background in same rhythm

Ventricular Bigeminy

HR:40-80

QRS Complex: wide/bizzare

T wave: opposite of polarity of QRS

R-R: irregular

QRS Duration: >120ms

every second beat

ventricular trigemeny

HR:50-75bpm

QRS Complex: wide

T wave: opposite of QRS

R-R: irregular

QRS Duration: >120ms

every third beat

ventricular quadrigeminy

HR:60-80bpm

QRS Complex: wide

T wave: opposite of QRS

R-R: irregular

QRS Duration: >120ms

every fourth beat

ventricular tachycardia

HR:100-250 bpm

QRS Complex: wide/ monomorphic

T wave: opposite of QRS

R-R: irregular

QRS Duration: >120ms

2 PVC in ventricular couplet, 3 is ventricular triplet, runs of V tach are short or non-sustained if they are less than 30-sec

monomorphic V-tach

HR:100-250bpm

QRS Complex: wide

T wave: opposite of QRS

R-R: regular

QRS Duration: >120ms

polymorphic V-tach

HR:150-300

QRS Complex: wide

T wave: opposite of QRS

R-R: irregular

QRS Duration: >120ms

Torsade de pointes

HR:150-300bpm

QRS Complex: wide

T wave: opposite of QRS

R-R: irregular

QRS Duration: >120ms/twisting

twisting of points, pattern of v-tachy where morphology consistently or predictions shift from large to small

R on T PVC

HR:60-100

QRS Complex: wide

T wave: hidden/ distorted

R-R: irregular

QRS Duration: >120ms

PVCs fall on T-wave of the previous beat, generally considered a more serious arrthymia because its more like to lead to V-fib or v-tach

Accelerated Idioventricular Rhythm

HR:50-100bpm

QRS Complex: wide

T wave: opposite of QRS

R-R: regular

QRS Duration: >120ms

Tachy exceeds 100 bpm, if its a ventricular rhythm less than 100, its considered accelerated

Ventricular Fib

HR:300 bpm

QRS Complex: wide

T wave: NONE

R-R: irregular

QRS Duration: >120ms

can be coarse or fine; looks like artifact with no visible waves or complexes, low amp, pulse-less

agonal rhythms

HR:very slow( 4/6 beats per min)

QRS Complex: wide

T wave: NONE

R-R: NONE

QRS Duration: NONE

typically very slow rate that precedes to death

asystole

HR:NONE

QRS Complex: NONE

T wave: NONE

R-R: NONE

QRS Duration: NONE

lack of rhythm, flat line, death

idioventricular escape

HR:20-40bpm

QRS Complex: wide

T wave: opposite of QRS

R-R: irregular

QRS Duration: >120ms