EKG rhythms

Sinus Rythms

Electricity originates in the SA node

Normal Sinus Rhytm (NSR)

P wave: Normal

QRS: Normal

PR interval: Normal

Reg/Irg: Regular

Rate: 60-100 (normal)

Other:

Sinus Tachycardia 

P wave: Normal

QRS: Normal

PR interval: Normal

Reg/Irg: Regular

Rate: over 100
Other: Causes could be caffeine, drugs, hyperthyroid, etc

Sinus BradyCardia

P wave:Normal

QRS:Normal

PR interval:Normal

Reg/Irg:regular

Rate: below 60
Other: Age, medications, drugs, heart disease, athlete, etc

Sinus Arrythmia

P wave:Normal

QRS:Normal

PR interval:Normal

Reg/Irg: Occasional Irregular

Rate: Persons underlying heart rate
Other:(Bc of breathing/ preassure from vagal nerve)

Normal Sinus Rythms with occasional (irregular)

Sinus Pause

Normal Sinus Rhythm with a pause.

• 2.5 seconds or longer

• If a 6 second pause =Medical emergency 

  

Atrial Rhythms

Orginates somewhere other than the SA node (in atrial)

• Ventricles are not affected (QRS is always normal)

Atrial Flutter ( Saw tooth)

P wave: Flutter Waves/sharp

QRS: Normal

PR interval:Cant determain (Mulitple P waves)

P:QRS: varies 2:1 3:1 4:1 (Always 1 QRS)

Reg/Irg: Regular

Rate: Varies with the P:QRS rate
Other: T waves are hidden

• AV node bocks the extra electrical defib

• Automatcity Bc electricity is coming from the wall of atrial cells

Only lets so many electrical impulses through at a time 

Atrial Fibrillation (A-FIB)

P wave: Fibrillatory waves 

QRS: Normal

PR interval: Cant determain

P:QRS:Cant determain

Reg/Irg: irregular

Rate:60-100bpm
Other: Decreased cardiac output

• scribbles

• chaos in atria 

Blood begins to pool= risk for a blood clot  

(problem in the atria) they don't coordinate in beat

AV node lets some of the electricity through more than atrial flutter

Atrial Fibrillation w Rapid Ventricular Reponse (AFIB w/ RVR)

P wave: Fibrillatory Waves 

QRS: Normal

PR interval: Cant determine

P:QRS: Cant determine

Reg/Irg: Irregular

Rate: Greater than 100
Other: Lets more impulses through

SupraVentricular Tachycardia (SVT)

P wave: P waves hidden in T waves

QRS: Normal 

PR interval: Cant determine 

P:QRS: Cant determine

Reg/Irg: Regular

Rate: 150 or greater
Other: Orginates in atria, AV junction, or SA node

• Lets every impulse through 

Premature Atrial Contraction (PAC)

EVerything normal except its (Irregular)

• Singular, P wave is distorted =comes from atria

Occurs because of an early electrical impulse occurs other from a location in the atria other than the SA node

• Looks like a thumb and on top of something - before the next normal sinus P wave should appear.

  

Junctional Ryhtms

AV node is the pacemaker

The p Wave is always either Inverted before QRS, Absent, Or inverted After QRS 

• The difference between junctional Ryhtms is the rate

Intrinsic Rate: 60-40

Junctional Brady Cardia

P wave: Inverted before QRS, Absent, Inverted After QRS

QRS: Normal

PR interval: N/A

P:QRS: N/A

Reg/Irg: Regular

Rate: 60-40
Other:

Junctional Escape 

P wave: Inverted before QRS, Absent, Inverted After QRS

QRS: Normal

PR interval: N/A

P:QRS: N/A

Reg/Irg: Regular

Rate: less than 40 BPM
Other:Whole Ryhthm will be junctional

Acclerated Junctional

P wave:Inverted before QRS, Absent, Inverted After QRS

QRS: Normal

PR interval: N/A

P:QRS: N/A

Reg/Irg: Regular

Rate: 60-100Bpm
Other:

Junctional Tachycardia

P wave:Inverted before QRS, Absent, Inverted After QRS

QRS: Normal

PR interval: N/A

P:QRS: N/A

Reg/Irg:Regular

Rate:Greater than 100 bpm
Other:

Heart Block Rhythms (AV Block)

-Problem in the AV node or the conduction pathways just below it (the His–Purkinje system).

electrical signals traveling from the atria (top chambers) to the ventricles (bottom chambers) are slowed down or completely blocked.

First Degree AV Block

P wave:Normal

QRS: Normal

PR interval: Yes but its long

P:QRS: 1:1 ratio 

Reg/Irg:Regular

Rate:Any
Other: Everything is normal except there is a long PR interval

Second Degree AV Block (Mobitz 1 or Wenkebach)

P wave:Normal

QRS: Normal

PR interval: Progressivley longer units and QRS drops

P:QRS Dropped beats but not always

Reg/Irg: irregular

Rate:Any
Other: Long, Longer, LONGERRR, Drop, Now you have a wenkebach

Second Degree AV Block (Mobitz 2)

P wave:Normal

QRS: Normal

PR interval: Yes.. but when QRS dropped no

P:QRSDropped QRS but not always 

Reg/Irg: Regular or Irregular 

Rate:Any
Other:Intermittent dropped QRS 

• no PR interval lengthening 

Third Degree AV Block (Complete Block)

P wave:Normal

QRS: Normal

PR interval: none

P:QRS none

Reg/Irg: regular or irregular

Rate:Any
Other: -

• P/QRS independent of eachother

• -Alls Ps will march together

• -All QRS will march together

Ventricular Ryhtms

• Orginates in the Ventricles 

Always WIDE QRS= ventricles receiving electrical impulses by themselves= EMERGENCY ACTION 

Idioventricular (AGONAL)

P wave:No

QRS:  Bizzare and Wide

PR interval: none

P:QRS none

Reg/Irg:Regular

Rate: intrinsic Rate 20-40 and accelerated 40-100
Other: NOT SHOCKABLE

Ventricular Tachycardia (V-TACH) Monomorphic

P wave:No

QRS: Wide, Upside down

PR interval: none

P:QRS none

Reg/Irg:N/A

Rate:N/A
Other: QRS is wide and similar in apperance 

• Shockable if person doesn't have a pulse and is unconscious, Not shock able if person has a pulse and is awake BUT, prepare for a code blue but iniate a rapid

Ventricular Tachycardia (VTACH) Polymorphic

P wave:No

QRS: Wide, Multifocal ballet like

PR interval: none

P:QRS none

Reg/Irg: N/A

Rate:N/A
Other:”Twisting of Points” torsades de pointes

-QRS can vary in size and shape

No pulse = shock

pulse=dont shock

Ventricular Fibrillation (VFIB)

P wave:No

QRS: Fibilitory Waves

PR interval: none

P:QRS none

Reg/Irg: N/A

Rate:N/A
Other: EMERGENCY IMMEDIATE ACTION=CODE BLUE

ALWAYS SHOCK (never a pulse)

Premature Ventricular Contraction (PVC)

Charateristics: QRS Wide and fat (lost p wave)

Concerns:More than 6 a min is not a perfusing beat

• Not a Ryhtms just an abnormal beat

Bigeminy- every other beat

Trigenimy- every 3 bats

quadrigeminy- every 4 beats

couplet- together

run of vtach- 3 PVC together

Atrial Pacer

spike before the p wave (Atrial)

Ventricular pacer

before the QRS (Ventricular)

atriocentricular pacer

2 spikes (atria and ventricles)

Asystole

no electrical rythm

• Do not shock ( START CPR)