EKG rhythms

normal sinus rhythm

sinus bradycardia

slow heart rate (<60 bpm)

sinus tachycardia

fast heart rate (>100 bpm)

atrial fibrilllation

irregular atrial activity

Atrial flutter

rapid, regular atrial activity

ventricular fibrillation

chaotic ventricular rhythm

ventricular tachycardia

rapid ventricular rhythm

asystole

flatline

heart block

delay or blockage in conduction system

1500 method

• most appropriate with fast rhythms (must be regular), count squares between two R waves, divide 1500 by that number

6 second method

used for estimating, especially irregular rhythm, count number of QRS complexes in two of the sections (30 boxes), multiply by 10

Lead I

records impulses between left and right arms

lead II

between right arm and left leg

lead III

between left arm and left leg

AVL

left leg and right arm with left arm tracing

AVR

left arm and left leg assist with the right arm tracing

AVF

right and left arms assist with left leg tracing

V1

fourth intercostal space, right of sternum

V2

fourth ICS, left of sternum, directly across from V1

V3

midway between V2 and V4

V4

fifth ICS, midclavicular line

V5

fifth ICS, midway between V4, and V6, at the anterior axillary line

V6

fifth ICS, at the midaxillary line

Ambulatory monitoring (holter monitor)

• 24hr or longer

• portable ekg

• bathe prior

• loose-fitting clothing

• record symptoms in log book

• avoid bathing and showering

Stress testing

• EKG monitor during exercise

• some patients receive meds

• avoid caffeine

• eat a light meal 2 hrs before

• take meds as usual

• loose-fitting clothing

• test stopped if bad symptoms

V7

left posterior axillary line, same horizontal plane as v6

v8

tip of scapula at the level of V6

v9

left parapspinous region at level of v6