EKG rhythms

What’s the rhythm?

Sinus rhythm: PR interval is 0.12-0.20, QRS complex is 0.11 or less

What’s the rhythm?

Sinus bradycardia: PR and QRS are normal. Less than 60 bpm

What’s the rhythm?

Sinus tachycardia: PR and QRS are normal, greater than 100 bpm

What’s the rhythm?

Sinus arrhythmia: everything is normal except an irregular rhythm

What’s the rhythm?

Sinus arrest: a pause in QRS activity (flatline). Everyhting else is normal

What’s the rhythm?

PAC: premature p wave. There will either be one P wave or one T wave that looks different than the rest. If no p wave visible, the T wave before will likely be abnormal looking. The beat will come early and the marching will not longer match up and it will be irregular

What’s the rhythm?

Wandering atrial pacemaker: 3 or more different looking P waves; an absent p wave counts

What’s the rhythm?

MAT: same was WAP except rate is above 100

What’s the rhythm?

Paroxysmal super ventricular tachycardia: goes from NSR to SVT then back to NSR

What’s the rhythm?

SVT: p and T waves slur together. You get those TP waves

What’s the rhythm?

WPW: short PR interval, widened QRS, Delta wave (A slurred, upward deflection right at the beginning of the QRS complex.)

What’s the rhythm?

Atrial flutter: sawtooth waves

What’s the rhythm?

A-fib: irregularly irregular. If HR >100, is A-fib with RVR

What’s the rhythm?

PJC: early p wave beat that is INVERTED. Can be before, in, or after the QRS (look for that outlier). If within the QRS you can tell it’s a PJC over a PAC because the T wave before will look the same as the other unlike in PAC when that T wave will look different.

What’s the rhythm?

Junctional escape rhythm: 40-60bpm, same rule of inverted p wave

What’s the rhythm?

Accelerated junctional rhythm: same inversion rule but rate is 61-100

What’s the rhythm

Junctional tachycardia: same inversion rules but rate is 101-180. (Can be mistake as SVT but you should still see that inversion here)

What’s the rhythm?

PVC: occasional wide/ bizarre QRS; QRS complex and T wave will be going in opposite directions, no p waves,

Uniform vs multifocal PVC? Bigeminy? Etc?

Uniform: all PVC look the same

Multifocal: PVC look different

Bigeminy: PVC every other beat

What’s the rhythm?

IVR: 20-40bpm, absent p wave, wide QRS and inverted T wave (opposite directions). A PVC is occasional, this is the rhythm the entire time.

If less than or equal 20bpm: it is called agonal rhythm

AIVR: same rules but rate is 41-100 bpm

What’s the rhythm?

Ventricular tachycardia

Polymorphic v tachycardia: QRS are different heights

What’s the rhythm?

PMVT: gradual alteration in direction and height of QRS complexes

What’s the rhythm?

V- fib

What’s the rhythm?

First degree heart block: prolonged PR interval greater than 0.20 seconds

What’s the rhythm?

Second degree heart block type 1: lengthen, lengthen, lengthen, drop

What’s the rhythm?

Second degree heart block type 2: consistent dropped QRS complex

What’s the rhythm?

Third degree heart block: atria and ventricles beats independent of one another

What’s the rhythm

Pacemaker failure to capture

What’s the rhythm?

Pacemaker under sensing:

What’s the rhythm?

Pacemaker oversensing

What’s the rhythm?

Analyzing pacemaker function: no atrial paced activity