Ventricular Rhythm’s

Ventricular tachycardia (monomorphic) rate

100–250 bpm

Ventricular tachycardia (monomorphic) rhythm

Regular

Ventricular tachycardia (monomorphic) P-wave

None

Ventricular tachycardia (monomorphic) PRI

None

Ventricular tachycardia (monomorphic) QRS

Wide, > 0.12 seconds

Ventricular tachycardia (monomorphic) etiology

Hypokalemia, heart failure, electrolyte imbalance, stimulant ingestion, drug toxicity, sympathomimetic drugs

Can monomorphic ventricular tachycardia be pulseless?

Yes

Polymorphic ventricular tachycardia (torsades de pointes) rate

100–250 bpm

Polymorphic ventricular tachycardia (torsades de pointes) rhythm

Regular

Polymorphic ventricular tachycardia (torsades de pointes) P-wave

None

Polymorphic ventricular tachycardia (torsades de pointes) PRI

None

Polymorphic ventricular tachycardia (torsades de pointes) QRS

Wide, > 0.12 seconds, QRS amplitude changes throughout rhythm

Polymorphic ventricular tachycardia (torsades de pointes) etiology

Hypokalemia, heart failure, electrolyte imbalance, stimulant ingestion, drug toxicity, sympathomimetic drugs, hypomagnesemia

Ventricular fibrillation rate

None, ventricles fibrillating/not producing pulse

Ventricular fibrillation rhythm

No organized rhythm

Ventricular fibrillation P-wave

None

Ventricular fibrillation PRI

None

Ventricular fibrillation QRS

Absent, wide fibrillatory waves

Ventricular fibrillation etiology

May be precipitated by PVCs, R-on-T phenomenon, or sustained VT, myocardial ischemia, AMI, cardiomyopathy, digitalis toxicity, hypoxia, acidosis, electrolyte imbalance, electrical injury, drug overdose

What is pulseless electrical activity (PEA)?

Electrical activity that appears to be an organized rhythm but is not generating a pulse

Which rhythms are not defibrillated?

Pulseless electrical activity (PEA)

Asystole rate

None

Asystole rhythm

None, flat line

Asystole P-wave

None

Asystole PRI

None

Asystole QRS

None

Asystole etiology

Final rhythm of cardiac arrest, absence of all electrical activity

Premature ventricular contraction (PVC) rate

Dependent on underlying rhythm

Premature ventricular contraction (PVC) rhythm

Underlying rhythm regular, overall irregular due to ectopic beats

Premature ventricular contraction (PVC) P-wave

None

Premature ventricular contraction (PVC) PRI

None

Premature ventricular contraction (PVC) QRS

0.12 seconds

Premature ventricular contraction (PVC) etiology

Usually have no significance, hypoxia (#1 cause), hypokalemia, drug toxicity, myocardial ischemia, electrolyte imbalance, stimulant ingestion, sympathomimetic drugs

What is bigeminy?

Every other complex is a PVC

What is trigeminy?

Every third complex is a PVC

What is unifocal?

Every PVC goes the same direction (up or down)

What is multifocal?

PVCs change direction (up or down)

Idioventricular (ventricular escape rhythm) rate

20–40 bpm

Idioventricular (ventricular escape rhythm) rhythm

Typically regular, may be irregular

Idioventricular (ventricular escape rhythm) P-wave

None

Idioventricular (ventricular escape rhythm) PRI

None

Idioventricular (ventricular escape rhythm) QRS

Wide, > 0.12 seconds

Idioventricular (ventricular escape rhythm) etiology

Impulses from higher pacemakers fail to fire or reach ventricles, often seen as first rhythm after defibrillation

Accelerated idioventricular rhythm rate

40–100 bpm

Accelerated idioventricular rhythm rhythm

Regular

Accelerated idioventricular rhythm P-wave

None

Accelerated idioventricular rhythm PRI

None

Accelerated idioventricular rhythm QRS

0.12 seconds