Sinus Rhythm Criteria

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38 Terms

1
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<p>What rhythm is this?</p>

What rhythm is this?

Sinus Rhythm (the normal, regular rhythm of the heart initiated by the sinoatrial (SA) node with a rate of 60-100 bpm)

2
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What is the criteria for a normal sinus rhythm?

• Preceded by a P wave

• Has a QRS complex

• Has a T wave

• The intervals are within normal ranges

• The heart rate is within 60 – 100/min

• P waves and QRS complexes are similar

• Distance of one R to the next is the same

• Regular rhythm

3
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<p>What rhythm is this?</p>

What rhythm is this?

Sinus Tachycardia (sinus rhythm with a heart rate greater than 100 bpm)

4
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<p>What rhythm is this?</p>

What rhythm is this?

Sinus Bradycardia (sinus rhythm with a heart rate less than 60 bpm)

5
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<p>What rhythm is this?</p>

What rhythm is this?

Sinus Arrhythmia (sinus rhythm with slight irregularity in the rate, often related to breathing)

6
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<p>What rhythm is this?</p>

What rhythm is this?

Atrial Fibrillation (A-Fib) (QRS, T, flat, QRS,,) (an irregularly irregular heart rhythm characterized by the absence of distinct P waves and erratic atrial electrical activity)

7
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<p>What rhythm is this?</p>

What rhythm is this?

Atrial Flutter (A-Flutter) (a rapid, regular atrial rhythm caused by a reentrant circuit, producing sawtooth-shaped flutter waves, typically with an atrial rate of 250–350 bpm)

8
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What are the waves called in between the atrial flutter?

Sawtooth flutter waves (especially visible in leads II, III, and aVF)

9
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<p>What rhythm is this?</p>

What rhythm is this?

Atrial Flutter with 2:1 AV Conduction

10
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<p>What rhythm is this?</p>

What rhythm is this?

Atrial Flutter with 3:1 AV Conduction

11
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<p>What rhythm is this?</p>

What rhythm is this?

Atrial Flutter with 4:1 AV Conduction

12
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<p>What rhythm is this?</p>

What rhythm is this?

1st Degree AV Block (a delay in AV conduction characterized by a prolonged PR interval > 0.20 seconds (1 block) with every P wave followed by a normal QRS complex)

13
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<p>What rhythm is this?</p>

What rhythm is this?

2nd Degree AV Block Type I (Mobitz I / Wenckebach) (PR interval gradually lengthens until a QRS complex is dropped)

14
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<p>What rhythm is this?</p>

What rhythm is this?

2nd Degree AV Block Type II (Mobitz II) (PR interval stays the same, but QRS complexes are suddenly dropped)

15
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<p>What rhythm is this?</p>

What rhythm is this?

3rd Degree AV Block (AV dissociation) (No relationship between P waves and QRS complexes)

16
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Why is 3rd degree AV block also called AV dissociation?

there is no relationship between atrial and ventricular events

17
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<p>What is a Premature Ventricular Contraction (PVC)</p>

What is a Premature Ventricular Contraction (PVC)

extra, abnormal heartbeats that originate in the ventricles, the heart's lower chambers, and disrupt the normal rhythm.

18
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<p>What rhythm is this?</p>

What rhythm is this?

Bigeminy (one, two, PVC (every beat)

19
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<p>What rhythm is this?</p>

What rhythm is this?

Trigeminy (one, two, three, PVC (every 2 beat)

20
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<p>What rhythm is this?</p>

What rhythm is this?

Quadrigeminy (one, two, three, four, PVC in every 3 beat)

21
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<p>What rhythm is this?</p>

What rhythm is this?

PVC in salvo (3 consecutive PVC)

22
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<p>What rhythm is this?</p>

What rhythm is this?

Multifocal (PVC in various forms)

23
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Whats the type of PVC if its less that 5 per min?

Infrequent PVCs

24
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Whats the type of PVC if its 5 or more per min?

Frequent PVCs

25
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What is it called if PVCs occurr singly?

Isolated PVCs (Beats)

26
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What is it called if PVCs occurring in groups of two or more?

Group Beats / Bursts / Salvos

27
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What is it called if 2 PVC’s in a row?

Paired PVCs (Couplet)

28
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What is it called if its three or more PVCs in a row?

Ventricular Tachycardia

29
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What is it called if PVCs alternating with the QRS complexes of the underlying rhythm?

Ventricular Bigeminy (Basically: one, PVC, one, PVC)

30
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What is it called if its PVCs following every two or three QRS complexes of the underlying rhythm?

Ventricular Trigeminy / Ventricular Quadrigeminy

31
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<p>What rhythm is this called?</p>

What rhythm is this called?

R-on-T Phenomenon (A PVC occurring during the downslope of the preceding T wave (vulnerable period of ventricular repolarization)

32
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<p>What rhythm is this called?</p>

What rhythm is this called?

Ventricular Tachycardia (VTAC) (No visible P wave & Ventricular rate 100-220 b/min)

33
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<p>What rhythm is this called?</p>

What rhythm is this called?

Ventricular Fibrillation (V-fib, sawtooth pattern, no visible P wave and QRS complex, chaotic pattern, no cardiac output, a medical emergency)

34
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Why is Ventricular fibrillation a medical emergency?

The heart does not pump blood/ no cardiac output

35
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<p>What rhythm is this called?</p>

What rhythm is this called?

Pulseless electrical activity (PEA) (is a condition where your heart stops. The electrical activity in your heart doesn't generate a heartbeat but it is still shown in the monitor)

36
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<p>What rhythm is this called?</p>

What rhythm is this called?

Asystole (cardiac arrest with no electrical activity)

37
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How to treat asystole?

treat with high quality CPR and 1mg Epinephrine given every 3-5 mins

38
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What will you do if you found out that the tracing of your patient is Asystole?

Check pulse & Start high quality chest compression/CPR