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ELECTROCARDIOGRAPH RHYTHMS

Sinus Rhythms: Contractions that originate from the SA Node

(Normal) Sinus Rhythm: follows the five standard rules, and is the ideal rhythm for any healthy individual.

  • RHYTHM is regular (if Atrial=70 bpm, then Ventricular=70 bpm)
  • RATE = 60-100 bpm
  • P-WAVE = visible, uniformity and upright, 1 for every QRS
  • PRI = between 0.12-0.20s
  • QRS = between 0.08-0.12s

    Sinus Bradycardia: an unusual slow heart rate

  • RHYTHM is regular (if Atrial=40 bpm, then Ventricular=40 bpm)
  • RATE < 60 bpm
  • P-WAVE = visible, uniformity and upright, 1 for every QRS
  • PRI = between 0.12-0.20s
  • QRS = between 0.08-0.12s

    Sinus Tachycardia: an unusual fast heart rate

  • RHYTHM is regular (if Atrial=120 bpm, then Ventricular=120 bpm)
  • RATE > 100 bpm
  • P-WAVE = visible, uniformity and upright, 1 for every QRS
  • PRI = between 0.12-0.20s
  • QRS = between 0.08-0.12s

    Sinus Dysrhythmia: is essentially a sinus rhythm with some irregularity. If there are 2 or more QRS complexes on a strip that vary in time between by greater than 0.16s (4 small squares) from the average R-R timing, it is a sinus dysrhythmia. The trick is to examine the rhythm and see if it looks slightly irregular between beats.

    Sinus Arrest: is a temporary loss of SA Node automaticity causing an inferior pacemaker site to depolarize (sometimes causing the loss of a P-wave for the following beat). The appearance on a strip will be a rhythm with a long period between contractions (like a dropped beat).

    Wandering Pacemaker: is a transient rhythm with different initial conduction sites (opposed to the SA node) within the Atria to the AVJ that cause the P-wave to vary in appearance. The P may be upright and then absent and then inverted while the the rest of the rhythm remains the same.



    • Atrial Rhythms: Contractions that originate in the Atria

    Supraventricular Tachycardia / PSVT: Paroxysmal SVT (PSVT) is SVT that comes and goes. SVT is a re-entry dysrhythmia where conduction occurs rapidly and overrides normal SA Node conduction entering the AV Node and is conducted entirely though.

  • RHYTHM is regular (if Atrial=180 bpm, then Ventricular=180 bpm)
  • RATE 150-250 bpm
  • P-WAVE = present, absent OR inverted
  • PRI = between 0.12-0.20s (most likely shorter tho)
  • QRS = between 0.08-0.12s (if no ventricular disturbances)

    Atrial Tachycardia:



  • Atrial Flutter:



  • Atrial Fibrillation:





    • Atriaventricular Junctional Rhythms: Contractions that originate from the AVJ

    Junctional Escape:



  • Accelerated Junctional:




    • Ventricular Rhythms: Contractions that originate in the Ventricles

    Ventricular Escape (Idioventricular):



  • Ventricular Tachycardia (V-tach):



  • Ventricular Fibrillation (V-fib):



  • Ventricular Asystole:



  • Artificial Pacemaker Rhythm:




    • Premature Contractions:

    Premature Atrial Contractions (PACs):



  • Premature Junctional Complex (PJCs):



  • Premature Ventricular Contractions (PVCs):




    • Conduction Disorders:

    1st Degree AV Block:



  • 2nd Degree AV Block, Type I (Wenckebach):



  • 2nd Degree AV Block, Type II:



  • 3rd Degree Complete Heartblock:



  • Bundle Branch Blocks:






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