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ECG rhythm interp

P53 interpretation of ECG basic

RhythmRate / RegularityP waveP wave durationQRS durationRation P to QRS notes
ECG Rules and Characteristics (5 step)Rhythm Interpretation Analyze Rate (How fast or slow) Analyze Rhythm (Regular?) (occasional irreg)(reg irreg)(irreg irreg) Analyze P wave (P present)(P regular to Ps)(One P for each QrS)(upright or inv)(look alike) Analyze PRI (norm 0.12-0.20sec) Analyze QRS (look alike)(Duration norm 0.04-0.12)
Normal Sinus Rhythm (NSR) 60-100bpm / Reg-Reg Upright and similar 0.12-0.20sec & consistent 0.04-0.10sec 1P:1qRs
Sinus Tachycardia >100bpm / Reg-Reg Upright and similar 0.12-0.20 sec & consistent 0.04-0.10 sec 1P:1qRs
Sinus Bradycardia <60bpm / Reg-Reg Upright & similar 0.12-0.20 sec & consistent 0.04-0.10 sec 1P:1qRs
Premature Atrial Contraction(PAC) usually <100bpm /dependant on underlying rhythm / Irregular Early & upright/ different from Sinus 0.12-0.20sec / different from Sinus 0.04-0.10sec 1P:1qRs
Atrial Flutter Atrial: 250-350 / Ventricle: 150 common/ A: Regular Vent: Reg or Irregular Not identifiable / F waves uniform (sawtooth) not measurable 0.04-0.10sec n/a due to no P defined
Atrial Fibrillation Atr: 400-700 /Vent: 160-180 /A: Irr V: Irr not identifiable P / f waves may be seen unable to measure usually normal n/a due to no P
Paroxysmal Atrial Tachycardia(PAT) usually 160-220bpm / Reg-Reg differ in shape from Sinus/ difficult to identify due to rate Normal when P identified / short if WPW normal 1P:1qRs onset sudden often inititated by PAC
Premature Junctional Conatraction(PJC) usually <100bpm (dependant on undr) /Irregular Inverted before or after qRs or not visible <0.12sec when inverted P is before qRs 0.04-0.10 sec 1P:1qRs if P visible
Junctional Escape Rhythm 40-60bpm or 61-100 (accelerated)/Regular Inverted before or after qRs or not visible <0.12sec when inverted before QRs 0.04-0.10sec 1P:1qRs if P visible
Junctional Tachycardia 101-200bpm/Regular Inverted before or after qRs or not visible <0.12sec when inverted before QRs 0.04-0.10sec 1P:1qRs if P visible
Supraventricular Tachycardia (SVT)/ umbrella term used when unable to distinquish which rhythm present >150bpm / absolutely regular P wave not visible not measurable 0.04-0.10sec
Premature Ventricular Complex (PVC) dependant / A: Reg V: Irr usually absent if present not associated with PVC if present? 0.12 or greater / bizarre and notched n/a ST&T often opposite qRs/ every other bigeminy / multifocal if different shape/ RonT =PVC
Ventricular Tachycardia (Vtach) >100bpm usually not >220 / usually regular no P or not associated n/a Wide and bizarre three PVC in row or more at 100bpm is Vtach
Ventricular Fibrillation (Vfib) could be any no regularity/chaotic undulating no P n/a No qRs
Idioventricular Rhythm 20-40bpm / 40-100bpm(accelerated) / Regular No P associated with qRs n/a >0.12sec notched /bizarre ST/T oppposite direction of qRs
Aystole 0 / unless P present then could be reg or irregular may be present n/a not there not there
1st degree AV block 1P:1qRs indicated by prolonged PRI (>0.20sec but not >0.40sec)
2nd degree AV block type 1 Ap not equal V More P waves than qRs PRI progressively increases until P appears w/o qRs cyclic pattern reoccurs non-conducted Pwave
2nd degree AV block type 2 could be Reg or Irreg More P waves than qRs PRI consistent qRs normal (if wide Bundled Branch block) non-conducted P waves present
3rd degree AV block More P waves than qRs P not related to qRs (P too close or too far) PRI varies greatly qRs normal or wide could have regular Vent
Created by: rdslack