| Term | Definition |
| Premature Atrial Complex (PAC) | Individual Complex that occurs earlier than next expected complex.
P waves- different in size, may be merged w/ T wave, or hidden under it. (T wave will look different than other)
***Depends
***Followed by a pause before rhythm returns |
| Bigeminy of PVC's | Every other QRS complex in a rhythm is a premature ventricular complex. (PVC)
QRS-unifocal or mulifocal
*Had delta little looking waves and every other QRS is flipped upside-down. |
| Sinus Brady | P waves- Upright (a little) before QRS complex
PR- 0.12-0.20
QRS- less than .12
HR- slower than 60
P-P & R-R (same size) |
| Premature Junctional (PJC) | Occurs Earlier than expected followed by pause. Not a true rhythm
P waves- inverted, hidden or retrograde
***PR-if seen, less than 0.12
QRS- less than 0.12
HR-
P-P & R-R (Vary depending on rhythm) |
| Sinus Arrhythmia | P waves- Upright (a little) before QRS complex
PR- 0.12-0.20
QRS- less than 0.12
HR- 60-100
***P-P & R-R- IRREGULAR (Change with respirations)
*Heart rate 6- second method is best to determine HR |
| Junctional Escape Rhythm | P waves- Retro, hidden, or upside
PR- Vary
QRS-less than 0.12
HR-40
****Looks like a Normal Sinus Rhythm except for a "Premature" beat is seen. But Sinus has no Premature beats so its either atrial or junctional depending on p wave shape. |
| Wandering Atrial Pacemaker | Originates from at least 3 different sites above the bundle of his, involves any pace maker.
P waves- lets you know location.
PR- usually 0.12-0.20, varies by location of pace maker.
QRS- vary
HR-60-100
P-P & R-R (vary) |
| Supra ventricular Tachycardia (SVT) | P waves- normal before QRS, may be hidden under T wave
PR- 0.12-0.20
QRS- less than 0.12
HR- 151-250 or more
P-P & R-R (same size) |
| Atrial Flutter | P waves- None.
**F waves instead **Saw-Toothed
F to QRS- 2:1 ration, etc..
**QRS- not present for every F wave, less than 0.12 if any (regular)
HR- 60-100<-- measured by QRS
AR-250-350<-- measured by F waves
R-R (Vary) <--6 sec strip |
| 3rd Degree Heart Block | When atria and ventricles both work independently as pace makers.
**P waves- shows they change length but they do not really.
PR- No true PR occurs
**QRS- Wide, longer than 0.12
HR- 20-40
AH- 60-100
P-P & R-R (look equal, but not to each other.) |
| Torsades de Pointes | Looks Similar to Ventricular Tachycardia "WW", but has no pattern, is very random, and sides get smaller.
P waves- Rarely seen
PR- Not measurable
QRS- Wide, Bizarre, longer than 0.12
HR- more than 150 HR
R-R (Regular or slightly irregular) |
| Normal Sinus | P waves- round (look same)
PR- 0.12-0.20
QRS- less than 0.12 (look same)
HR-60-100
P-P & R-R (same size) |
| Sinus Tachycardia | P waves- Upright (a little) before QRS complex, May be hidden if fast HR under T wave.
PR- 0.12-0.20
QRS- less than 0.12
HR- 101-150
P-P & R-R (same size) |
| Bundle Branch Block (BBB) | Impulse takes detour. "Rabbit Ears"<-- look like a delta dent in QRS
P waves- Vary
PR-Vary
**QRS- more than 0.12 (Wider)
HR-Vary
P-P & R-R (Vary on Rhythm) |
| Accelerated Idioventricular dysrhythmia (AIVR) | *looks alike a sharp p, and low Q with. Like a V, but other side is not as steep.
P waves-not present
PR- Not measurable
QRS- gradually decreases in amplitude, greater than 0.12, wide
HR- 41-100
P-P & R-R (irregular) |
| Ventricle Tachycardia | Look like "WWWWW"
P waves- Not usually present
PR- Not measurable
QRS- Wide, Bizarre, longer than 0.12
HR- 101-250
R-R (Regular, slightly irregular) |
| ST Elevation | the S wave and T wave are higher then the p wave.
has to be more than one small box above baseline. |
| Ventricle Fibrillation (V-Fib) | Chaotic Wavy line on monitor. (No pattern)
P waves- Not present
PR- Not Present
QRS- Not Present
HR- Not Measurable
P-P & R-R (Not Present) |
| Atrial Fibrillation (A Fib) | P waves and PR- No true waves exist because of quivering
QRS- less than 0.12
HR- 60-100
AH- 350-500
R-R (irregular and no pattern)<-- Give away |
| 2nd Degree Type I | Mobitz I, Wenckeback
More P waves than QRS
PR- BECOME LONGER IN RHYTHM until QRS is dropped
PR **Greater than 0.20
QRS- less than 0.12
HR- Vary |
| 2nd Degree Type II | Mobitz II, Classic
P waves- More p waves than QRS
PR- Normal or a little longer (DOES NOT GET LONGER IN RHYTHM)
QRS- is dropped suddenly, (Wide)
HR- Varies
P-P & R-R (Regular until QRS dropped) |
| Asystole | Complete Lack of Electrical Activity in Heart. (No Pulse) Appears as a slightly wavy or straight linen screen.
P waves- None
PR- None
QRS- None
HR-
P-P & R-R (None) |
| Paced Atrial Rhythm | P waves-Spike is seen at beginning of P wave.
You can see a line where the artificial pacer started the impulse. |
| Premature Ventricular Complex (PVC) | Followed by a compository pause. You can measure by measuring R-R before and after PVC. Distance will be 2x more
P waves- No P Wave when happening
**QRS- Wide, bizarre looking, greater than 0.12 (Some appear Upside down)
HR-Vary
P-P & R-R (Vary) |
| Paced Ventricle Rhythm | P waves- Spike
QRS- usually greater than 0.12 looks downward
P-P & R-R (regular)
You can see the line where Artificial pacer started impulse. |
| Accelerated Junctional | P waves- inverted, hidden, or retorgrade
*PR- if present less than 0.12
QRS-less than 0.12
HR- 61-100
P-P & R-R (Regular) |
| Normal Rhythm | Sinus Rhythm, SVT, Accelerated Junctional |
| Irregular Rhythm | Sinus Arrhythmia, PAC, A-Fib, PJC, 2nd Degree type I, 2nd Degree type II, 3rd Degree HB, PVC, Idioventricular, |
| PAC | **Normal Sinus Rhythm if not for that ONE irregular one w/ pause making it an irregular rhythm. |
| SVT | **Confused with Sinus Tachycardia. Only its 150-250 and not 100-150
**Originates from above the bundle of his
**Triggered by irritability in atria |
| Life Threatening | 2nd Degree Type II, 3rd Degree HB, Ventricular Tachycardia, Ventricular Fibrillation, Asystole, |
| Junctional | Inverted P wave (Upside down P wave)
Buried P wave (Under QRS)
Retrograde P wave (After QRS, close to J point) |
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