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P53 interpretation of ECG basic

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Rhythm
Rate / Regularity
P wave
P wave duration
QRS duration
Ration 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)  
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Normal Sinus Rhythm (NSR)   60-100bpm / Reg-Reg   Upright and similar   0.12-0.20sec & consistent   0.04-0.10sec   1P:1qRs  
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Sinus Tachycardia   >100bpm / Reg-Reg   Upright and similar   0.12-0.20 sec & consistent   0.04-0.10 sec   1P:1qRs  
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Sinus Bradycardia   <60bpm / Reg-Reg   Upright & similar   0.12-0.20 sec & consistent   0.04-0.10 sec   1P:1qRs  
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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  
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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  
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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  
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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  
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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  
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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  
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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  
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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    
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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  
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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  
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Ventricular Fibrillation (Vfib)   could be any   no regularity/chaotic undulating   no P   n/a   No qRs  
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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  
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Aystole   0 / unless P present then could be reg or irregular   may be present   n/a   not there   not there  
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1st degree AV block   1P:1qRs   indicated by prolonged PRI (>0.20sec but not >0.40sec)        
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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    
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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  
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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  
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