ecg Flashcards
Normal Sinus Rhythm
Rate: 59-100bpm
Rhythm: regular
P wave: 1 wave before every QRS
PR Interval: 0.12 - 0.20 sec
QRS: < 0.12 sec
QT Interval: < 0.44 sec
ST Segment isoelectric
Sinus Bradycardia
Rate: < 59 bpm
Rhythm: regular
P wave: 1 wave before every QRS
PR interval: 0.12 - 0.20 sec
QRS: < 0.12 sec
Sinus Tachycardia
Rate: > 101 (101-150) bpm
Rhythm: regular
P wave: 1 wave before every QRS
PR interval: 0.12 - 0.20 sec
QRS: < 0.12 sec
Sinus Arrhythmia
Rate: varies
Rhythm: irregular
P waves: 1 p wave for every QRS
PR interval: 0.12 to 0.20 sec
QRS: < 0.12 sec
Sinus Exit Block
Rate: varies
Rhythm: irregular secondary to missing at least 1 P-R-QRS-T
P waves: 1 p wave for every QRS
PR interval: 0.12 to 0.20 sec
QRS: < 0.12 sec
[ pause = multiple R to R ]
Sinus Arrest
Rate: varies
Rhythm: irregular secondary to missing at least 1 P-R-QRS-T
P waves: 1 p wave for every QRS
PR interval: 0.12 to 0.20 sec
QRS: < 0.12 sec
Atrial Arrhythmias
-origin of the pacemaker site is at or above the AV Node junction but is not the SA Node
-single atrial node
-multiple atrial node
Common characteristics:
-narrow QRS
-Without regular, typical appearing, or discernible P waves
-Regular or Irregular rhythm
Premature & Ectopic
-Premature beats occur before the next R wave s expected
-Ectopic beats originate outside of the “normal” conduction
Examples:
Premature Atrial Contraction (PAC)
Premature Junctional Contraction (PJC)
Premature Ventricular Contraction (PVC)
Premature Atrial Contraction (PAC)
Rate: Underlying rhythm
Rhythm: irregular w/ PACs
P waves: P Wave associated with PAC is premature & abnormal in size & shape.
PR interval: usually normal
QRS: premature w/ normal duration (< 0.12 sec)
Supraventricular Tachycardia (SVT, Atrial Tach)
Rate: 151-250 bpm
Rhythm: regular
P waves: usually hidden
PR interval: not measurable
QRS: < 0.12 sec
Atrial Flutter (A-flutter)
Rate: Atrial -> 250-400 bpm (not measured), Ventricular-> varies
Rhythm: irregular and regular
P waves: “saw tooth” or flutter waves
PR interval: not measurable
QRS: < 0.12 sec
Atrial Fibrillation (A-Fib)
Rate: uncontrolled > 100 bpm
controlled < 100 bpm
Rhythm: grossly irregular; irregular and irregularly
Atrial: fast
Ventricular: varies
P waves: none
PR interval: not measurable
QRS Complex: Normal < 0.12 sec
Junctional Rhythms
Rate: 40-60 bpm: junctional escape
60-100 bpm: Accelerated Junctional
> 100 bpm: Junctional Tachycardia
Rhythm: regular
P waves: inverted and too close to QRS; immediately after the QRS complex; or hidden within the QRS complex
PR interval: < 0.12 sec or not present
QRS: < 0.12 sec
-> originate in the AV Node
-> AV Node
-> backup pacemaker
-> “gatekeeper”
-> delays impulse (PR Interval)
-> screens out excessive impulses
-> QRS should be narrow
Premature Junctional Contraction (PJC)
Rate: that of underlying rhythm
Rhythm: irregular with PJC
P waves: premature inverted & too close to QRS; immediately after the QRS complex; or hidden within the QRS complex
PR interval: < 0.12 or not measurable
QRS: < 0.12 sec
Heart block
the atria and the ventricles are having communication problems; possible heading for divorce
-> P’s atria
-> QRS ventricles
-> healthy relation
-> 1:1 relationship P:QRS
-> PR interval normal
-> QRS should be narrow
First degree AV block
Rate: varies 60-100 bpm
Rhythm: usually regular
P waves: 1 P wave to each QRS complex
PR interval: > 0.20 sec
QRS: < 0.12 sec
[ If the R is far from P, then you have a ___. ]
Second degree type 1 AV block
Rate: varies
Rhythm: Atrial -> regular
Ventricles -> irregular
P waves: move P’s than QRS
PR interval: varies progressively lengthens until a P wave is not conducted through to a QRS
QRS: < 0.12 sec
[ LONGER, LONGER, LONGER drop then you have a “wenkebenon ]
Second Degree Type 2 AV Block
Rate: varies can be bradycardiac
Rhythm: Atrial -> regular
Ventricles -> regular / irregular
P waves: extra “Ps”
PR interval: remains constant: when conducted beat the P with the QRS remains the same
QRS: could be normal or < 0.12 sec
[ If some Ps don’t get through you have “Mobitz 2”
Third degree (complete) AV block
Rate: varies usually less than 60
Rhythm: Atrial -> regular greater than ventricular
Ventricles -> regular
P waves: no constant relationship to QRS complex
PR interval: varies greatly: fake interval
QRS: could be normal or < 0.12 sec
[ If Ps & Qs don’t agree, then you have a 3rd degree ]
Buddle Branch Block
Rate: that of the underlying rhythm
NSR with BBB, sinus Brady with a BBB
(right vs left BBB : 12 lead ECG)
Rhythm: usually regular
P waves: normal
PRI: 0.12-0.20 sec
QRS: > 0.12 secs; wide
premature ventricular contraction (PVC)
Rate: underlying rhythm
Rhythm: irregular or regular
P waves: no P waves for a __.
PRI: none
QRS: if premature > 0.12 secs
Accelerate IVR
Rate: 41-100bpm
Rhythm: regular
P waves: none, the impulse originates in the ventricles
PRI: none
QRS: > 0.12 sec wide
Idioventricular Rhythm (IVR)
Rate: 30-40 bpm; sometimes less
Rhythm: regular
P waves: none, the impulse originates in the ventricles
PRI: none
QRS: > 0.12 sec wide
Ventricular Tachycardia (VT)
Rate: > 100 bpm
Rhythm: regular
P waves: none, the impulse originates in the ventricles
PRI: none
QRS: > 0.12 sec wide
Torsades de pointes
Rate: too fast
Rhythm: irregular
P waves: none, the impulse originates in the ventricles
PRI: none
QRS: > 0.12 sec wide “twisting about the points” a polymorphic VTach
Ventricular fibrillation (V-fib)
Rate: none
Rhythm: chaotic, irregular deflections no organized depolarization
P waves: none, the impulse originates in the ventricles
PRI: none
QRS: none, chaotic irregular deflections
Asytole
-absence of ventricular activity
-> no impulse, cardiac output, or electrical activity
-P waves ___
-> Atria still trying but.. ventricles not trying
Pulseless Electrical Activity (PEA)
organized (expecting a pulse) rhythm on monitor
-> no pulse
