ECG rhythms Flashcards

1
Q

How to identify:

LBBB

A

QRS >120ms

QRS downwardly deflecting in V1

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2
Q

Normal Sinus rhythm

A

Regular

Rate 60-100 bpm

PR interval 120-200 ms (3-5 small squares)

P wave precedes each QRS complex

QRS 80-120 ms (2-3 small squares)

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3
Q

Sinus tachycardia

A

Regular

Rate >100 but <150 bpm

Popping P waves

Each P followed by QRS

PR normal and constant

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4
Q

Sinus Bradycardia

A

Regular

Rate <60 bpm

Popping P waves

Each P followed by QRS

PR normal and constant

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5
Q

Atrial ectopics

A

Originates from a focus in the atria

Usually P wave is abnormal in shape - Not Popping

Usually normal QRS

Followed by a compensatory pause

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6
Q

Atrial Fibrilation

A

Irregularly Irregular

No P waves

Rate may be slow, normal or fast

QRS usually normal

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7
Q

Atrial Flutter

A

Usually regular

No popping P waves

Flutter waves - saw tooth appaerance

Atrial rate around 300bpm

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8
Q

Narrow Complex Tachycardia

A

rate >100 (usually >150 bpm)

regular

QRS normal (narrow equal to or <120 ms)

Absence of P waves

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9
Q

Ventricular Tachycardia

A

Very broad complexes (>160ms).

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10
Q

Heart block:

1st degree

A

Regular

popping P’s

Each followed by QRS

QRS normal

PR interval prolonged and constant

Usually benign except in combination with other blocks

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11
Q

Heart Block:

2nd degree AV block
mobitz type I (wenckebach AV block)

A

Irregular

Can be slow/normal

Popping P’s

PR interval progressively lengthens

until P wave is not followed by QRS

Life in the fast lane:
Progressive prolongation of the PR interval culminating in a non-conducted P wave

PR interval is longest immediately before the dropped beat

PR interval is shortest immediately after the dropped beat

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12
Q

Heart Block:

Mobitz Type II (Hay AV block)

A

usually Irregular (may be regular)

Usually slow

Popping P waves

Not every P wave followed by QRS

PR interval constant when present

Sudden drop of QRS

Life in the fast lane:
Intermittent non-conducted P waves without progressive prolongation of the PR interval

PR interval in the conducted beats remains constant.
P waves ‘march through’ at a constant rate.

RR interval surrounding the dropped beat(s) is an exact multiple of the preceding RR interval (e.g. double the preceding RR interval for a single dropped beat, treble for two dropped beats, etc).

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13
Q

Heart Block:

AV block: 3rd degree CHB (complete heart block)

A

Regular ventricular rate (QRS)

Regular atrial rate (p)

NO RELATIONSHIP between P and QRS

Usually slow

P waves popping

QRS often wide in acute setting

Life in the fast lane:
In complete heart block, there is complete absence of AV conduction – none of the supraventricular impulses are conducted to the ventricles.

Perfusing rhythm is maintained by a junctional or ventricular escape rhythm. Alternatively, the patient may suffer ventricular standstill leading to syncope (if self-terminating) or sudden cardiac death (if prolonged).

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