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ECG Course > Rhythms > Flashcards

Rhythms Flashcards

1
Q

What are the features of Sinus Rhythm?

A 
P wave followed by QRS complex
P-waves: Present and upright
Rate: 60-99bpm
Rhythm: regular
PR Interval:
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2
Q

What defines Sinus Arrhythmia?

A

P-waves: Present and upright
Rate: 60-99bpm
Rhythm: irregular
PR Interval:

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3
Q

What feature distinguishes bradycardia?

A

Rate >60bpm

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4
Q

What feature distinguishes Tachycardia?

A

Rate >100

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5
Q

What is a sinus pause?

A

Failure of the atria to depolarise for 1-2 beats. Sinus node does not reset and the impulse formed is blocked by the atria.

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6
Q

Describe sinus arrest

A

Failure of SA node to generate an impulse for >2 cycle lengths; SA node needs to reset.

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7
Q

What is/ are Junctional Escape Rhythm / Beats?

A

≤2 consecutive QRS complexes from escape pacemaker = junctional beats. ≥ 3 onsecutive QRS complexes from escape pacemaker = junctional rhythm.
Rhythm originating from AV junction escape pacemaker causing Antegrade Ventricular depolarisation and retrograde atrial depolarisation. It appears after the next sinus beat is due.

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8
Q

What are the ECG features of Junctional Rhythm/ Accelerated Junctional Rhythm/ Junctional Tachycardia?

A 
P-waves: absent/inverted/ in QRS
Rate: 40-60bpm
Rhythm: Regular
PR Interval: N/a due to absent P-Waves
QRS complex: narrow and normal
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9
Q

What is a super ventricular ectopic?

A

A narrow looking premature beat originating from a site in the atria or AV node.

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10
Q

Define the ECG features of Supraventricular Tachycardia.

A

Rate: 140-250bpm
Rhythm: Regular
P-waves: Absent/ hidden in previous T-wave/ Different morphology or configuration.

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11
Q

What does an ECG depicting Atrial Flutter look like?

A

P-waves: Replaced by saw tooth flutter waves.
Rate: Atrial: 250-400bpm, Ventricular: 60-100bpm
Rhythm: Atrial: Regular, Ventricular: regular/irregular

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12
Q

What does an ECG depicting Atrial Fibrilation look like?

A

P-waves: Replaced by erratic baseline fibrillatory waves.
Rate: Atrial: >400bpm, Ventricular: Slow 100bpm
Rhythm: irregular

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13
Q

What is a wandering Atrial pacemaker and how does it present on ECG?

A

Vagal tone decreases SA node activation causing atrial depolarisation to be stimulated by different pacemakers in the atria and AV junction. Pacemaker site generally changes changing P-wave morphology.

P-waves: Differing morphology
Rhythm: Irregular/ regular

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14
Q

What are the ECG features of Idioventricular rhythm?

A

P-waves: absent/ present if there is AV dissociation
Rate: 20-40bpm
Rhythm: regular/ irregular
QRS: >0.12s - wide and bizarre
Accelerated Idioventricular rhythm = 40-100bpm

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15
Q

What is a Ventricular Ectopic?

A

Premature beats arising from a ventricular escape pacemaker (bundle branches, Purkinje network, ventricular myocardium)
QRS: >0.12s - wide and bizarre
No P-wave preceding beat.

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16
Q

What is unofficial VE?

A

VE arrises from the same focus; same morphology

17
Q

What is a multifocal VE?

A

Arises from different foci; different morphology.

18
Q

What is ventricular bi- and tri- geminy?

A

A VT occurring every 2nd or 3rd beat respectively.

19
Q

What is Ventricular Tachycardia and what are the ECG Features?

A

Originates in a ventricular ectopic pacemaker. Is a run of ≥3 VE’s. Sustained VT= >30s; non-sustained VT = VT 0.12s

20
Q

What is R on T phenomenon?

A

VE occures in Relative refractory period (Halfway through T-Wave). Can cause VT or VF.

21
Q

What is ventricular fibrillation?

A

Asynchronis and rapid ventricular twitching. CO ceases, patient loses consciousness.

22
Q

What is Ventricular Standstill (Asystole)?

A

Absence of ventricular contraction. No QRS. P waves may occur at 60-100bpm.

23
Q

What is Electromechanical Dissociation or Pulseless Electrical Activity?

A

Any rhythm that appears on ECG but does not produce a pulse.

24
Q

What are the ECG features of 1st Degree AV Block?

A

PR interval constant and >0.2s

25
Q

What are the ECG features of 2nd Degree AV Block, Moritz Type 1 (Wenchebach)?

A

Lengthening PR interval until conduction fails and a QRS is dropped.

  • Count Atrial and Ventricular Rates
  • Look at Atrial and Ventricular Rhythms
  • Cyclical Rhythm
26
Q

What are the ECG features of 2nd Degree AV Block, Moritz Type 2?

A

-Constant PR Interval with a dropped beat.
- Atrial rate and rhythm regular
_ Ventricular rate and rhythm irregular

27
Q

What are the ECG features of 2nd Degree 2:1 and High degree block?

A

Atrial rate > ventricular rate. 2:1 = 2 p-waves: 1 QRS. High Degree block = ≥3 p-waves : 1 QRS.
- if P-wave occurs before the T-wave cannot measure QT interval.

28
Q

What are the ECG features of 3rd degree AV Block?

A
  • Dissociation between SA node and AV node
  • Atrial and Ventricular rhythm are regular but independent
  • interpretation= sinus rhythm with an atrial rate of….. with junctional rhythm and a ventricular rate of……
  • measure p-p interval to check rhythm regularity
29
Q

What are the ECG Features of Right Bundle Branch Block?

A
  • QRS: incomplete: 0.10-0.11s, complete: >0.12
  • Wide rSR’ wave (M shape) V1 - V2 with possible T wave inversion
  • V5-V6 qRS with slurred S wave
  • Left anterior fascicular block also present if LAD is present
30
Q

What are the ECG Features of Left Bundle Branch Block?

A
  • QRS: incomplete: 0.10-0.11s, complete: >0.12
  • deep wide QRS complexes with slurred S waves V1-V3
  • Tall Wide RS, notched at peak. May have T-wave inversion
  • ST: N/A due to LBBB
  • T-wave: N/A due to LBBB
  • QTc: N/A due to LBBB
  • Axis: usually LAD
31
Q

What are the ECG characteristics and the common causes of LAFB?

A
  • ECG Characteristics:
  • Left axis
  • small +ve R waves in II, III, and aVF
  • small q waves in I and aVL

Cause: acute anteroseptal MI

32
Q

What are the ECG characteristics and the common causes of LPFB?

A
  • ECG Characteristics:
  • Right axis
  • small +ve R waves in I and aVL
  • small q waves in II, III, and aVF

Cause: acute anteroseptal MI involving LAD and either acute right ventricular or inferior MI involving PDA.

ECG Course (2 decks)

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