BASIC ECG RHYTHM RECOGNITION - CPR Classes, … · SINUS TACHYCARDIA •Rounded P waves •Narrow QRS •Normal T wave •Regular rate •Rate above 100 and below 150 •If Rate exceeds

BASIC ECG RHYTHM

RECOGNITION

SINUS RHYTHM

•Rounded P waves

•Narrow QRS

•Normal T wave

•Regular rate

SINUS BRADYCARDIA

•Rounded P waves

•Narrow QRS

•Normal T wave

•Regular rate

•Rate below 60

SINUS TACHYCARDIA

•Rounded P waves

•Narrow QRS

•Normal T wave

•Regular rate

•Rate above 100 and below 150

•If Rate exceeds 150 rhythm becomes SVT

PAROXYSMAL

SUPRAVENTRICULAR

TACHYCARDIA (PSVT)

ATRIAL FLUTTER

•Narrow QRS

•3:1 Conduction rate

•3 “notched” P waves to 1 QRS

•The faster the heart rate the less time for the 3:1 Conduction

•Can be 2:1 or 1:1

ATRIAL FIBRILLATION

•Irregular rhythm

•Narrow QRS

•Some discernable P waves but mostly just “fibrillation” in

between the QRS

PREMATURE VENTRICULAR

COMPLEXES (PVC)

MONOMORPHIC

VENTRICULAR

TACHYCARDIA

POLYMORPHIC VTACH

FINE VENTRICULAR

FIBRILLATION

COARSE VFIB

ASYSTOLE

AV BLOCKS

There are 4 Heart Blocks

1St Degree- Always has an underlying rhythm. Example Sinus Bradycardia with a 1st Heart Block

2nd Degree Type 1 (Mobitz 1)- Very rarley symptomatic

2nd Degree Type 2 Classical (Mobitz 2)- Patient will require implanted pacemaker

3rd Degree (Complete A/V dissociation)- Patient will require implanted pacemaker

Common misconception of heart blocks is that the patient will begin in 1st and progress to 3rd. This is not true. They are 4

totally separate rythms.

1ST DEGREE AV BLOCK

•Rounded P waves

•Narrow QRS

•Normal T wave

•Regular rate

•Small delay in conduction between the SA and AV node

•This causes the PR interval to be prolonged

•PR interval stays regular and consistent

•Treatment is rarely needed except in cases where the underlying rhythm is bradycardia and the patient is symptomatic

•Treatment with Atropine in acceptable

2ND DEGREE TYPE I

•Rounded P waves

•Narrow QRS

•Normal T wave

•Regular rate

•Progressive delay in conduction between the SA and AV

node

•This causes the PR interval to get longer and

longer

•Will drop a QRS

•Treatment is rarely needed except in cases where the

underlying rhythm is bradycardia and the patient is

symptomatic

•Treatment with Atropine in acceptable

Dropped QRS complex. PR Interval getting longer

2ND DEGREE TYPE II

•Rounded P waves

•Narrow QRS or may be widened

•Normal T wave

•Regular rate

•Ventricular pacer is periodically failing to fire

•Treatment with external pacing is needed immediately in

symptomatic patients

•Definite treatment will be a transvenous pacer

•Treatment with Atropine is NOT acceptable

•Atropine will elevate the heart rate without

correcting the underlying firing problem.

QRS complexes fail to fire

2ND DEGREE TYPE II

3RD DEGREE AV BLOCK

•Rounded P waves

•Narrow QRS or may be widened

•Normal T wave

•Regular rate

•R to R interval and P to P is regular

•The Atrial and Ventricular pacers are firing at different

speeds. “The Timing Belt is off”

•Treatment with external pacing is needed immediately in

symptomatic patients

•Definite treatment will be a transvenous pacer

•Treatment with Atropine is NOT acceptable

•Atropine will elevate the heart rate without

correcting the underlying firing problem.

Hidden buried P waves