Sinus rhythm
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN6KQwZJj9N3LBnNMWIdQ39ptDzQ1kBObzpZxDHZk6gZUN1USdLjttw3X-k8LCYjQRp7RLjcTFKeV5Q1NNKQ8rZFhM8hlKQ-p51Ux0GNzheBWoqPcG5pJUZPoHvYapXCM1s0xZs6tTqQC7/s320/Slide2.GIF)
sinus rhythm has the following Criteria:
Rate should range between 60-100, regular, there is P wave preceding each complex ,the PR interval is 3-5 small square ,and QRS complex is narrow 1-3 small square
sinus bradycardia
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5l00WRJ-Y_eV5dDcE5ExkmeuCthyphenhyphen7vynhtb3XXKyX0QRcRbe2P9l624GMgLJpNHGfElCnBLkQG7OXmMccdkZpINMK06v8FaByD99KsEnB5p4KSqU1nbUSUJ7MAEk4oGaYkpgeYHOzB0at/s320/Brady.gif)
sinus bradycardia Everything is normal except that rate less than 60/min.
sinus tachycardia
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqN9qjILeZTpvrsZbtwO-jcrK_J4zFwQH60Y1Q2Llg0OkI7sNQauZ6UqwvnGaX3RtYMxZHVBCaqu2FWQ0sIa_dObLHZ1yjzPcaElO5YI0SoodzkZoSSaQ8qMlgxY3W84KHYexu3WCAuw6y/s320/Tachy.gif)
Everything is normal except that rate more than 100 up to 150/min.
PAC (premature atrial CONTRACTION)
Occasional irregularity with some beats came early in position followed by pause look like the preceding wave narrow in nature (beat number 3 &6)
PVC (premature ventricular CONTRACTION)
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjeaDS_MPXn-ZBI8mYcOvuiIL16HtlQmVnp5Wo1dxwZKvfdDsb4PSDxvLjhAO_jn3szkawDaSMH5sCFjdsClRs6dlQRgIC6caF4MJzuTQrxLti3umi4LKJVd6HCF1PCAkPqKaA1TZTAzh1s/s320/PVC_multi.gif)
Occasional irregularity with some beats came early in position followed by pause but wide bizarre shape so the difference between PAC and PVC is is the width of the complex
AF
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPLrR7KoQ3Qd_gE_Utz3voc8mGTQQpJ_2L6LMLVdHbZZkTfyD-nNKTvMFuHLuq8gg53hg9fq_8-ZarGO6Kv5LzWLlBaFLY2Xx9zIQ64B0kW_KjvNOrTs9j_-uRLD6hBt68OTWCTlUNd2iW/s320/Afib.gif)
the above rhythm is AF it is totally irregular and no P wave
Atrial Flutter
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi19T2n2PrB-QBdU2k7H3hA0LRK5RCrPvqn3Ulv719Ixz_aPZqGAFkQxQ2KacDBZJ1UqY1e7Oi8VDF8oKhmGHQN_s4k6rfbcri8uOXUUy9eUsPJojCTOBRLNNvHheho_hgCTXrq8n6t7mNC/s320/Flutter.gif)
Most of the time it is regular rhythm with flutter wave like saw tooth appearance
SVT
The above rhythm is PAT or SVT regular rhythm rate 150-250 no P wave and complex is narrow
VT
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhd8xJ2XmGYm4749TjSoSxh4HKgWmjL2oOeKDdETf_AwSdJtiOlqsCrQ9GMz4mjN7AibVI2NOvwLlczJSkjiNnmenBnZZdHSwAyfNsaKa9vRj6n-q28X8E1qBEgaIlt2o0gMWFgK9G9DtXr/s320/VT.gif)
The above rhythm is VT has same criteria like SVT with exception of the width of the complex it is wide bizarre shape (regular rhythm rate 150-250 no P wave and complex is wide)
VF
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhM1dO6UNKz50SUOh5P7Dwa_jK4Ov6A2JmfcEzU6dgOrgV64elSQu67dv9sRCP7I9jgZSU3oiBju4Teekt8jWblXFNoj5kdDA1ZgXyTVShaY94wRN3XGbK1L_LYwq_0H4E5aT7S_Qog44lR/s320/VF.gif)
Disorganized chaotic electrical signals this VF
This patient needs to be defibrillated!! QUICKLY
Asystole
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgd-c3350mbVQgkqh0Q1b5VsyDgtxTORqRfdyAdsG5OgflC4vOboblqFNypp9ZO4RXX1NjIUM9V2N8bQK-j88yBB5EnnoJQ2YcXZ3EDyz_kMBjlvangFBbAF1AfxLDvYCVe1n5eKPqnupmy/s320/Asystole.gif)
Looking at the ECG you'll see that:
Rhythm - Flat
Rate - 0 Beats per minute
QRS Duration - None
P Wave - None so this asystole
carry on CPR
now we talk about heart blocks we have three types of heart block first ,second and third but the second degree has two subtypes type one and two
first degree heart block
the above tracing is first degree heart block fixed prolonged PR interval above 5 small square
second degree type 1
2nd Degree Block Type 1 (Wenckebach or Mobitz type I)progressive prolongation of PR interval until P had no QRS complex
second degree type 2
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgO1-foMgwSVBx5nSnL0dymGO42Cr9LdGllTP8iDxaj8wDWulAbBWQjEe4HJ-jX9pBR_qgIlx9KENadnpCaoq-upS_NS3izdzax5xb6xFLe5UxO7x3vuwvlHBCXCqXki60CGmldTDMdCbUf/s400/second2.bmp)
fixed block One beat will be conducted other not conducted so some P wave followed by QRS complex other P wave not followed by P wave
Third degree heart block
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg62IbP_vqYQ8kmqpxeGOJysiO25zVGHPsKo0sFaAbkZW_dVPE6wFIq4m66WZUOvy8btSN_3cxtvS6ab9IyEVuPCYjd5TmLTmKulWvdV35GUx91oWG2CEY5CrbmqicWqJWluKC2VCWtxeKZ/s400/third.bmp)
No relation between P wave and QRS complex (p wave regular at normal rate and QRS complex is regular at slower rate but no relation between them
Junctional Rhythms
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhkR1_F7ngd3s4syC3Z1Zstbaput_ww8ifwa8aQ4aJKFTDd92Mn9RZV25fzWcuoLGI-qzpTHwHhY5r2QIrJyTxFvKlrTKNIVIoTtsxeadTajz0ON0D7uyHxAfpGQOTJ6-d6KwdmOkU7s-pH/s400/junctional2.bmp)
Regular rhythm with inverted P wave or no P wave note that the complex is narrow at rate of 40-60 /min.
IDIOVENTRICULAR rhythm
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEitmPrJ6urPO-M3lcn0g5ziHm3IOmqAjKs__P9ks-iN8B4edeXEsemPLH3fGGEBAZ0bYkUbiSZBis9xhkZl-QwaRLeb0j6Lnqg2JVcrtzGoFL_XntEDqYFN6XgUsnPMXutnBkuWgig6T2O6/s400/idiov.gif)
Rate: 40 bpm
Rhythm: Regular
P wave: no look
the complex is wide
paced rhythm
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgC9pD6e39EIuF5gqdVxi_IHsJkjf-i0iqDja_xmwkDuWCyG76VWe5Ff188u3XJDHERzcC8ttq3_9fOOORCYnS0Gar1fmXZA2MKKYVqJd9I2mVQERcjdNBh3-oz8vQaqmD6Vya1J0pld420/s400/paces.gif)
Artificial spike before each complex
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