Wednesday, March 4, 2009

Basic ECG rhthym

Sinus rhythm
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
sinus bradycardia Everything is normal except that rate less than 60/min.
sinus tachycardia
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)
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
the above rhythm is AF it is totally irregular and no P wave
Atrial Flutter 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
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 Disorganized chaotic electrical signals this VF This patient needs to be defibrillated!! QUICKLY Asystole 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

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

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 Regular rhythm with inverted P wave or no P wave note that the complex is narrow at rate of 40-60 /min. IDIOVENTRICULAR rhythm

Rate: 40 bpm

Rhythm: Regular

P wave: no look

the complex is wide

paced rhythm

Artificial spike before each complex

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