ECG Strips

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created 3 weeks ago by rob_coleman_ems
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Basic Arrhythmias
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updated 3 weeks ago by rob_coleman_ems
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1
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Normal Sinus Rhythm

Rhythm: Regular
Rate: Normal (60-100 bpm)
P Wave: Normal (positive & precedes each QRS)
PR Interval: Normal (0.12-0.20 sec)
QRS: Normal (0.06-0.10 sec)

2
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Sinus Arrhythmia

Rhythm: Irregular, varying with respiration
Rate: Normal (60-100 bpm) and rate may increase during inspiration
P Wave: Normal
PR Interval: Normal (0.12-0.20 sec)
QRS: Normal (0.06-0.10 sec)
Notes: Heart rate frequently increases with inspiration, decreasing with expiration

3
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Sinus Bradycardia

Rhythm: Regular
Rate: Slow (< 60 bpm)
P Wave: Normal
PR Interval: Normal (0.12-0.20 sec)
QRS: Normal (0.06-0.10 sec)

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Sinus Tachycardia

Rhythm: Regular
Rate: Fast (> 100 bpm)
P Wave: Normal, may merge with T wave at very fast rates
PR Interval: Normal (0.12-0.20 sec)
QRS: Normal (0.06-0.10 sec)
Notes: QT interval shortens with increasing heart rate

5
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Atrial Fibrillation

Rhythm: Irregular
Rate: Very fast (> 350 bpm) for Atrial, but ventricular rate may be slow, normal or fast
P Wave: Absent - erratic waves are present
PR Interval: Absent
QRS: Normal but may be widened if there are conduction delays

6
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Atrial Flutter

Rhythm: Regular or irregular
Rate: Fast (250-350 bpm) for Atrial, but ventricular rate is often slower
P Wave: Not observable, but saw-toothed flutter waves are present
PR Interval: Not measurable
QRS: Normal (0.06-0.10 sec)

7
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Premature Atrial Complex

Rhythm: Irregular
Rate: Usually normal but depends on underlying rhythm
P Wave: Premature, positive and shape is abnormal
PR Interval: Normal or longer
QRS: 0.10 sec or less

8
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Multifocal Atrial Tachycardia

Rhythm: Irregular
Rate: Fast (> 100 bpm)
P Wave: Often changing shape and size from beat to beat (3+ differing forms)
PR Interval: Variable
QRS: Normal (0.06-0.10 sec)
Notes: T wave is often distorted

9
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Supraventricular Tachycardia

Rhythm: Regular
Rate: Fast (150-250 bpm)
P Wave: Merged with T wave
PR Interval: Normal (0.12 sec)
QRS: Normal (.10 sec)
Notes: PR interval can be difficult to measure

10
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Wandering Atrial Pacemaker

Rhythm: May be irregular
Rate: Normal (60-100 bpm)
P Wave: Changing shape and size from beat to beat (3+ different forms)
PR Interval: Variable
QRS: Normal (0.06-0.10 sec)
Notes: T wave normal. If heart rate exceeds 100 bpm, then rhythm may be multifocal atrial tachycardia (MAT)

11
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Wolff-Parkinson-White Syndrome

Rhythm: Regular unless atrial fibrillation present
Rate: Normal (60-100 bpm)
P Wave: Normal
PR Interval: Can be short (<0.12 sec)
QRS: Usually wide (> 0.12 sec)
Notes: Look for short PR interval and/or delta wave

12
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Accelerated Junctional Rhythm

Rhythm: Regular
Rate: Normal (60-100 bpm)
P Wave: Present before, during (hidden) or after QRS, if visible it is inverted
PR Interval: Not measurable
QRS: Normal (0.06-0.10 sec)

13
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Junctional Escape Rhythm

Rhythm: Regular
Rate: Slow (40-60 bpm)
P Wave: Present before, during (hidden) or after QRS, if visible it is inverted
PR Interval: Not measurable
QRS: Normal (0.06-0.10 sec)

14
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Junctional Tachycardia

Rhythm: Regular
Rate: Fast (100-180 bpm)
P Wave: Present before, during (hidden) or after QRS, if visible it is inverted
PR Interval: Absent or short
QRS: Normal (0.06-0.10 sec)

15
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Premature Junctional Complex

Rhythm: Regular with premature beats
Rate: The underlying rate
P Wave: Present before, during (hidden) or after QRS, if visible it is inverted
PR Interval: Absent or short
QRS: Normal (0.06-0.10 sec)

16
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Accelerated Idioventricular Rhythm

Rhythm: Regular
Rate: 50-120 bpm
P Wave: Absent
PR Interval: Not measurable
QRS: Wide (>0.10 sec), bizarre looking

17
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Idioventricular Rhythm

Rhythm: Regular
Rate: Slow (20-40 bpm)
P Wave: Absent
PR Interval: Not measurable
QRS: Wide (>0.10 sec), bizarre appearance

18
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Premature Ventricular Complex

Rhythm: Irregular
Rate: The underlying rate
P Wave: Absent
PR Interval: Not measurable
QRS: Wide (> 0.10 sec), bizarre appearance
Notes: Don't forget bigeminy, trigeminy, quadrigeminy, etc

19
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Ventricular Fibrillation

Rhythm: Highly irregular
Rate: Unmeasurable
P Wave: Absent
PR Interval: Not measurable
QRS: None
Notes: Don't forget monomorphic vs polymorphic

20
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Ventricular Tachycardia

Rhythm: Regular
Rate: Fast (100-250 bpm)
P Wave: Absent
PR Interval: Not measurable
QRS: Wide (>0.10 sec), bizarre appearance

21
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Torsade de Pointes

Rhythm: Irregular
Rate: Fast (200-250 bpm)
P Wave: Absent
PR Interval: Not measurable
QRS: Wide (>0.10 sec), bizarre looking

22
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First Degree Heart Block

Rhythm: Regular
Rate: The underlying rate
P Wave: Normal
PR Interval: Prolonged (>0.20 sec)
QRS: Normal (0.06-0.10 sec)
Notes: First degree indicates slowed conduction without missed beats.

23
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Second Degree Heart Block - Mobitz Type I (Wenckebach)

Rhythm: Irregular but with progressively longer PR interval lengthening
Rate: The underlying rate
P Wave: Normal
PR Interval: Progressively longer until a QRS complex is missed
QRS: Normal (0.06-0.10 sec)

24
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Second Degree Heart Block - Mobitz Type II

Rhythm: Regular (atrial) and irregular (ventricular)
Rate: Atrial rate usually faster than ventricular rate (usually slow)
P Wave: Normal form, but more P waves than QRS complexes
PR Interval: Normal or prolonged
QRS: Normal or wide

25
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Third Degree Heart Block

Rhythm: Regular, but atrial and ventricular rhythms are independent
Rate: Atrial rate usually normal and faster than ventricular rate
P Wave: Normal shape and size, may appear within QRS complexes
PR Interval: Absent: the atria and ventricles beat independently.
QRS: Normal, but wide if junctional escape focus