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Premature Ventricular Complex Quadrigeminy
- Rhythm: Irregular
- Rate: The underlying rate
- P Wave: Absent
- PR Interval: Not measurable
- QRS: Wide (> 0.10 sec), bizarre appearance
- Notes: PVC appears every fourth beat
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Premature Ventricular Complex Trigeminy
- Rhythm: Irregular
- Rate: The underlying rate
- P Wave: Absent
- PR Interval: Not measurable
- QRS: Wide (> 0.10 sec), bizarre appearance
- Notes: PVC appears every third beat
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Second Degree Heart Block Type I
- 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, then cycle repeats
- QRS: Normal (0.06-0.10 sec)
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Second Degree Heart Block Type II
- Rhythm: Regular (atrial) and irregular (ventricular)
- Rate: Characterized by 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
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Sinoatrial Block
- Rhythm: Irregular when SA block occurs
- Rate: Normal or slow
- P Wave: Normal
- PR Interval: Normal (0.12-0.20 sec)
- QRS: Normal (0.06-0.10 sec)
- Notes: Pause time is an integer multiple of the P-P interval Try to identify specific type of atrial tachycardia - see other pages
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Sinus Arrest
- Rhythm: Irregular due to pause
- Rate: Normal to slow
- P Wave: Normal
- PR Interval: Normal (0.12-0.20 sec)
- QRS: Normal (0.06-0.10 sec)
- Notes: Pause time is not an integer multiple of the P-P interval
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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
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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
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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
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Third Degree Heart Block
- Rhythm: Regular, but atrial and ventricular rhythms are independent
- Rate: Characterized by 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
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Ventricular Fibrillation
- Rhythm: Highly irregular
- Rate: Unmeasurable
- P Wave: Absent
- PR Interval: Not measurable
- QRS: None
- Notes: EKG tracings is a wavy line
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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
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Ventricular Tachycardia Monomorphic
- Rhythm: Regular
- Rate: Fast (100-250 bpm)
- P Wave: Absent
- PR Interval: Not measurable
- QRS: Wide (>0.10 sec), bizarre looking
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Ventricular Tachycardia Polymorphic
- Rhythm: Regular or irregular
- Rate: Fast (100-300 bpm)
- P Wave: Absent
- PR Interval: Not measurable
- QRS: Normal or wide (>0.10 sec), bizarre looking
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Ventricular Tachycardia Torsade de Pointes
- Rhythm: Irregular
- Rate: Fast (200-250 bpm)
- P Wave: Absent
- PR Interval: Not measurable
- QRS: Wide (>0.10 sec), bizarre looking
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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 (at least three 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 (MAP)
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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 A delta wave (positive or negative) distorts the early part of the QRS complex
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