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Sinus Rhythm
- Rate: 60 to 100 beats per minute
- Regularity: Regular
- P waves: Upright in Lead II, all look alike
- PR interval: Generally constant; less than 0.2 secs
- QRS complex: Usually normal appearing; less than 0.12 secs
- --
- Pacemaker site: SA node
- R-R interval: usually regular
- P to QRS ratio: 1 P to 1 QRS
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Sinus Bradycardia
- Rate: Less than 60 beats per minute
- Regularity: Regular
- P waves: Upright in Lead II, all look alike
- PR interval: Generally constant; less than 0.2 secs
- QRS complex: Usually normal appearing; less than 0.12 secs
- --
- Pacemaker site: SA node
- R-R interval: usually regular
- P to QRS ratio: 1 P to 1 QRS
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Sinus Tachycardia
- Rate: Greater than 100 beat per minute
- Regularity: Regular
- P waves: Upright in lead II, all look alike
- PR interval: Less than 0.2 seconds
- QRS complex: Less than 0.12 seconds
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Sinus Arrhythmia
- Rate: 60 to 100 beats per minute, may be slower or faster
- Regularity: Irregular
- P waves: Upright in lead II, all look alike
- PR interval: Less than 0.2 seconds
- QRS complex: Less than 0.12 seconds
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Sinus Arrest
- Rate: 60 to 100 beats per minute
- Regularity: Irregular during periods of arrest
- P waves: Not present during periods of arrest
- PR interval: Not present during periods of arrest
- QRS complex: Not present during periods of arrest
- Hint: appears as a normal sinus rhythm with periods of no conduction
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Wandering Atrial Pacemaker
- Rate: Usually 60 to 100, but can be variable
- Regularity: Irregular
- P waves: Vary as the pacemaker site changes
- PR Interval: Will vary slightly as the pacemaker site changes, ususally less than 0.2 secs
- QRS complex: Less than 0.12 secs
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Premature atrial complex
- Not a rhythm!!
- Looks like a complete heart cycle, but early
- Also note the compensatory pause as the heart recycles
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Atrial Tachycardia
- Rate: 150 to 250 beats per minute
- Regularity: Regular
- P waves: Present; if p waves are not present, then the rhythm is called Supraventricular Tachycardia (SVT).
- PR Interval: Less than 0.2 secs
- QRS complex: Less than 0.12 secs
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Atrial Flutter
- Rate: 250 to 350 bpm (but can be variable, 150, 75)
- Regularity: Regular
- P waves: Not present, replaced by flutter waves (F)
- PR interval: N/A
- QRS complex: Less than 0.12 secs
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Atrial Fibrillation
- Rate: Atrial rate can average 400bpm, ventricular rate is variable
- Regularity: Irregularly irregular
- P waves: Not present, replaced by fibrillation waves (f)
- PR Interval: N/A
- QRS complex: Less than 0.12 secs
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Premature Junctional Complex
- Not a rhythm!!
- Consists of an inverted P wave (or no p wave), a QRS complex, and a T wave
- Note the compensatory pause as the heart recycles
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Junctional Escape Rhythm
- Rate: 40 to 60bpm
- Regularity: Regular
- P wave: May not be present, inverted if it is
- PR interval: If p waves present, PRI wil be shorter than normal
- QRS complex: Less than 0.12 secs
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Accelerated Junctional Rhythm
- Rate: 60 to 100bpm
- Regularity: Regular
- P wave: May not be present, inverted if it is
- PR Interval: if p waves present, PRI will be shorter than normal
- QRS complex: Less than 0.12 secs
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Junctional Tachycardia
- Rate: 100 to 180bpm
- Regularity: Regular
- P wave: May not be present, inverted if it is
- PR interval: if p waves present, PRI will be shorter than normal
- QRS complex: Less than 0.12 secs
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Premature Ventricular Complexes
- Not a rhythm!!
- Consists of a wide, bizarre ventricular complex
- Note the comepnsatory pause
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Ventricular Tachycardia
- Rate: 150 to 250 beats per minute
- Regularity: Regular
- P waves: Not present
- PR Interval: Not applicable
- QRS complex: Wide and bizarre, usually greater than 0.12 secs
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Ventricular Fibrillation
- Rate: None
- Regularity: None, the baseline is chaotic
- P waves: Not present
- PR Interval: Not applicable
- QRS complex: None
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Idioventricular
- Rate: 20 to 40 beats per minute
- Regularity: Regular
- P wave: None
- PR Interval: Not applicable
- QRS complex: Wide and bizarre, 0.12 secs or greater
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1st Degree Heart Block
- Not a rhythm!
- PR interval will be greater than 0.20 seconds
- Everything else depends on the underlying rhythm
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2nd Degree Heart Block (Type I)
- Rate: Slower than normal
- Regularity: Irregular
- P waves: Upright and uniform
- PR Interval: Gets progressively longer until one P wave isn't followed by a QRS complex. There can be a pattern to this cycle.
- QRS complex: Less than 0.12 seconds
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2nd Degree Heart Block (Type II)
- Rate: Slower than normal
- Regular: Irregular
- P wave: Upright and uniform
- PR interval: Constant, except when the QRS complex is dropped
- QRS complex: Less than 0.12 seconds
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3rd Degree Heart Block (Complete)
- Rate: 40 to 60 bpm if junctional focus; 20 to 40 bpm if ventricular focus
- Regularity: Regular
- P waves: Upright and uniform, but no correlation to the QRS complexes
- PR interval: Not applicable due to no correlation of the atria and ventricals
- QRS Complex: Normal if junctional focus; greater than 0.12 secs if ventricular focus
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