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Sinus Bradycardia
- Rate-- < 60
- Rhytnm-- regular
- P waves-- upright & normal in morphology
- PR-- normal (0.12-0.20 sec & constant)
- QRS-- Normal (0.04-0.12 sec)
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Sinus Tachycardia
- Rate-- >100
- Rhythm-- regular
- P Waves-- upright & normal in morphology
- PR-- Normal (0.12-0.20 sec & constant)
- QRS--Normal (0.04-0.12 sec)
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Sinus Dysrhythmia
- Rate-- 60-100 varies w/resp
- Rhythm-- irregular
- P waves-- upright & normal in morphology
- PR-- Normal (0.12-0.20 sec & constant)
- QRS-- Normal (0.04-0.12 sec)
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Sinus Arrest
- Rate-- Normal to slow depending frequency & duration of arrest
- Rhythm-- irregular
- P waves-- upright & normal morphology
- PR-- Normal (0.12-0.20 sec & constant)
- QRS-- Normal (0.04-0.12 sec)
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Sinus Block
- Rate-- Normal to slow depending on frequency & duration of arrest
- Rhythm-- regular
- P waves--Upright & normal Morphology
- PR-- Normal (0.12-0.20 sec & constant)
- QRS-- Normal (0.04-0.12 sec)
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Sinus Pause
- Rate-- Normal to slow depending on duration & frequency of arrest
- Rhythm-- Irregular
- P Waves-- Upright & normal in morphology
- PR-- Normal (0.12-0.20 sec & constant)
- QRS-- Normal (0.04-0.12 sec)
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Sick Sinus Syndrome
- Rate-- Extremely variable
- Rhythm-- irregular
- P Waves-- Upright & normal morphology
- PR-- Normal (0.12-0.20 sec & constant)
- QRS-- Normal (0.04-0.12 sec)
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Wandering Atrial Pacemaker
- Rate-- Usually normal
- Rhythm-- Slightly Irregular
- P waves-- Morphology changes beat to beat; Waves may disappear completely
- PR-- Varies fr. <0.12 sec to normal to >0.20
- QRS-- Normal (0.04-0.12 sec)
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PACs
- Rate-- Dependent upon underlying rhythm
- Rhythm-- Dependent upon underlying rhythm; usually reg except for PAC
- P Waves-- P wave of PAC differs fr P wave of underlying rhythm. It occurs earlier than the next expected P wave & may be hidden in the preceding T wave
- PR-- Usually normal but may vary w/location of ectopic focus. Nearer SA node 0.12 sec or greater. Nearer AV node 0.12 sec or less
- QRS-- Usually normal; may be >0.12 if PAC abnormally conducted thru partially refrac ventricles. In some cases the ventricles are refractory & won't depolarize in response to the PAC making QRS absent
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Paroxysmal Supraventricular Tachycardia
- Rate-- 150-250/min
- Rhythm-- Characteristically regular, except @ onset & termination
- P Waves-- Atrial Ps differ slightly fr atrial Ps. P often buried in preceding T. P may be impossible to see.
- PR-- Usually normal but can vary w/location of ectopic pacemaker (nr SA will be close to 0.12 sec, nr AV 0.12 or less)
- QRS-- Normal (0.04-0.12 sec)
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Supraventricular Tachycardia
- Rate-- 150-250 bpm
- Rhythm-Characteristically normal except @ onset & termination
- P Waves-- May be impossible to see due to rate
- PR-- Usually normal but can vary w/location of ectopic pacemaker (nr SA close to 0.12, nr AV 0.12 or less)
- QRS-- Normal (0.04-0.12 sec)
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Atrial Flutter
- Rate-- Atrial rate 250-350 bpm. Vent rate varies w/ratio of AV conduction
- Rhythm-- Atrial is reg. Vent rhythm usually reg but can be irregular if block is variable
- P Wave-- Flutter (F) waves (resemble saw tooth) are present. Pattern difficult to ID in 2:1 flutter however if vent rate is 150ish suspect 2:1
- PR-- Usually constant but may vary
- QRS-- Normal (0.04-0.12 sec)
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Atrial Fibrillation
- Rate-- Atrial rate is 350-750; Vent rate varies greatly depending on conduction thru AV node
- Rhythm-- Irregularly irregular
- P Wave-- None discernible; Fibrillation (f) waves are present, indicating chaotic atrial activity
- PR-- none
- QRS-- Normal
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PJCs (not an actual rhythm)
- Rate-- Depends on underlying rhythm
- Rhythm-- Underlying rhythm usually reg except for PJCs
- P Waves-- Inverted, May appear b/f or aft QRS. May be masked by QRS or absent completely
- PR-- If P b/f QRS <0.12. If P aft technically RP interval
- QRS-- Usually narrow but may > 0.12 sec if PJC is conducted thru partial refractory vents
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Junctional Escape Rhythm
- Rate--40-60 bpm
- Rhythm-- Ventricular rhythm is reg
- P Wave-- May or may not be present; may precede, be buried in or follow QRS; abnormal appearing
- PR-- Usually abnormally short
- QRS-- Usually narrow
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Accelerated Junctional Rhythm
- Rate-- 60-100 bpm
- Rhythm-- Ventricular Rhythm is reg
- P Wave-- May or may not be present; may precede, be buried in or follow QRS; abnormal appearing
- PR-- Usually abnormally short
- QRS-- Usually narrow
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Junctional Tachycardia
- Rate-- >100 bpm
- Rhythm-- Vent rhythm is reg
- P Wave-- May or may not be present; may precede, be buried in or follow QRS; abnormal appearing
- PR-- Usually abnormally short
- QRS-- Usually narrow
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PVCs ( Not an actual rhythm)
- Rate--Depends on underlying rhythm & rate of PVCs
- Rhythm-- Interrupts regularity of underlying rhythm; occasionally irregular
- P Wave-- None; however a normal sinus P wave sometimes appears b/f a PVC
- PR-- none
- QRS-- Greater than 0.12 sec & bizarre in morphology
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Idioventricular Rhythms
- Rate-- Usually 20-40 bpm
- Rhythm-- Regular rhythm
- P Wave-- No P waves
- PR-- No PR b/c no P wave
- QRS-- Wide & bizarre
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Accelerated Idioventricular
- Rate-- > 40 but < 100
- Rhythm-- Regular rhythm
- P Wave-- No P waves
- PR-- No PR b/c no P waves
- QRS-- wide & bizarre
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