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ECG Demographics Rate: 300/# Large Box in RR Interval

This document provides an overview of ECG abnormalities and classifications including: 1. It describes how to analyze the rate, rhythm, axis, and wave forms of an ECG including P waves, PR interval, QRS complex, QT interval, ST segment, and T wave. 2. It lists and describes common ECG abnormalities such as sinus tachycardia, atrial fibrillation, heart block, ventricular tachycardia, and asystole. 3. It provides classifications for narrow complex tachycardias, wide complex tachycardias, shockable versus non-shockable rhythms, and cardio pulmonary arrest rhythms.

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Jonathan Davis
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82 views11 pages

ECG Demographics Rate: 300/# Large Box in RR Interval

This document provides an overview of ECG abnormalities and classifications including: 1. It describes how to analyze the rate, rhythm, axis, and wave forms of an ECG including P waves, PR interval, QRS complex, QT interval, ST segment, and T wave. 2. It lists and describes common ECG abnormalities such as sinus tachycardia, atrial fibrillation, heart block, ventricular tachycardia, and asystole. 3. It provides classifications for narrow complex tachycardias, wide complex tachycardias, shockable versus non-shockable rhythms, and cardio pulmonary arrest rhythms.

Uploaded by

Jonathan Davis
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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ECG

Demographics

Rate
300/# large box in RR interval

Rhythm
Regular/Regularly irregular/Irregularly Irregular?

Sinus Rhythm-upright p wave in II, III & aVF (inverted in aVR) followed by QRS complex

NB. Atrial Fib-> no discernible P wave & QRS complex irreg-irreg

Atrial Flutter-> “sawtooth” baseline (~300/min) w/ reqular QRS

Ventricular rhythm-> QRS >0.12 w/ p wave following them

Axis
Axis=Lead I + aVF

NB. If complexes in Ld I & II are both positive, the axis is normal.

Wave forms:
P wave-(normally preceed each QRS)

Absent: AFib, SA block, juctional (AV nodal) rhythm

Dissociated p wave & QRS: complete heart block

Bifid p wave-aka p mitrale-> left atrial hypertrophy

Peaked p wave-mrignt atrial hypertrophy (P. Pulmonale)

PR Interval: (measure-start of P wave to start of QRS)

Normal=0.12-0.2s (3-5small squares)

Prolonged-delay in AV conduction: 1st degree Heart Block

Short-fast AV conduction: Wolff-Parkinson-White Syndrome

QRS Complex:

Normal: 0.06-0.1s

Delayed: 0.11s

Prolonged: > 0.12 (suggest ventricular conduction defect e.g. BBB-bundle branch block)
Large QRS-ventricular hypertrophy

Normal Q wave-<0.04 wide & <2mm deep

(Pathological Q waves occur within a few hr of an Acute MI)

QT interval: measure from start of QRS->end of Twave

QTc=QT/√RR Normal=0.38-0.42

Prolonged QT: Acute MI

ST segment: usually isoelectric

Planar elevation: >1mm

Depression: >0.5mm

Abnormal-> infarction/ischemia

T wave: Normally inverted-> aVR, V1, V2

Abnormal if inverted in: Ld I, II, V6-V7

Peaked in hyperkalemia; Flattened in hypokalemia


ECG Abnormalities
Sinus tachycardia- Rate >100bpm

Sinus bradycardia- Rate <60bpm

Atrial Fibrillation-

Atrial Flutter
1st & 2nd degree heart block (Mobitz I/II)

Mobitz Type 1: PR interval increasingly prolonged

Mobitz Type 2: PR interval constant


3rd degree heart block:
Junctional Tachycardia
Idioventricular Rhythym

Torsades de pointes

Ventricular Fibrillation
Ventricular Tachycardia

Asystole
Pulseless Electrical Activity:

Occurs when there is organized electrical activity (except VT) is present on the cardiac monitor
but the patient is apneic & pulseless.

Classifications of Tachycardias

Narrow Complex Tachycardias


Regular Irregular
A Tach (Non Sinus) A Tach (multifocal)
A Flutter (Fixed AVN block) A Flutter (Variable block)
Juctional Tachycardia Sinus Tachcardia + PAC
PSVT (Paroxysmal Supraventricular tachycardia) A Fib

Wide Complex Tachycardias: V Tach


Torsades de Pointes

Shockable Rhythms Non Shockable Rhythms


Ventricular Fibrillation (VF) Pulseless Electrical Activity (PEA)
Pulseless Ventricular Tachycardia (VT) Asystole
CardioPulmonary Arrest Rhthyms

Other

Q-wave pathologies

ST elevation/depression

T wave inversion

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