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40 Cards in this Set
- Front
- Back
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Normal sinus rhythm |
Criteria: 1. Rhythm: regular 2. Heart rate: 60 - 100 3. QRS: less than 0.10 4. P wave: only one precedes each QRS, all have same size, shape and deflection 5. PR interval: 0.12 - 0.20 6. Interpretation: Sinus Rhythm |
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Sinus Tachycardia
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Criteria: 1. Rhythm: regular 2. Heart rate: 100 - 150 3. QRS: less than 0.10 4. P wave: only one precedes each QRS, all have same size, shape and deflection 5. PR interval: 0.12 - 0.20 6. Interpretation: Sinus Tachycardia |
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Sinus Bradycardia |
Criteria: 1. Rhythm: regular 2. Heart rate: 40 -60 3. QRS: less than 0.10 4. P wave: only one precedes each QRS, all have same size, shape and deflection 5. PR interval: 0.12 - 0.20 6. Interpretation: Sinus Bradycardia |
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Sinus Arrhythmia |
Criteria: 1. Rhythm: irregular 2. Heart rate: normal, 60 - 100 or slow, 40 - 60 3. QRS: less than 0.10 4. P wave: only one precedes each QRS, all have same size, shape and deflection 5. PR interval: 0.12 - 0.20 6. Interpretation: Sinus Arrhythmia |
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Sinus Arrest |
Criteria: 1. Rhythm: irregular – the underlying rhythm does not resume on time following the pause 2. Heart rate: can be normal, 60 - 100 or slow, 40 - 60 3. QRS: less than 0.10 4. P wave: only one precedes each QRS, all have same size, shape and deflection 5. PR interval: 0.12 - 0.20 6. Interpretation: Underlying rhythm with Sinus Arrest |
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Sinus Exit Block |
Criteria: 1. Rhythm: irregular – the underlying rhythm resumes on time following the pause, with the length of the pause being a multiple of the underlying R-R interval 2. Heart rate: can be normal, 60 - 100 or slow, 40 - 60 3. QRS: less than 0.10 4. P wave: only one precedes each QRS, all have same size, shape and deflection 5. PR interval: 0.12 - 0.20 6. Interpretation: Underlying rhythm with Sinus Exit Block |
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Atrial rhythms |
Atrial rhythms include 1. Wandering atrial pacemaker 2. Premature atrial contractions 3. Nonconducted premature atrial contractions 4. Atrial tachycardia 5. Paroxysmal atrial tachycardia 6. Supraventricular tachycardia 7. Atrial flutter 8. Atrial fibrillation |
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Wandering Atrial Pacemaker |
Criteria: 1. Rhythm: usually irregular, but may be regular 2. Rate: usually 60 - 100, but may be slower 3. QRS: less than 0.10 4. P wave: only one precedes each QRS, but vary is size, shape, and deflection 5. PR interval: varies from 0.12 - 0.20 6. Interpretation: Wandering Atrial Pacemaker |
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Premature Atrial Contraction |
Criteria: 1. Rhythm: underlying rhythm regular, irregular with PAC 2. Heart rate: that of underlying rhythm 3. QRS: less than 0.10 4. P wave: abnormal in size, shape, deflection, or may be hidden in the preceding T wave distorting the T wave contour 5. PR interval: normal but may be shortened 6. Interpretation: Underlying rhythm with Premature Atrial Contraction |
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Nonconducted PAC |
Criteria: 1. Rhythm: underlying rhythm regular, irregular with nonconducted PAC 2. Heart rate: that of underlying rhythm 3. QRS: absent 4. P wave: abnormal in size, shape, deflection, or may be hidden in the preceding T wave distorting the T wave contour 5. PR interval: absent 6. Interpretation: Underlying rhythm with Nonconducted PAC |
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Atrial Tachycardia |
Criteria: 1. Rhythm: usually regular 2. Heart rate: 150 - 250 3. QRS: usually normal, less than 0.10 4. P wave: may not always be discernible due to fast rate, frequently obscured in the preceding T wave 5. PR interval: not measurable 6. Interpretation: Atrial Tachycardia |
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Paroxysmal Atrial Tachycardia |
Criteria: 1. Rhythm: usually regular 2. Heart rate: 150 - 250 3. QRS: usually normal, less than 0.10 4. P wave: may not always be discernible due to fast rate, frequently obscured in the preceding T wave 5. PR interval: not measurable 6. Interpretation: Paroxysmal Atrial Tachycardia |
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Supraventricular Tachycardia |
Criteria: 1. Rhythm: regular 2. Heart rate: >150 beats/min 3. QRS: normal, less than 0.10 4. P wave: difficult or unable to visualize 5. PR interval: not measurable 6. Interpretation: Supraventricular Tachycardia |
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Atrial Flutter |
Criteria: 1. Rhythm: atrial– regular, ventricular– regular if conduction is regular 2. Heart rate: atrial– 250 - 400, ventricular– varies depending on conduction but will be less than atrial rate 3. QRS: less than 0.10 4. P waves: sawtooth looking, more P waves than QRS 5. PR interval: not measurable 6. Interpretation: Atrial Flutter |
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Atrial Fibrillation |
Criteria: 1. Rhythm: atrial and ventricular irregular 2. Heart rate: atrial– 350 - 600 (400 average), ventricular– 160 - 180 or depending on conduction 3. QRS: less than 0.10 4. P waves: absent, irregular fibrillation waves seen instead 5. PR interval: not measurable 6. Interpretation: Atrial Fibrillation a) If ventricular rate is >100, called uncontrolled A-fib b) If ventricular rate is < 100, called controlled A-fib |
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Junctional rhythms |
A. Originate from the area around the AV node B. If the SA node fails to function, the AV junction contains specialized pacemaker cells and can serve as a secondary pacemaker site C. The inherent firing rate of the junctional pacemaker cells is 40 - 60 beats per minute D. Enhance automaticity may accelerate the rate beyond the inherent firing rate |
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AV junction as a pacemaker |
Location of the P wave relative to the QRS depends on the speed of conduction 1. P wave in front of the QRS – if the electrical impulse from the junction depolarizes the atria first, then the ventricles a) May produce negative P waves before the QRS b) PR interval will be short (0.10 seconds or less) c) Ventricles will depolarize normally, resulting in a narrow QRS 2. P wave after the QRS – if the electrical impulse from the junction depolarizes the ventricles first, then the atria 3. P wave hidden in the QRS – if the electrical impulse from the junction depolarizes both the atria and the ventricles simultaneously |
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Rhythms from the AV junction |
1. Premature junctional contraction
2. Junctional escape beats 3. Junctional rhythm
4. Accelerated junctional rhythm
5. Junctional tachycardia |
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Premature Junctional Contraction (PJC) |
Criteria: 1. Rhythm: underlying rhythm is regular, irregular with extra beat 2. Rate: is that of the underlying rhythm 3. QRS: normal (<0.10 sec) 4. P wave: depends on speed of conduction a) Negative P waves before the QRS b) P wave after the QRS c) P wave hidden in the QRS 5. PR interval: if present, short 6. Interpretation: Underlying rhythm with Premature Junctional Contraction |
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Junctional Escape Beats |
Criteria: 1. Rhythm: underlying rhythm is regular; irregular with escape beat 2. Rate: is that of the underlying rhythm 3. QRS: width is normal (<0.10 sec) 4. P wave: depends on speed of conduction a) Negative P waves before the QRS b) P wave after the QRS c) P wave hidden in the QRS 5. PR interval: If present, short 6. Interpretation: Underlying rhythm with Junctional Escape |
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Junctional Rhythm |
Criteria: 1. Rhythm: regular 2. Rate: 40 - 60 beats per minute 3. QRS: width is normal (<0.10 sec) 4. P wave: depends on speed of conduction a) Negative P waves before the QRS b) P wave after the QRS c) P wave hidden in the QRS 5. PR interval: if present, short 6. Interpretation: Junctional rhythm |
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Accelerated Junctional Rhythm |
Criteria: 1. Rhythm: regular 2. Rate: 60 - 100 beats per minute 3. QRS: width is normal (<0.10 sec) 4. P wave: depends on speed of conduction a) Negative P waves before the QRS b) P wave after the QRS c) P wave hidden in the QRS 5. PR interval: if present, short 6. Interpretation: Accelerated Junctional Rhythm |
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Junctional Tachycardia |
Criteria: 1. Rhythm: regular 2. Rate: >100 beats per minute 3. QRS: width is normal (<0.10 sec) 4. P wave: depends on speed of conduction a) Negative P waves before the QRS b) P wave after the QRS c) P wave hidden in the QRS 5. PR interval: if present, short 6. Interpretation: Junctional Tachycardia |
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Heart Blocks Rhythms |
Heart block rhythms 1. First degree AV block 2. Second degree AV block, type I ( Mobitz I, Wenckebach) 3. Second degree AV block, type II (Mobitz II) 4. Third degree AV block (complete heart block) 5. AV dissociation 6. Bundle branch blocks |
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First Degree AV Block |
Criteria: 1. Rhythm: regular 2. Heart rate: normal, 60 - 100 3. QRS: normal, less than 0.10 4. P waves: normal configuration, one for every QRS 5. PR interval: > .20 seconds and is consistent with every beat 6. Interpretation: First Degree AV Block |
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Second Degree AV Block, type I ( Mobitz I, Wenckebach) |
Criteria: 1. Rhythm: irregular (regularly irregular), P wave will be regular 2. Heart rate: usually normal, depends on the P to QRS ratio 3. QRS: normal, less than 0.10 4. P waves: normal configuration, more P waves than QRS complexes 5. PR interval: progressively longer until a P wave is not conducted and the QRS complex dropped, then the cycle repeats 6. Interpretation: Second Degree AV Block, type I ( Mobitz I, Wenckebach) |
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Second Degree AV Block, type II (Mobitz II) |
Criteria: 1. Rhythm: atria regular, ventricles regular unless the conduction rate varies 2. Heart rate: atrial rate usually 60 - 100, ventricular rate slower depending on the number of impulses conducted 3. QRS: a) Normal, <0.10, if blocked at the bundle of His b) Wide, > 0.10, if blocked at the bundle branches 4. P waves: normal contour, more P waves than QRSs 5. PR interval: may be normal or prolonged, but remains constant 6. Interpretation: Second Degree AV Block, type II (Mobitz II) |
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Third Degree AV Block (Complete Heart Block) |
Criteria: 1. Rhythm: Atrial– regular (P waves march out, but some may be hidden in T wave or QRS complexes), Ventricular– regular 2. Heart rate: Atrial– usually that of the sinus node, 60 - 100 a) Ventricle– 40 - 60 if paced by the AV junction b) Ventricle– 20 - 40 if paced by the ventricles 3. QRS: a) Normal if blocked at the AV node or bundle of His b) Wide if blocked at the bundle branches 4. P waves: normal configuration, more P waves than QRSs 5. PR interval: varies greatly – no relationship between Ps and QRSs 6. Interpretation: Third Degree AV Block (Complete Heart Block) |
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Complete AV dissociation |
Criteria: 1. Rhythm: Atrial and Ventricular rates nearly equal, regular 2. Heart rate: at least 60 - 100, atria and ventricles are within 10 beats of each other 3. QRS: Normal or Wide depending on where the escape pacemaker is 4. P wave: are always present, but may move in and out of the QRS, are not related to the QRS complexes 5. PR interval: changes as the rhythm dissociates 6. Interpretation: Complete AV dissociation |
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Bundle Branch Block |
Criteria: 1. Rhythm: is that of the underlying rhythm 2. Heart rate: is that of the underlying rhythm 3. QRS: wide, greater than 0.12 seconds 4. P waves: usually normal depending on underlying rhythm 5. PR interval: normal depending on underlying rhythm 6. Interpretation: underlying rhythm with accompanying bundle branch block |
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Ventricular rhythms |
1. Premature ventricular contraction (PVC) 2. Ventricular escape beats 3. Fusion beats 4. Ventricular tachycardia 5. Torsade de pointes 6. Ventricular fibrillation 7. Idioventricular rhythm (Ventricular escape rhythm) 8. Accelerated idioventricular rhythm 9. Ventricular standstill (Ventricular asystole) |
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Premature Ventricular Contraction |
Criteria: 1. Rhythm: underlying rhythm usually regular, irregular with PVC 2. Heart rate: that of the underlying rhythm 3. QRS: wide and bizarre, greater than 0.12 seconds, and differ from the QRS complexes of the underlying rhythm 4. P wave: none with the PVC, P waves may be present in the underlying rhythm 5. PR interval: none to measure with the PVC 6. Interpretation: underlying rhythm with PVC |
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Ventricular Escape Beat |
Criteria: 1. Rhythm: underlying rhythm usually regular, irregular with the escape beat 2. Heart rate: that of the underlying rhythm 3. QRS: wide and bizarre, greater than 0.12 seconds, and differ from the QRS complexes of the underlying rhythm 4. P wave: none with the escape beat, P waves may be present in the underlying rhythm 5. PR interval: none to measure with the escape beat 6. Interpretation: underlying rhythm with Ventricular Escape Beat |
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Fusion Beats |
Criteria: 1. Rhythm: regular 2. Heart rate: that of the underlying rhythm 3. QRS: wide, usually greater than 0.12 4. P wave: will be the same as those of the underlying rhythm 5. PR interval: may be somewhat shorter than that of the underlying rhythm 6. Interpretation: underlying rhythm with Fusion beat |
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Ventricular Tachycardia |
Criteria: 1. Rhythm: usually regular, may be somewhat irregular 2. Heart rate: 150 - 250 3. QRS: wide and bizarre, greater than 0.12 seconds 4. P wave: none associated, the SA node does continue to fire independently, so P waves may be seen at random, but are usually hidden in the QRS complexes 5. PR interval: not measurable 6. Interpretation: Ventricular Tachycardia |
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Torsade de Pointes |
Criteria: 1. Rhythm: somewhat irregular 2. Heart rate: 150 - 250 3. QRS: wide and bizarre, greater than 0.12 seconds, polarity changes from positive to negative around the isoelectric line 4. P wave: none associated 5. PR interval: not measurable 6. Interpretation: Torsade de Pointe |
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Ventricular Fibrillation |
Criteria: 1. Rhythm: chaotic 2. Heart rate: none 3. QRS: no complexes are present 4. P waves: none 5. PR interval: none 6. Interpretation: Ventricular Fibrillation CALL CODE |
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Idioventricular Rhythm |
Criteria: 1. Rhythm: usually regular 2. Heart rate: 20 - 40 beats per minute, sometimes slower 3. QRS: wide, greater than 0.12 seconds 4. P wave: none 5. PR interval: none 6. Interpretation: Idioventricular Rhythm |
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Accelerated Idioventricular Rhythm |
Criteria: 1. Rhythm: usually regular 2. Heart rate: 50 - 100 3. QRS: wide, greater than 0.12 seconds 4. P wave: none 5. PR interval: none 6. Interpretation: Accelerated Idioventricular Rhythm |
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Ventricular Standstill (Ventricular Asystole) |
Criteria: 1. Rhythm: none 2. Heart rate: none 3. QRS: none 4. P wave: may be present or have none 5. PR interval: none 6. Interpretation: Ventricular Standstill (Ventricular Asystole) |
