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31 Cards in this Set
- Front
- Back
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Normal sinus rhythm with bundle-branch block |
Rhythm: Usually reg Rate: underlying rhythm (usually sinus) P waves: sinus PR interval: Normal (0.12 to 0.20 second) QRS complex: WIDE (0.12 second or greater) |
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Atrial fibrillation (with controlled ventricular rate) |
Rhythm: Grossly irr (unless ventricular rate is rapid, in which case the rhythm becomes more reg) Rate: Atrial: 400 beats/min or more; NM due to wavy baseline. Ventricular: varies, controlled if rate <100 beats/min; uncontrolled if rate >100 beats/min P waves: wavy deflections that affect the entire baseline PR interval: NM QRS complex: Normal (0.10 second or less) |
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Atrial flutter with variable AV conduction |
Rhythm: Reg or irr Atrial rate: 250-400 Vent rage: Varies; will be less than atrial P waves: SAWTOOTH wave delfections affecting the entire baseline PR interval: NM QRS complex: Normal (0.10 second or less) |
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Normal sinus rhythm with one nonconducted PAC (abnormal P wave assoc with PAC is hidden in preceding T wave, distorting T-wave contour) |
Rhythm: Underlying rhythm usu reg; irr with nonconducted PACs Rate: underlying rhythm P waves: premature and abnormal; often found hidden in preceding T wave, distorting T-wave contour; a pause follows the nonconducted P wave PR interval: Absent with nonconducted PAC QRS complex: Absent with nonconducted PAC |
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Normal sinus rhythm with 2 PACs |
Rhythm: Underlying rhythm usually regular; irr with premature beat Rate: underlying rhythm P waves: P wave associated with PAC is premature, abnormal (commonly appears small, upright, and pointed, but may be inverted or a squiggle); abnormal P wave is often found hidden in preceding Twave, distorting T-wave contour PR interval: Usually normal but may be abnormal QRS complex: Premature, normal duration QRS (0.10 sec or less); followed by a pause |
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Second-degree AV block, Mobitz I |
Rhythm: Atrial reg; ventr irr Rate: Atrial underlying rhythm; ventricular depends on # of impulses conducted thru AV node; will be less than atrial P waves: sinus PR interval: varies; progressively lengthens until a P wave isn't conducted (P wave appears without QRS complex); a pause follows the dropped QRS complex QRS complex: Normal (0.10 sec or less) |
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Paroxysal atrial tachycardia |
Rhythm: reg Rate: 140 - 250 P waves: Abnormal (commonly pointed); usually hidden in preceding T wave so that T wave and P wave appear as one wave deflection (T-P wave); one P wave to each QRS unless AV block is present PR interval: Usually NM QRS complex: Normal (0.10 or less) |
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Junctional rhythm |
Rhythm: REgular Rate: 40-60 P waves: Inverted in lead II (a positive lead) and will occur immediately before the QRS, immediately after the QRS, or will be hidden within the QRS complex PR interval: Short (0.10 sec or less) QRS complex: Normal (0.10 or lexx) |
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Normal bradycardia with one PJc |
Rhythm: underlying rhythm; irr with prob Rate: That of underlying rhy P waves: P waves assoc with the prob will be premature, inverted in lead II, and will occur immed before the QRS, immed after the QRS, or will be hidden within the QRS complex PR interval: short (0.10 sec or less) QRS: Normal (0.10 sec or less) |
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Atrial fibrillation (with uncontrolled ventricular rate) |
Rhythm: grossly irr Atrial Rate: 400 or more; NM Ventr rate: varies, controlled if rate is less than 100; uncontrolled if rate is greater than 100 P waves: wavy deflections that affect the entire baseline PR interval: NM QRS complex: Normal (0.10 second or less) |
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Sinus rhythm with first-degree AV block |
Rhythm: Usu reg Rate: underly sinus rhythm P waves: sinus; one P wave to each QRS complex PR interval: Prolonged (greater than 0.20 sec); remains consistent QRS complex: Normal (0.10 second or less) |
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Normal sinus rhythm with one PJC |
rhythm: underlying rhythm reg; otherwise irr rate: underly rhythm P waves: P waves assoc with the prob will be premature, inverted in lead II, and will occur immed before the QRS, immed after the QRS, or will be hidden within the QRS. Pr interval: short (0.10 or less) QRS: Normal (0.10 or less) |
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sinsu bradycardia |
Rhythm: reg rate: 40-60 P waves: normal in size, shape, direction; positive in lead II; one P wave precedes each QRS complex PR interval: normal (0.12 to .20) QRS complex: Normal (.10 or less) |
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ventricular fibrillation (fine deflections present) |
Rhythm: none (P wave and QRS are absent) Rate: None (P wave and QRS are absent) P waves: Wavy, irr deflections representative of quivering; deflections may be fine or coarse. PR interval: NM QRS complex: absent QT interval: N/M |
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Third-degree AV block |
Rhythm: Reg Atrial rate: underly sinus Ventri rate: 40-60 if paced by AV junction; 30 - 40 or less if paced by the ventricles; will be less than atrial P waves: sinus p waves with no consistent relationship to the QRS complex; P waves found hidden in QRS complexes, ST segments, and T waves PR interval: varies QRS complex: normal if at AV node or bundle of His; wide if in bundle branches |
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Second-degree AV block, Mobitz II with 2: 1 and 3:1 AV conduction |
Rhythm: Atrial reg; ventr usu reg; may be irr if AV conduction ratios vary Atrial Rate: underly rhy Ventr rate: depends on # of impulses conducted thru AV node, but will be less than atrial P waves: sinus; 2 or 3 P waves (sometimes more) before each QRS complex QRS complex: Normal duration if at bundle of His; wide if in bundle branches |
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Third-degree AV block |
Rhythm: regular Atrial rate: underlying Ventr rate: 40-60 if paced by AV junct; 30-40 if paced by ventr; rate will be less than atrial P waves: sinsu p waves with no consistent relationship to the QRS complex; P waves found hidden in QRS complexes, ST segments, and T waves PR interval: varies QRS complex: Normal duration if at level of AV node or bundle of His; wide if block in bundle branches |
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Second-degree AV block, Mobitz II with 3:1 AV conduction (one P wave hidden on top of T wave) |
Rhythm: Atrial: Reg; Ventri: Usu reg, may be irr if AV conduction ratios vary Atrial rate: underly rhythm Ventri rate: depends on number of impulses conducted thru AV node; will be less than atrial P waves: Sinus; 2 or 3 P waves (sometimes more) before each QRS complex PR interval: Normal or prolonged: remains consistent QRS complex: Normal duration if at level of bundle of His; wide if in bundle branhes |
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Second-degree AV block, Mobitz I |
Atrial rhythm: reg Ventr rhythm: irr Atrial Rate: underlying rhythm Ventric rate: depends on # of impulses conducted thru AV node, will be less than atrial P waves: sinus PR interval: varies; progressively lengthens until a P wave isn't conducted (P wave appears without QRS complex); a pause follows the dropped QRS complex |
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Normal sinus rhythm with first-degree AV block |
Rhythm: usually reg Rate: that of the underlying sinus rhythm P waves: sinus; one P wave to each QRS complex PR interval: Prolonged (greater than 0.20 second); remains consistent QRS complex: normal (0.10 or less) |
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Accelerated idioventricular rhythm |
Rhythm: reg Rate: 50-100 P waves: absent PR interval: NM QRS complex: Wide (0.12 or greater) |
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Sinus bradycardia with one PAC |
Rhythm: underly rhythm usu reg; irreg with premature beat Rate: underlying rhythm P waves: p wave associated with PAC is premature, abnormal (commonly appears small, upright, and pointed, but may be inverted or a squiggle); abnormal P wave is often found hidden in preceding T wave, distorting T-wave contour PR interval: Usually normal, but may be abnormal QRS complex: Premature, normal duration QRS (0.10 second or less); followed by a pause |
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Junctional tachycardia |
Rhythm: reg Rate: >100 P waves: Inverted in lead II and will occur immed before the QRS, immed after the QRS, or will be hidden within the QRS complex PR interval: Short (0.10 or less) QRS: Normal (0.10 second or less) |
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Atrial flutter with 2:1 AV conduction |
Rhythm: reg or irr Atrial Rate: 250 - 400 Ventri rate: varies with # of impulses conducted thru AV node; will be less than the atrial rate P waves: Sawtooth wave deflections affecting the entire baseline PR interval: NM QRS complex: Normal (<=0.10) |
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Normal sinus rhythm with 3-beat run AIVR (Accelerated idioventricular rhythm) |
Rhythm: reg Rate: 50 - 100 P wave: absent PR interval: NM QRS complex: Wide (>=0.12) |
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List the 8 steps for identifying a rhythm. |
1. P wave 2. Atrial rhythm 3. Atrial rate 4. PR interval 5. Ventricular rhythm 6. Ventricular rate 7. QRS complex 8. QT interval |
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3 ways for determining heart rate: |
Times 10 Sequence (start with heavy black line, count off heavy black lines in sequence 300, 150, 100, 75, 60, 50...) 1500 Method (count # of small boxes between 2 P or r waves and divide 1500 by # of small boxes) Use on reg rhythm only |
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Normal range for PR interval: |
0.12 - 0.20 |
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Normal range for QRS complex: |
0.06 - 0.10 |
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Normal range for QT interval: |
0.36 - 0.44 |
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Ranges for atrial rates from SA, AV, Bundle branches |
SA - 60-100 AV 40-60 Branches 20-40 (must confirm these) |
