Basic Dysrhythmia Recognition

Basic Dysrhythmia Recognition Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with first-degree AV block, ST-segment depression ● Ventricular rhythm Regular ● Ventricular rate 68/min ● Atrial rhythm Regular ● Atrial rate 68/min ● PRI: 0.28 sec ● QRS: 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Second-degree AV block, type I ● Ventricular rhythm Irregular ● Ventricular rate 38 to 75/min ● Atrial rhythm Regular ● Atrial rate 75/min ● PRI: Lengthening ● QRS: 0.06 to 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Idioventricular rhythm (IVR) (ventricular escape rhythm) ● Ventricular rhythm Regular ● Ventricular rate 40/min ● Atrial rhythm None ● Atrial rate None ● PRI: None ● QRS: 0.18 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus tachycardia with uniform PVCs ● Ventricular rhythm Regular except for events ● Ventricular rate 107/min (sinus beats) ● Atrial rhythm Regular except for events ● Atrial rate 107/min (sinus beats) ● PRI: 0.20 sec (sinus beats) ● QRS: 0.08 sec (sinus beats) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with a wide QRS, ST-segment depression ● Ventricular rhythm Regular ● Ventricular rate 94/min ● Atrial rhythm Regular ● Atrial rate 94/min ● PRI: 0.18 sec ● QRS: 0.12 sec (wide, probably due to RBBB) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Atrial flutter ● Ventricular rhythm Irregular ● Ventricular rate 75 to 107/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Accelerated idioventricular rhythm (AIVR) ● Ventricular rhythm Regular ● Ventricular rate 88/min ● Atrial rhythm None ● Atrial rate None ● PRI: None ● QRS: 0.12 to 0.14 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm, ST-segment depression ● Ventricular rhythm Regular ● Ventricular rate 75/min ● Atrial rhythm Regular ● Atrial rate 75/min ● PRI: 0.16 sec ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Agonal rhythm/asystole ● Ventricular rhythm Two ventricular complexes to none ● Ventricular rate None ● Atrial rhythm None ● Atrial rate None ● PRI: None ● QRS: 0.14 sec to none Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Complete (third-degree) AV block with ST-segment elevation ● Ventricular rhythm Regular ● Ventricular rate 60/min ● Atrial rhythm Regular ● Atrial rate 114/min ● PRI: Varies ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. AV nodal reentrant tachycardia (AVNRT) with ST-segment depression ● Ventricular rhythm Regular ● Ventricular rate 184/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Monomorphic ventricular tachycardia ● Ventricular rhythm Regular ● Ventricular rate 214/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.16 to 0.18 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus bradycardia with ventricular bigeminy ● Ventricular rhythm Regular except for the event (every other beat is an ectopic beat) ● Ventricular rate44/min (sinus beats) ● Atrial rhythm Regular except for the event ● Atrial rate 44/min (sinus beats) ● PRI: 0.20 sec (sinus beats) ● QRS: 0.06 sec (sinus beats) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus tachycardia, ST-segment depression ● Ventricular rhythm Regular ● Ventricular rate 120/min ● Atrial rhythm Regular ● Atrial rate 120/min ● PRI: 0.16 sec ● QRS: 0.08 to 0.10 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Polymorphic ventricular tachycardia ● Ventricular rhythm Irregular ● Ventricular rate 300 to 375/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: Varies Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Accelerated junctional rhythm ● Ventricular rhythm Regular ● Ventricular rate 62/min ● Atrial rhythm Regular ● Atrial rate 62/min ● PRI: 0.14 sec ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm to monomorphic ventricular tachycardia (VT) ● Ventricular rhythm Regular (sinus beats), regular (VT) ● Ventricular rate 94/min (sinus beats) to 150/min (VT) ● Atrial rhythm Regular to unable to determine ● Atrial rate 94/min (sinus beats) ● PRI: 0.16 sec (sinus beats) ● QRS: 0.10 sec (sinus beats) to 0.14 sec (VT) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Second-degree AV block type II ● Ventricular rhythm Irregular ● Ventricular rate 20 to 79/min ● Atrial rhythm Regular ● Atrial rate 79/min ● PRI: 0.14 sec ● QRS: 0.16 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Asystole ● Ventricular rhythm None ● Ventricular rate None ● Atrial rhythm None ● Atrial rate None ● PRI: None ● QRS: None Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with a PAC ● Ventricular rhythm Regular except for the event ● Ventricular rate 71/min ● Atrial rhythm Regular except for the event ● Atrial rate 71/min ● PRI: 0.12 sec ● QRS: 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Ventricular fibrillation ● Ventricular rhythm Unable to determine ● Ventricular rateUnable to determine ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: Unable to determine Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Complete (third-degree) AV block with ST-segment elevation ● Ventricular rhythm Regular ● Ventricular rate 42/min ● Atrial rhythm Regular ● Atrial rate 71/min ● PRI: Varies ● QRS: 0.12 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Second-degree AV block type I with ST-segment depression ● Ventricular rhythm Irregular ● Ventricular rate 41 to 63/min ● Atrial rhythm Regular ● Atrial rate 88/min ● PRI: Lengthens ● QRS: 0.08 to 0.10 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Atrial fibrillation with a wide-QRS and ST-segment elevation ● Ventricular rhythm Irregular ● Ventricular rate 107 to 150/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.12 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus beat to junctional escape rhythm with inverted T waves ● Ventricular rhythm Regular ● Ventricular rate 52/min ● Atrial rhythm None ● Atrial rate None ● PRI: None ● QRS: 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Complete (third-degree) AV block ● Ventricular rhythm Regular ● Ventricular rate 29/min ● Atrial rhythm Regular ● Atrial rate 115/min ● PRI: Varies ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. ● Ventricular rhythm Regular ● Ventricular rate 128/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.06 to 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. ● Ventricular rhythm Essentially regular ● Ventricular rate 150/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.12 to 0.16 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Complete (third-degree) AV block ● Ventricular rhythm Regular ● Ventricular rate 32/min ● Atrial rhythm Regular ● Atrial rate 79/min ● PRI: Varies ● QRS: 0.12 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Complete (third-degree) AV block with ST-segment elevation ● Ventricular rhythm Regular ● Ventricular rate 29/min ● Atrial rhythm Regular ● Atrial rate 94/min ● PRI: Varies ● QRS: 0.16 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. AV nodal reentrant tachycardia (AVNRT) with ST-segment depression ● Ventricular rhythm Regular ● Ventricular rate 214/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.04 to 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Accelerated idioventricular rhythm (AIVR) with ST-segment elevation ● Ventricular rhythm Regular ● Ventricular rate 71/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.12 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with ST-segment elevation ● Ventricular rhythm Regular ● Ventricular rate 93/min ● Atrial rhythm Regular ● Atrial rate 93/min ● PRI: 0.14 sec ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Complete (third-degree) AV block with ST-segment elevation ● Ventricular rhythm Regular ● Ventricular rate 58/min ● Atrial rhythm Regular ● Atrial rate 100/min ● PRI: Varies ● QRS: 0.04 to 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus tachycardia ● Ventricular rhythm Regular ● Ventricular rate 111/min ● Atrial rhythm Regular ● Atrial rate 111/min ● PRI: 0.16 sec ● QRS: 0.04 to 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with a PJC ● Ventricular rhythm Regular except for the event ● Ventricular rate 75/min (sinus beats) ● Atrial rhythm Regular except for the event ● Atrial rate 75/min (sinus beats) ● PRI: 0.16 sec (sinus beats) ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Second-degree AV block type I with a ventricular complex ● Ventricular rhythm Irregular ● Ventricular rate 42 to 68/min ● Atrial rhythm Regular ● Atrial rate 68/min ● PRI: Lengthens ● QRS: 0.10 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus bradycardia with first-degree AV block to junctional escape rhythm ● Ventricular rhythm Regular (junctional beats) ● Ventricular rate 48/min (junctional beats) ● Atrial rhythm Unable to determine (junctional beats) ● Atrial rate Unable to determine (junctional beats) ● PRI: Unable to determine (junctional beats) ● QRS: 0.06 to 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Atrial fibrillation (controlled) ● Ventricular rhythm Irregular ● Ventricular rate 75 to 94/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with ST-segment elevation ● Ventricular rhythm Regular ● Ventricular rate 86/min ● Atrial rhythm Regular ● Atrial rate 86/min ● PRI: 0.18 to 0.20 sec ● QRS: 0.10 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus bradycardia with ventricular bigeminy ● Ventricular rhythm Regular except for the event (every other beat is an ectopic beat) ● Ventricular rate 42/min (sinus beats) ● Atrial rhythm Regular except for the event ● Atrial rate 42/min (sinus beats) ● PRI: 0.16 to 0.20 sec (sinus beats) ● QRS: 0.12 sec (sinus beats) Copyright © 2006 by Mosby Inc. All rights reserved. Sinus arrhythmia ● Ventricular rhythm Irregular ● Ventricular rate 64 to 94/min ● Atrial rhythm Irregular ● Atrial rate 64 to 94/min ● PRI: 0.16 sec ● QRS: 0.06 to 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Accelerated junctional rhythm ● Ventricular rhythm Regular ● Ventricular rate 79/min ● Atrial rhythm None ● Atrial rate None ● PRI: None ● QRS: 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. P wave asystole ● Ventricular rhythm None ● Ventricular rate None ● Atrial rhythm Regular ● Atrial rate 38/min ● PRI: None ● QRS: None Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm ● Ventricular rhythm Regular ● Ventricular rate 71/min ● Atrial rhythm Regular ● Atrial rate 71/min ● PRI: 0.20 sec ● QRS: 0.10 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with PJCs ● Ventricular rhythm Regular except for the event(s) ● Ventricular rate 77/min (sinus beats) ● Atrial rhythm Regular except for the event(s) ● Atrial rate 77/min (sinus beats) ● PRI: 0.16 sec (sinus beats) ● QRS: 0.04 to 0.06 sec (sinus beats) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Ventricular fibrillation to sinus beat, ST-segment depression ● Ventricular rhythm None to a single sinus beat ● Ventricular rate Unable to determine ● Atrial rhythm None to a single sinus beat ● Atrial rate Unable to determine ● PRI: 0.24 sec (sinus beat) ● QRS: 0.08 sec (sinus beat) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with 2 PACs, ST-segment depression ● Ventricular rhythm Regular except for the events ● Ventricular rate68/min (sinus beats) ● Atrial rhythm Regular except for the events ● Atrial rate 68/min (sinus beats) ● PRI: 0.20 sec (sinus beats) ● QRS: 0.06 sec (sinus beats) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus bradycardia with first-degree AV block ● Ventricular rhythm Regular ● Ventricular rate 57/min ● Atrial rhythm Regular ● Atrial rate 57/min ● PRI: 0.28 sec ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Atrial fibrillation (uncontrolled) ● Ventricular rhythm Irregular ● Ventricular rate 100 to 150/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.08 to 0.10 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Complete (third-degree) AV block with ST-segment depression ● Ventricular rhythm Regular ● Ventricular rate 60/min ● Atrial rhythm Regular ● Atrial rate 115/min ● PRI: Varies ● QRS: 0.14 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with PACs ● Ventricular rhythm Regular except for the event ● Ventricular rate79/min (sinus beats) ● Atrial rhythm Regular except for the event ● Atrial rate 79/min (sinus beats) ● PRI: 0.16 sec ● QRS: 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus tachycardia with a first-degree AV block, wide QRS, and uniform PVCs ● Ventricular rhythm Regular except for the event ● Ventricular rate 125/min (sinus beats) ● Atrial rhythm Regular except for the event ● Atrial rate 125/min (sinus beats) ● PRI: 0.22 sec (sinus beats) ● QRS: 0.12 to 0.14 sec (sinus beats) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Atrial fibrillation ● Ventricular rhythm Irregular ● Ventricular rate 57 to 125/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus tachycardia with a PVC ● Ventricular rhythm Regular except for the event ● Ventricular rate 111/min (sinus beats) ● Atrial rhythm Regular except for the event ● Atrial rate 111/min (sinus beats) ● PRI: 0.16 sec ● QRS: 0.04 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Complete (third-degree) AV block to an idioventricular (ventricular escape) rhythm ● Ventricular rhythm Regular ● Ventricular rate 32/min ● Atrial rhythm Regular ● Atrial rate 91/min ● PRI: Varies ● QRS: 0.16 to 0.18 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Second-degree AV block type II ● Ventricular rhythm Regular ● Ventricular rate 29/min ● Atrial rhythm Regular ● Atrial rate 88/min ● PRI: 0.22 sec ● QRS: 0.12 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Atrial flutter ● Ventricular rhythm Regular ● Ventricular rate 65/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.10 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with ST-segment elevation ● Ventricular rhythm Regular ● Ventricular rate 94/min ● Atrial rhythm Regular ● Atrial rate 94/min ● PRI: 0.16 sec ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Atrial fibrillation ● Ventricular rhythm Irregular ● Ventricular rate 65 to 103/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.06 to 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Ventricular escape beat/asystole ● Ventricular rhythm None ● Ventricular rate None ● Atrial rhythm None ● Atrial rate None ● PRI: None ● QRS: 0.12 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus tachycardia ● Ventricular rhythm Regular ● Ventricular rate 125/min ● Atrial rhythm Regular ● Atrial rate 125/min ● PRI: 0.16 sec ● QRS: 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. AV sequential demand pacemaker ● Atrial paced activity? Yes ● Ventricular paced activity? Yes ● Paced interval rate? Atrial = 79 Ventricular = 100 Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus bradycardia with ventricular bigeminy ● Ventricular rhythm Regular except for the event (every other beat is an ectopic beat) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Agonal / asystole ● Ventricular rhythm None ● Ventricular rate None ● Atrial rhythm None ● Atrial rate None ● PRI: None ● QRS: 0.28 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Accelerated junctional rhythm with ST-segment elevation ● Ventricular rhythm Regular ● Ventricular rate 71/min ● Atrial rhythm Regular ● Atrial rate 71/min ● PRI: 0.14 sec ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Atrial fibrillation with uniform ventricular complexes ● Ventricular rhythm Irregular ● Ventricular rate 88 to 167/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.06 to 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Second-degree AV block type 1 ● Ventricular rhythm Irregular ● Ventricular rate 51 to 83/min ● Atrial rhythm Regular ● Atrial rate 88/min ● PRI: Lengthens ● QRS: 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Atrial flutter with ST-segment depression ● Ventricular rhythm Regular ● Ventricular rate 88/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.06 to 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Complete (third-degree) AV block with ST-segment depression ● Ventricular rhythm Regular ● Ventricular rate 34/min ● Atrial rhythm Regular ● Atrial rate 88/min ● PRI: Varies ● QRS: 0.16 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus bradycardia with ventricular bigeminy ● Ventricular rhythm Regular except for the event (every other beat is an ectopic beat) ● Ventricular rate 36/min (sinus beats) ● Atrial rhythm Regular except for the event ● Atrial rate 36/min (sinus beats) ● PRI: 0.16 to 0.18 sec (sinus beats) ● QRS: 0.04 to 0.06 sec (sinus beats) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Complete (third-degree) AV block ● Ventricular rhythm Regular ● Ventricular rate 53/min ● Atrial rhythm Regular ● Atrial rate 136/min ● PRI: Varies ● QRS: 0.04 to 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus tachycardia with a wide-QRS and ST-segment depression ● Ventricular rhythm Regular ● Ventricular rate 130/min ● Atrial rhythm Regular ● Atrial rate 130/min ● PRI: 0.16 sec ● QRS: 0.12 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Junctional escape rhythm ● Ventricular rhythm Regular ● Ventricular rate 45/min ● Atrial rhythm None ● Atrial rate None ● PRI: None ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus bradycardia with ST-segment elevation and tall T waves ● Ventricular rhythm Regular ● Ventricular rate 58/min ● Atrial rhythm Regular ● Atrial rate 58/min ● PRI: 0.16 sec ● QRS: 0.08 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Atrial fibrillation with ST-segment depression ● Ventricular rhythm Irregular ● Ventricular rate 75 to 176/min ● Atrial rhythm Unable to determine ● Atrial rate Unable to determine ● PRI: Unable to determine ● QRS: 0.08 to 0.10 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Second-degree AV block type II ● Ventricular rhythm Irregular ● Ventricular rate 28 to 55/min ● Atrial rhythm Regular ● Atrial rate 55/min ● PRI: 0.40 sec ● QRS: 0.12 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus bradycardia with ventricular bigeminy and a run of VT, ST-segment depression ● Ventricular rhythm Irregular ● Ventricular rate 56/min (sinus beats) ● Atrial rhythm Irregular (sinus beats) ● Atrial rate 56/min (sinus beats) ● PRI: 0.16 sec (sinus beats) ● QRS: 0.06 sec (sinus beats) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus tachycardia ● Ventricular rhythm Regular ● Ventricular rate Approximately 110/min ● Atrial rhythm Regular ● Atrial rate Approximately 110/min ● PRI: 0.18 sec ● QRS: 0.06 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm (with tall T waves) ● Ventricular rhythm Regular ● Ventricular rate 70/min ● Atrial rhythm Regular ● Atrial rate 70/min ● PRI: 0.18 sec ● QRS: 0.08 to 0.10 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with uniform PVCs ● Ventricular rhythm Regular except for the event ● Ventricular rate 68/min (sinus beats) ● Atrial rhythm Regular except for the event ● Atrial rate 68/min (sinus beats) ● PRI: 0.18 sec (sinus beats) ● QRS: 0.06 sec (sinus beats) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Second-degree AV block type II with ST-segment depression ● Ventricular rhythm Irregular ● Ventricular rate 48 to 83/min ● Atrial rhythm Regular ● Atrial rate 167/min ● PRI: 0.24 sec ● QRS: 0.12 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus tachycardia with PACs ● Ventricular rhythm Regular except for the event ● Ventricular rate 115/min (sinus beats) ● Atrial rhythm Regular except for the event ● Atrial rate 115/min (sinus beats) ● PRI: 0.16 sec ● QRS: 0.08 to 0.10 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Asystole ● Ventricular rhythm None ● Ventricular rate None ● Atrial rhythm None ● Atrial rate None ● PRI: None ● QRS: None Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with first-degree AV block, wide QRS (bundle branch block), multiform PVCs, and ST-segment elevation ● Ventricular rhythm Irregular ● Ventricular rate 65 to 75/min (sinus beats) ● Atrial rhythm Irregular ● Atrial rate 65 to 75/min (sinus beats) ● PRI: 0.32 sec (sinus beats) ● QRS: 0.18 sec (sinus beats) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Complete (third-degree) AV block ● Ventricular rhythm Regular ● Ventricular rate 45/min ● Atrial rhythm Regular ● Atrial rate 115/min ● PRI: Varies ● QRS: 0.16 sec Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Junctional bradycardia to sinus bradycardia ● Ventricular rhythm Irregular (junctional beats) to regular (sinus beats) ● Ventricular rate 30/min (junctional beats) to 56/min (sinus beats) ● Atrial rhythm None (junctional beats) to regular (sinus beats) ● Atrial rate None (junctional beats) to 56/min (sinus beats) ● PRI: None (junctional beats) to 0.18 (sinus beats) ● QRS: 0.04 sec (junctional beats) to 0.08 (sinus beats) Copyright © 2006 by Mosby Inc. All rights reserved. Copyright © 2006 by Mosby Inc. All rights reserved. Sinus rhythm with uniform PVCs ● Ventricular rhythm Regular except for the event ● Ventricular rate96/min (sinus beats) ● Atrial rhythm Regular except for the event ● Atrial rate 96/min (sinus beats) ● PRI: 0.12 sec (sinus beats) ● QRS: 0.08 to 0.10 sec (sinus beats) Copyright © 2006 by Mosby Inc. All rights reserved.