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    IVA. Heart Arrhythmias

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    John Christopher P. Tiamzon
    This document discusses ECG rhythm interpretation and focuses on sinus rhythms and premature beats. It provides examples of normal sinus rhythm as well as sinus bradycardia and sinus tachycardia. It also discusses premature atrial contractions which present with irregular P wave contours and timing. Premature ventricular contractions are characterized by absent P waves and wide, bizarre QRS complexes. The goal is to recognize normal sinus rhythm and the 13 most common rhythm disturbances on an ECG.

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    IVA. Heart Arrhythmias

    Uploaded by

    John Christopher P. Tiamzon
    177 views21 pages
    This document discusses ECG rhythm interpretation and focuses on sinus rhythms and premature beats. It provides examples of normal sinus rhythm as well as sinus bradycardia and sinus tachycardia. It also discusses premature atrial contractions which present with irregular P wave contours and timing. Premature ventricular contractions are characterized by absent P waves and wide, bizarre QRS complexes. The goal is to recognize normal sinus rhythm and the 13 most common rhythm disturbances on an ECG.

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    This document discusses ECG rhythm interpretation and focuses on sinus rhythms and premature beats. It provides examples of normal sinus rhythm as well as sinus bradycardia and sinus tachycardia. It also discusses premature atrial contractions which present with irregular P wave contours and timing. Premature ventricular contractions are characterized by absent P waves and wide, bizarre QRS complexes. The goal is to recognize normal sinus rhythm and the 13 most common rhythm disturbances on an ECG.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    177 views21 pages

    IVA. Heart Arrhythmias

    Uploaded by

    John Christopher P. Tiamzon
    This document discusses ECG rhythm interpretation and focuses on sinus rhythms and premature beats. It provides examples of normal sinus rhythm as well as sinus bradycardia and sinus tachycardia. It also discusses premature atrial contractions which present with irregular P wave contours and timing. Premature ventricular contractions are characterized by absent P waves and wide, bizarre QRS complexes. The goal is to recognize normal sinus rhythm and the 13 most common rhythm disturbances on an ECG.

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    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
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    ECG Rhythm Interpretation

    Module IV a

    Sinus Rhythms and


    Premature Beats
    Course Objectives

    • To recognize the normal rhythm of the


    heart - “Normal Sinus Rhythm.”
    • To recognize the 13 most common
    rhythm disturbances.
    • To recognize an acute myocardial
    infarction on a 12-lead ECG.
    Learning Modules

    • ECG Basics
    • How to Analyze a Rhythm
    • Normal Sinus Rhythm
    • Heart Arrhythmias
    • Diagnosing a Myocardial Infarction
    Arrhythmias

    • Sinus Rhythms
    • Premature Beats
    • Supraventricular Arrhythmias
    • Ventricular Arrhythmias
    • AV Junctional Blocks
    Sinus Rhythms

    • Sinus Bradycardia
    • Sinus Tachycardia
    Rhythm #1

    • Rate? 30 bpm
    • Regularity? regular
    • P waves? normal
    • PR interval? 0.12 s
    • QRS duration? 0.10 s
    Interpretation? Sinus Bradycardia
    Sinus Bradycardia

    • Deviation from NSR


    - Rate < 60 bpm
    Sinus Bradycardia

    • Etiology: SA node is depolarizing slower


    than normal, impulse is conducted
    normally (i.e. normal PR and QRS
    interval).
    Rhythm #2

    • Rate? 130 bpm


    • Regularity? regular
    • P waves? normal
    • PR interval? 0.16 s
    • QRS duration? 0.08 s
    Interpretation? Sinus Tachycardia
    Sinus Tachycardia

    • Deviation from NSR


    - Rate > 100 bpm
    Sinus Tachycardia

    • Etiology: SA node is depolarizing faster


    than normal, impulse is conducted
    normally.
    • Remember: sinus tachycardia is a
    response to physical or psychological
    stress, not a primary arrhythmia.
    Premature Beats

    • Premature Atrial Contractions


    (PACs)
    • Premature Ventricular Contractions
    (PVCs)
    Rhythm #3

    • Rate? 70 bpm
    • Regularity? occasionally irreg.
    • P waves? 2/7 different contour
    • PR interval? 0.14 s (except 2/7)
    • QRS duration? 0.08 s
    Interpretation? NSR with Premature Atrial
    Contractions
    Premature Atrial Contractions

    • Deviation from NSR


    – These ectopic beats originate in the
    atria (but not in the SA node), therefore
    the contour of the P wave, the PR
    interval, and the timing are different
    than a normally generated pulse from
    the SA node.
    Premature Atrial Contractions

    • Etiology: Excitation of an atrial cell


    forms an impulse that is then conducted
    normally through the AV node and
    ventricles.
    Teaching Moment

    • When an impulse originates anywhere in


    the atria (SA node, atrial cells, AV node,
    Bundle of His) and then is conducted
    normally through the ventricles, the QRS
    will be narrow (0.04 - 0.12 s).
    Rhythm #4

    • Rate? 60 bpm
    • Regularity? occasionally irreg.
    • P waves? none for 7th QRS
    • PR interval? 0.14 s
    • QRS duration? 0.08 s (7th wide)
    Interpretation? Sinus Rhythm with 1 PVC
    PVCs

    • Deviation from NSR


    – Ectopic beats originate in the ventricles
    resulting in wide and bizarre QRS
    complexes.
    – When there are more than 1 premature
    beats and look alike, they are called
    “uniform”. When they look different, they are
    called “multiform”.
    PVCs

    • Etiology: One or more ventricular cells


    are depolarizing and the impulses are
    abnormally conducting through the
    ventricles.
    Teaching Moment

    • When an impulse originates in a


    ventricle, conduction through the
    ventricles will be inefficient and the
    QRS will be wide and bizarre.
    Ventricular Conduction

    Normal Abnormal
    Signal moves rapidly Signal moves slowly
    through the ventricles through the ventricles

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