Date post: | 13-Apr-2017 |
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Health & Medicine |
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Rhythm RecognitionAndey bin Rahman
Tachyarrhythmia
Narrow complexRegular•SVT•Sinus tachycardia•Atrial flutter•Junctional rhythm
Irregular•Atrial fibrillation•Atrial flutter with variable block•Multifocal atrial tachycardia
Narrow Complex
Sinus Rhythm
Sinus Tachycardia
Atrial Flutter
Rate A: 300 V:<150Rhythm RegularQRS NarrowFeature sawtooth
Supraventricular Tachycardia
Rate >150Rhythm RegularQRS NarrowFeature P not visible
Junctional rhythm Rate 40-60Rhythm RegularQRS NarrowFeature P not visible,
inverted or after QRS
Atrial fibrillation
Rate A: 600 V:variableRhythm irregularQRS NarrowFeature Irregularly irregular
Atrial flutter with variable block
Rate A: 300 V:<150Rhythm IrregularQRS NarrowFeature sawtooth
Multifocal Atrial Tachycardia
Rate VariableRhythm IrregularQRS NarrowFeature 3 or more P waves
that differ in polarity (up/down),shape, and size
Wide complex
Ventricular TachycardiaRate >150Rhythm IrregularQRS wideFeature No visible p
SVT with aberancy
Ventricular fibrillation
Rate Very fastRhythm IrregularQRS bizarreFeature no recognizable P,
QRS, or T waves
Torsades de pointes
Rate V: 150-200
Rhythm IrregularQRS QRS complexes display
“spindle-node” patternFeature no recognizable P &T
waves, prolong QT before occurence
Bradyarrhythmia
Bradyarrhythmia
Sinus Bradycardi
a1st degree
Heart block2nd degree Heart block (Mobitz 1)
2nd degree Heart block (Mobitz 2)
3rd degree Heart block
Sinus Bradycardia
1st degree Heart block• P-R Interval > 200msec (5 small box)• No dropped beat
2nd degree heart block , Mobitz 1 (Wenckebach)• Progressive prolongation of P-R intervals• P-P intervals constant• Dropped beat • PR interval is longest immediately before the dropped beat• PR interval is shortest immediately after the dropped beat
2nd degree HB Mobitz II• Intermittent non-conducted P waves without progressive prolongation of the PR
interval• PR interval in the conducted beats remains constant• P-P constant• RR interval surrounding the dropped beat(s) is an exact multiple of the preceding
RR interval
3rd degree HB (complete HB)• complete absence of AV conduction (AV dissociation)• Perfusing rhythm is maintained by a junctional or ventricular escape rhythm
Pulseless Electrical Activity (PEA)
• presence of coordinated electrical activity in myocardium but no detectable cardiac output• formerly known as EMD
(electromechanical dissociation)
Asystole
Arrest rhythm
• VF• VT• PEA• Asystole
ACLS 2010
Thank you