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EKGREVIEWterry I miller rn msn cern

ECG paper is graph paper made up of small and larger, heavy-lined squares- Smallest squares are 1 mm wide and 1 mm high

5 small squares between the heavier black lines- 25 small squares within each large square

I ~ ~ 'I~~~.- 0.2 sec-f---.'- t L ~~- .04sec-1

Width of each small box =0.04 second Width of each large box (5 small boxes) =0.20 second

- 5 large boxes (each consisting of 5 small boxes) = 1 second15 large boxes =3 seconds

30 large boxes =6 seconds

Normal P WAVE:

~ - - I - - - + - ! j~-.---t-

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" \ /

SI,R.,-~'-.r" LVI

Resting

I- \St '

R - - : . ~ ~ > - = -LVI Resting

Depolarization R ..poianzanon Resting

Depolarization R ._---polarizalion Resting

NORMALPRI :

NORMALQRS:

NORMAL STSEGMENT:

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R

EGG deflections

Tp

a sAtrial depolarjzationVentrrcuIar..depo Iarizati on

(and atrial repo ariza ion)Time Ventricular repo larization

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SINUS RHYTHM

Normal, Healthy, SynchronizedAllows time for all chambers to fill with blood and pumps it efficiently to the body.RATE:RHYTHM:PWave:PRI:QRS:

SINUS BRADYCARDIA

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SINUS TACHYCARDIA

Fast but in synch, can be caused by exercise, stress, temperature, disease or fear.Usually short term and returns to normal rate when cause is gone. Ifprolonged, tires the heart and

deprives the body of efficient rhythmic pumping.RATE:RHYTHM:P Wave:PRI:QRS:

ATRIAL FIBRILLATION

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ATRlAL FLUTTER

Irregular and the atrium is pumping more often than the ventricle, therefore, does not allow for efficientblood movement through the heart and to the body. Treatment consists of medications, ablation orcardioversion, thus, converts the irregular rhythm back to normal sinus.

RATE:RHYTHM:PWave:PRl:QRS:

SVT& PSVT

r'-.~

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PREMATURE ATRIAL COMPLEXES-e-e- "ThT+t - ~ ..,..,--,." : J TjJ ffit fm l+ f ~ .. : 1 " 1 r- ~'" r ~~H , H1" FHH+III -.i-II~ ,+'H1H : 1 + < 1 1 , Ii - . pi-1T . r n m .. :t!: t:il'" .~ 1 :~ ~ ) - . - , '- ; '+ ;4 m t H~ .++.,;. it'b ;J..,f~ ~ . +--+ ~ :~ .2. . ~ j J : - + + t . l B .~, . I . . . . .u. > , - , 1 . f I g Z~- +;-'- ~.!+ ~ l : : ! : i:f'.+t:;:;~ ~ -- + 1 - -' : :o.~F m ; p '1~' --.. EEi;::;:;';' . . . . .. . f F j ~ - l . . ; 1 : : , " 1 - 0 - . . .ill ,,'''''t r . ..-:+ i ~ - " , - - ~ _ i . - : - < ' . . _ ' t ' f . m t !:~ r.~i1 ~ '''-+- - + - f - .: ' - + ttn --+ -~ :' 1 '. . , .~ ,, '. 't" . .. t,.jt '.. '. , " :W .- .. ;'T-++ . " , . 'W t -~. "':-~" lr.i;

7 " " " " " " ' " . -, + . + . : , . , . . . + ! + M::, I - . i c i = f . ' ; ' _ '.- + ~.-1-_ - . ~I I U :t -~;t, ..;.r"- H : t - . ~ ~ - : : :~t: : m F . ~jE4 ~t~ . ~ .;:.... . . . . ., + , ~b'1+" r:n ~ ~' rrt . .. . , 1ill ] i l i : f i r 1 f d rt,-.j. -,+1. "" l 1 ' ~ "~l iiL1; 1 t t 1- : . j : . : 1 1 ] # ' f n P ~ ~-.d:rtt.-e -r+r- 1 r; .: ff ' ., I T t L t.~1 " 1 I f+r,~~!tin f f i ; 1 t n I T ilp!1l T r , t l j l i~n:;:lli'L:tt IH t11~, , l.w i.tu u t 1 rtt ,. . fe r. . it~~ I ;.,L.,I~~t I ___..ll '.,;. .... . a .. a .! J

" Irregular Rhythm, Not uniformed with early contractions and decreases function of the heart".RATE:RHYTHM:PWave:PRI:QRS:

PREMATURE VENTRICULAR COMPLEXES

" Irregular Rhythm, Not uniformed with early contractions and may lead to further cardiaccomplications". PVCs on their own my not be a concern, but when they occur frequently or have runs of

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@NCTIONAL RHYTHM

" Electrical impulses down the heart from top to bottom and may be delayed".RATE:RHYTHM:P Wave:PRI:QRS:

F~STDEGREEHEARTBLOCK

--!-.----~- --t=.;.:

" The communication between the Atrium and the Ventricles is slightly delayed" This is not a dangerous

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SECOND D EGREE HEART BLOCK TYPE Ir-. '--- .-..-: :{.-~~-' --,

-1- ~ -- -i= = -r =- c=:=~.i ---=FT- ...~..": .1:-=. '----'--- -; i'~ -. i ' - t!_-'-1-- - --.-- - i ~- -i . I 1--1'- ..-- -.,- T - +-- j -. -:-:- ';-:.~ --.:..: :---=t-:-. --- --r--- - -- - 1- f ~ 1". t . . . . . : - + : : . 3 ' - _ . ' -1- 1""""-- I--- -- .. -- - -::::::t:. - t +r -. "t I' ::s--~-"~- '.- ::::t ~ -" -.:::- ~~+-~I---l- .:-;.~'1t- -'--1--4-1:;:--- t ~ -- - - -.-=-.. -~ r- "~-= .- --- - "-=-, t, j I I' I i 11---- It --::i!- -+-

" T he communication b etw een th e A trium an d th e V en tricle p rogressiv ely b ecom es m ore a nd m ored elay ed u ntil a b eat is m issed altog eth er" T he m ore freq uent there is a m issed b eat, th e m ore serio us th eproblem.

RATE:RHYTHM :PWave:PRI:QRS: . .

SECOND DEGREE HEART BLOCK TYPE II

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TIllRD DEGREE HEARTBLOCK- -1 1-=

I--+- -- ."There is no communication between the Atrium and the Ventricle, therefore beats are missedfrequently, will require external source for impulse production and control. i. e. Pacemaker"

RATE:RHYTHM:PWave:PR 1:QRS:

VENTRICULAR FIDRILLATION

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IDIOVENTRICULAR RHYTHM

" A lethal rhythm, rate is very slow with minimal to no circulation, requires immediate interventions"RATE:RHYTHM:PWave:PRI:QRS:

VENTRICULAR TACHYCARDIA

" A lethal rhythm, the heart beat fa idly but with less than adequate circulation, requires immediate ASYSTOLE

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" The Worst and Most lethal rhythm, there is no electrical nor mechanical activity in the heart"RATE:RHYTHM:PWave:PRI:QRS: