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EKG Rhythm Identification

Rhythm Rate Regularity P-Waves PRI QRS

Normal Sinus Rhythm 60-100 Regular Upright, Uniform, 1 Before every QRS .12-.20 Sec <.12 seconds
Sinus Bradycardia less than 60 Regular Upright, Uniform, 1 Before every QRS .12-.20 Sec <.12 seconds
Sinus Dysrhythmia 60-100 Varies with Respirations Upright, Uniform, 1 Before every QRS .12-.20 Sec <.12 seconds
Sinus Tachycardia 100-160 Regular Upright, Uniform, 1 Before every QRS .12-.20 Sec <.12 seconds
Sinus Arrest 60-100 Irregular Upright, Uniform, 1 Before every QRS .12-.20 Sec <.12 seconds
Sinus Block 60-100 Irregular Upright, Uniform, 1 Before every QRS .12-.20 Sec <.12 seconds
Wandering Atrial Pacemaker 60-100 Slightly Irregular Changing Morphology (size and shape) May vary <.12 seconds
Atrial Fibrillation Atrial rate:350-750 Irregularly Irregular Fibrillatory waves ( f - waves ) None <.12 seconds
Atrial Flutter Atrial rate:250-450 Regular or Irregular Flutter waves ( F - waves ) None <.12 seconds
Atrial Tachycardia 150-250 Regular Upright, Uniform, 1 Before every QRS .12-.20 Sec <.12 seconds
Multifocal Atrial Tachycardia 100-250 Irregularly Irregular Morphology Changes, 1 Before every QRS May vary <.12 seconds
Junctional Escape Rhythm 40-60 Regular Inverted, Uniform, 1 before,after or buried in QRS If before <.12 <.12 seconds
Junctional Tachycardia 100-180 Regular Inverted, Uniform, 1 before,after or buried in QRS If before <.12 <.12 seconds
Junctional Accelerated Rhythm 60-100 Regular Inverted, Uniform, 1 before,after or buried in QRS If before <.12 <.12 seconds
Supraventricular Tachycardia 150-250 Regular Before,after or buried in QRS - or Absent .12-.20 Sec <.12 seconds
Ventricular Tachycardia 100-250 Regular None None >.12 seconds
Ventricular Fibrillation None Chaotic None None None
Asystole None None None None None
Idioventricular / Accelerated 20-40 / 40-100 Regular None None >.12 seconds
Polymorphic Ventricular Tach/ 100-250 Regular, Slightly Irregular QRS Amplitude changes throughout Rhythm None >.12 seconds
Torsades des Pointes
First Degree AV Block Underlying Rhythm Underlying Rhythm Upright, Uniform, 1 before every QRS complex Constant & <.12 seconds
> .20 seconds
Second Degree Type 1- Normal or Slow Irregularly Regular Upright, Uniform, More P waves than QRS Lengthens until <.12 seconds
Wenckebach complexes dropped beat
Regular (typically) Constant PRI
Second Degree Type 2 Normal or Slow May be irregular Upright, Uniform, More P waves than QRS complex with conducted <.12 seconds
complecomplexes beats
Third Degree Complete Block Usually less than 60 Regular P-P & R-R Upright, Uniform, More P waves than QRS complex Varies / Chaotic <.12 seconds
Premature Atrial Contractions Ectopic Beat Underlying Rhythm Upright, Not Uniform, Notched appearance .12-.20 seconds <.12 seconds
Premature Junctional Etopic Beat Underlying Rhythm Inverted or hidden If visible, <.12 <.12 seconds
Contractions
Premature Ventricular Etopic Beat Underlying Rhythm None None Wide and Bizarre
Contractions T-wave will be in opposite deflection as the R wave

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