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E.C.G. Part 4
This document provides an overview of a module on ECG rhythm interpretation. It outlines the objectives of recognizing normal sinus rhythm and 13 common rhythm disturbances. It describes learning modules that will cover ECG basics, analyzing rhythms, normal sinus rhythm, heart arrhythmias, diagnosing myocardial infarction, and different types of arrhythmias including sinus rhythms, premature beats, supraventricular arrhythmias, and ventricular arrhythmias. Examples are provided of sinus bradycardia, sinus tachycardia, premature atrial contractions, and premature ventricular contractions, along with their characteristics and etiologies.
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E.C.G. Part 4
- 1. ECG Rhythm InterpretationModule IV a Sinus Rhythms and Premature Beats
- 2. Course Objectives Torecognize 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.
- 3. Learning Modules ECGBasics How to Analyze a Rhythm Normal Sinus Rhythm Heart Arrhythmias Diagnosing a Myocardial Infarction
- 4. Arrhythmias Sinus RhythmsPremature Beats Supraventricular Arrhythmias Ventricular Arrhythmias AV Junctional Blocks
- 5. Sinus Rhythms SinusBradycardia Sinus Tachycardia
- 6. Rhythm #1 30b.p.m Rate? Regularity? regular normal 0.10 s P waves? PR interval? 0.12 s QRS duration? Interpretation? Sinus Bradycardia
- 7. Sinus Bradycardia Deviationfrom NSR - Rate < 60 bpm
- 8. Sinus Bradycardia Etiology: SA node is depolarizing slower than normal, impulse is conducted normally (i.e. normal PR and QRS interval).
- 9. Rhythm #2 130bpm Rate? Regularity? regular normal 0.08 s P waves? PR interval? 0.16 s QRS duration? Interpretation? Sinus Tachycardia
- 10. Sinus Tachycardia Deviationfrom NSR - Rate > 100 b.p.m
- 11. 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.
- 12. Premature Beats PrematureAtrial Contractions (PACs) Premature Ventricular Contractions (PVCs)
- 13. Rhythm #3 70b.p.m Rate? Regularity? occasionally irreg. 2/7 different contour 0.08 s P waves? PR interval? 0.14 s (except 2/7) QRS duration? Interpretation? NSR with Premature Atrial Contractions
- 14. Premature Atrial ContractionsDeviation 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.
- 15. Premature Atrial ContractionsEtiology: Excitation of an atrial cell forms an impulse that is then conducted normally through the AV node and ventricles.
- 16. Teaching Moment Whenan 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).
- 17. Rhythm #4 60b.p.m Rate? Regularity? occasionally irreg. none for 7 th QRS 0.08 s (7th wide) P waves? PR interval? 0.14 s QRS duration? Interpretation? Sinus Rhythm with 1 PVC
- 18. PVCs Deviation fromNSR 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”.
- 19. PVCs Etiology: One or more ventricular cells are depolarizing and the impulses are abnormally conducting through the ventricles.
- 20. Teaching Moment Whenan impulse originates in a ventricle, conduction through the ventricles will be inefficient and the QRS will be wide and bizarre.
- 21. Ventricular Conduction NormalSignal moves rapidly through the ventricles Abnormal Signal moves slowly through the ventricles