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# Name That Rhythm! - PowerPoint PPT Presentation

Name That Rhythm!. Sinus Bradycardia (SB). Normal except HR<60. V-paced. Spike before the QRS. Clogged blood vessels = i oxygen to the heart = heart attack. Electricity blocked from traveling normally = arrhythmia.

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Presentation Transcript

• Normal except HR<60

Spike before the QRS

Clogged blood vessels = ioxygen to the heart = heart attack

Electricity blocked from traveling normally = arrhythmia

What’s the Difference Between Heart Blockage & Block?

• Ventricular beats, but…

at a slow rate

Going down the

Drain if he stays

In this rhythm very

Long!

• Normal rhythm, but…

• No Pulse*

Gabriel is blowing his horn!!

Call Code!

longer

longer

dropped QRS

Mobitz I: Wenkebach

• PR interval gradually longer until a QRS is dropped

• Pattern repeats

• Every second beat is a PVC

Geminy

Cricket!

• Irregular

• No definable P waves

unable to count the # of waves

• Early ventricular beat

Heart Rate:

60-100 beats per minute

.12-.20 seconds

PR Interval:

QRS Interval:

< .11 seconds

• Pacer spike is fired, but no beat follows

Mobitz II

• PR interval consistent except some QRS missing

Example PR intervals: .16 – B - .16 – B - .16 - .16 - B

• Rhythm is normal

• Rate normal 60-100

• PR normal .12-.20

• QRS normal < .11

• No P wave or PR < .12

• Period of no electrical activity, then resumes

QRS look similar in shape

Paroxysmal Atrial Tachycardia (PAT)

• Sudden rate change > 150 bpm

• QRS shape is similar before & after rate change

PR interval >.20

PR intervals:

.24 - .24 - .24 - .24 - .24

• Normal except HR >100 bpm

• Ventricular beats (wide QRS’s)

• Rate > 150 bpm

Call Code!

• Normal except irregular

• No electrical activity

Call Code!

My heart may stop if

This guy was swimming

With me!!!

Every 3rd beat is a PVC

normal

blocked

blocked

blocked

blocked

blocked

short

3rd Degree AV Block(3º AVB)

Atria & ventricles act independently

• Regular P waves

• Regular QRS complexes

But…P waves and QRS not working together

• PR interval varies (but not in Wenkebach pattern)

• Harmful -- patient needs a pacemaker soon!

Example PR intervals: .14 – B - .20 – B – B - .12 – B - .44 - .32 - B

• A form of VTach which looks like the rhythm strip is twisting

Call CODE!

ATRIAL

JUNCTIONAL

VENTRICULAR

Steps to Interpret Rhythms

• 1. Are the beats at regular or irregular intervals apart?

• 2. Do you see P, QRS, T pattern?

• 3. What is the HEART RATE?

• 4. What is the PR interval?

• 5. What is the QRS interval?

A spike before the P wave site

PR regular except some QRS are dropped

PR intervals:

.12 – B - .12 - .12 – B - .12 – B

QRS

• Numerous P waves that you can count

PVC

PJC

PAC

Wide QRS

PR<.12

PR=.12-.20

PR gradually longer until QRS dropped

PR intervals:

.12 - .18 - .24 – B - .12 - .18 - .24 – B

• Squiggly line

Call CODE!

• Heart is beating just fine, but pacemaker fires anyway

• Spikes are not in a consistent place before P or QRS --seen in many different places

enters

ST Elevation

QRS exits higher than it starts

• P waves vary in shape (at least 3 different P waves)

PR interval varies, but not in Wenkebach pattern

PR intervals:

.12 – B - .20 – B – B - .16 - .44 – B - .32

3 Types

Premature AtrialContraction (PAC)

Premature JunctionalContraction (PJC)

Premature Ventricular Contraction (PVC)

QRS >.11

Spikes before the P wave site & QRS

Premature JunctionalContraction (PJC)

• Early beat

• No P wave or PR interval is <.12

A

V

First Degree AV Block(1º AVB)

• PR interval > .20

Example PR intervals: .28 - .28 - .28 - .28 - .28 - .28

exits

ST Depression

QRS exits lower than it starts

QRS look different in shape

Paroxysmal Supraventricular Tachycardia (PSVT)

• Sudden rate change >150 bpm

• QRS may look different after rate change

Wenkebach

Mobitz II

Types of AV Blocks

Premature Atrial Contraction (PAC)

• Early beat

• Normal PR interval

The alarm clock

Always goes off

PREMATURELY!!

• VT

• VFib

• Asystole