Cardiac EKG Rhythms (Updated) Normal Sinus Rhythm

Cardiac EKG Rhythms (Updated). Normal Sinus Rhythm Normal Sinus Rhythm ● Rate: 60-100 beats per minute ● Rhythm: Atrial and Ventricular Regular ● P Wave: Uniform in appearance, upright, normal shape, one preceding each QRS complex ● PR Interval: 0.12- 0.2 seconds ● QRS: 0.12 second or less. (If larger than 0.12- QRS is wide and there may be a bundle branch block) Sinus Bradycardia ● Rate: Less than 60 beats per minute ● Rhythm: Atrial and Ventricular Regular ● P Waves: Uniform in appearance, upright, normal shape, one preceding each QRS complex ● PR Interval: 0.12-0.2 seconds ● QRS: Usually 0.12 seconds or less ● Etiology: athletic training, MI, hypothyroidism, hypothermia, sick sinus syndrome, medications, increased ICP ● Treatment: *None may be indicated* ○ Treat underlying cause ○ Atropine #1 medication to treat bradycardia!!!!! ○ Pacemaker for patients with chronic bradycardia, takes over SA node; puts intrinsic rate into heart Sinus Tachycardia Cardiac EKG Rhythms ● Rate: Usually 100-140 beats per minute ● Rhythm: Atrial and ventricular regular ● P Waves: Uniform in appearance, upright, normal shape, one preceding each QRS ● PR Interval: 0.12-0.2 second ● QRS: Usually 0.12 second or less ● Etiology: stress or fear, anemia, fever, hypoxia, shock, hyperthyroidism, drugs, heart failure, pain, hypoglycemia ● Treatment: ○ Treat underlying cause ○ β Blocker ○ Calcium Channel Blocker (Diltiazem aka Cardizem) ○ Valsalva Maneuvers – series of motions that stimulates nerve, running by the heart, which slows it down; ex: bearing down Sinus Arrhythmia ● Rate: Usually 60-100 beats per minute ● Rhythm: Atrial and ventricular occasionally have an irregular beat ● P Waves: Uniform in appearance, upright, normal shape, one preceding each QRS ● PR Interval: 0.12-0.2 second ● QRS: Usually 0.12 second or less ● Etiology: idiopathic (unknown cause), stress, electrolyte imbalance – first sign ● Treatment: likely no treatment unless symptomatic -- treat underlying condition!