EKG Interpretation (HCA) | ECG Rhythm Strip Practice & Exam Prep Guide

https://www.stuvia.com/user/stillo
EKG Interpretation (HCA) _ ECG Rhythm Strip Practice & Exam Prep Guidehttps://www.stuvia.com/user/stillo
Page 1 of 20https://www.stuvia.com/user/stillo



https://www.stuvia.com/user/reeveanthony
https://www.stuvia.com/user/reeveanthonyhttps://www.stuvia.com/user/reeveanthony




EKG Interpretation (HCA) |
ECG Rhythm Strip Practice
& Exam Prep Guide




https://www.stuvia.com/user/reevhttps://www.stuvia.com/user/reeveanthony
eanthonyhttps://www.stuvia.com/user/reeveanthonyhttps://www.stuvia.com/user/reeveanthony



Page 1 of 20https://www.stuvia.com/user/stillo
EKG Interpretation (HCA) _ ECG Rhythm Strip Practice & Exam Prep Guidehttps://www.stuvia.com/user/stillo
https://www.stuvia.com/user/stillo

,https://www.stuvia.com/user/stillo EKG Interpretation (HCA)https://www.stuvia.com/user/stillo Page 2 of 20https://www.stuvia.com/user/stillo




Atrial Rhythms • Are not classic “P-wave” rhythms, if equal/consistent/nonvarying P-waves are
easily identified then the rhythm is NOT atrial in origin
• Atrial rhythms are routinely fast
• Ventricular rates can be controlled (<100) or uncontrolled (>100)
• Ventricular responses and rates can reach up to 220 – 240 ppm
• Ventricular regularity can be regular or irregular, depending on the rhythm:
- AFib, WAP & MAT = ALWAYS IRREGULAR
- Aflutter = Regular or Irregular
- SVT/PSVT, ATach = ALWAYS REGULAR
• QRS-complexes can be Narrow (<0.12 sec) or Wide (>0.12 sec). This is measured
using the ECG paper (<0.12 = less than 3 small boxes; <0.12 = greater than 3 small
boxes)


Atrial Rhythms & Associated Rates • A-Fib: Atria Rate >350 – 500; Ventricular Rate >220 – 240 ppm
• A-Flutter: Atrial Rate >250 – 450; Ventricular Rate >220 – 240 ppm
• Atrial Tachycardia: Atria > 220 – 240; Ventricular Rate = Atrial Rate (1:1 ratio)
• Supraventricular Tachycardia: >150 – 160 ppm, even upwards of 220 – 240 ppm;
Ventricular Rate = Atrial Rate (1:1 ratio)
• Wandering Atrial Pacemaker (WAP): Atrial Rate <100 ppm; Ventricular Rate =
Atrial Rate
• Multifocal Atrial Tachycardia (MAT): Atrial Rate >100 ppm; Ventricular Rate =
Atrial Rate


Page 2 of 20https://www.stuvia.com/user/stillo EKG Interpretation (HCA)https://www.stuvia.com/user/stillo https://www.stuvia.com/user/stillo

,https://www.stuvia.com/user/stillo EKG Interpretation (HCA)https://www.stuvia.com/user/stillo Page 3 of 20https://www.stuvia.com/user/stillo


Premature Atrial Contraction (PAC) Atrial ectopy (not a rhythm) similar to an ill timed hiccup within the atria, or the
atria playing a game of interrupting cow.




Atrial Fibrillation (A-Fib) Wavy and chaotic baseline, noted overall irregularity, AFib QRS complexes can be
'wide' or 'narrow'




Page 3 of 20https://www.stuvia.com/user/stillo EKG Interpretation (HCA)https://www.stuvia.com/user/stillo https://www.stuvia.com/user/stillo

, https://www.stuvia.com/user/stillo EKG Interpretation (HCA)https://www.stuvia.com/user/stillo Page 4 of 20https://www.stuvia.com/user/stillo


Narrow QRS Complex <0.12 seconds (3 small boxes)


Wide QRS Complex >0.12 seconds (3 small boxes)


Atrial Flutter (A-Flutter) Consistent atrial depolarization waves creating "flutter" or "saw-tooth" appearance
on baseline.
Can be regular or irregular.
QRS complexes can be 'wide' or 'narrow'
Different ratios (2:1, 3:1, 4:1) possible




Atrial Tachycardia (A-Tach) Atrial Tachycardia is caused when abnormal electrical signals inersect with signals
coming from the SA node.
It can prevent the heart from filling normally and refuse the overall blood flow out
of the heart due to rapid rate.
'Teeny-tiny' P's noted, FAST rate, narrow complexes and REGULAR




Page 4 of 20https://www.stuvia.com/user/stillo EKG Interpretation (HCA)https://www.stuvia.com/user/stillo https://www.stuvia.com/user/stillo