Cardiac Dysrhythmia Overview to help with ACLS Precourse Examination 2025 Rhythm Strip Samples to help with ACLS Precourse Assessment with Unique Criteria. Heart Block Tricks from Terry

Agonal rhythm/asystole Atrial Fibrillation Atrial Flutter Ventricular Fibrillation Monomorphic Ventricular Tachycardia Normal Sinus Rhythm Polymorphic Ventricular Tachycardia Pulseless Electrical Activity Supraventricular Tachycardia Second-degree atrioventricular block (Mobitz I, Wenckebach) Second-degree atrioventricular block (Mobitz II block) Sinus bradycardia Sinus tachycardia Third-degree atrioventricular block RHYTHM &  ETIOLOGY CRITERIA OVERVIE W UNIQUE CRITERI A SAMPLE STRIPS ***Normal Sinus Rhythm  Normal, None RHY – Regular R – 60-100 P – Upright PRI – 0.12 – 0.20 QRS – 0.04 – 0.10 None, normal rhythm 2 ***Sinus Tachycardia  Exercise  Anxiety  Caffeine  Nicotine  Fever  Shock  CHF  Hypotension  Pain  Hypoxemia  Anterior MI RHY – Regular R – 100 - 160 P – Upright PRI – 0.12 – 0.20 QRS – 0.04 – 0.10 Rate 100 - 160 ***Sinus RHY – Regular Rate below RHYTHM &  ETIOLOGY CRITERIA OVERVIE W UNIQUE CRITERI A SAMPLE STRIPS Bradycardia  Damage SA  Normal sleep athletes  Vagal  Glaucoma  Hypothermia  Inferior MI  Drugs – MS, digoxin, Inderal  IICP R – below 60 P – Upright PRI – 0.12 – 0.20 QRS – 0.04 – 0.10 60 ***PVC/PVD Premature Ventricular Contraction/Depolari zati on  Hypoxia,  Hypotension  anemia  Ischemic hrt dis  Electrolytes AN ECTOPIC BEAT RHY – Irregular R – 60-100 P – Upright PRI – 0.12 – 0.20 QRS– 0.04 – 0.10 SR, early beat has VENT beat (wide & bizarre) 3  M.I.  Myocarditis, pericarditis  CHF  Stress, fatigue, smoking, overeating, caffeine  Hypoglycemia  Sepsis  Cyclic anti- depressants  Acidosis Supraventricular Tachycardia  Not visible sudden start or stop. RHY – Regular R – 160 - 250 P – Upright PRI – 0.12 – 0.20 QRS– 0.04 – 0.10 Rate above 160 - 250 ***Atrial Flutter RHY – Regular or Regular or RHYTHM &  ETIOLOGY CRITERIA OVERVIE W UNIQUE CRITERI A SAMPLE STRIPS  Ischemic heart disease  MI  Dig toxicity  Mitral, Tricuspid valve disease  Stress  PE  Hyperthyroid  Often temp Irregular R– Atrial 250– 400 Vent: 70 - 150 P – none, F’s PRI – none QRS – 0.04 – 0.10 Irregular, no P’s (called F’s) Saw tooth 4 Atrial Fibrillation  Ischemic heart disease  Dig toxicity  CHF  MI  Mitral or Tricuspid valve disease RHY – Irregular R– atrial 350- 600 Vent. – below 100 controlled, above 100 uncontrolled . P – None f’s PRI – none QRS – 0.04– 0.10 Irregular, no P’s (called f’s) ***PEA Pulseless Electrical Activity  Looks like any rhythm that should have a pulse but does not ***2nd degree AV Block Type I – Mobitz I, Wenckeback RHY – Irregular PRI – vary QRS– 0.04 – 0.10 Irregular EXTRA Ps PRI longer & longer, Dropped QRS RHYTHM &  ETIOLOGY CRITERIA OVERVIE W UNIQUE CRITERI A SAMPLE STRIPS ***2nd degree AV Block Type II or Mobitz II RHY – Regular or Irregular PRI – constant QRS – normal or wide Regular or Irregular EXTRA Ps 5 3rd degree AV Block, Complete Heart Block  Same as 1st degree RHY - Regular PRI – vary QRS – usually wide Regular EXTRA Ps PRI varies greatly ***Ventricula r Tachycardia monomorpic  All complexes are the same shape and look the same  Wide complex tachycardia RHY – Regular R – Above 100 P – None PRI –None QRS – Wide, Bizarre R over 100 All Vent beats ***Ventricular Fibrillation  Following V Tach  Acute MI  Electrolyte Imbalance RHY – Chaotic R – None P – None PRI –None QRS – none, fibrillatory line Chaotic wavy line. No pulse. RHYTHM &  ETIOLOGY CRITERIA OVERVIE W UNIQUE CRITERI A SAMPLE