Basic Dysrhythmia interpretation
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1. General Rules First and most important, look at your patient. Read left to right. Apply the system-
atic approach. Avoid shortcuts and assumptions. Ask and answer each question in
the ECG analysis approach.
2. ECG Rhythm Analyze P waves (P wave is present, shape is consistent, must be before each
Analysis QRS), Analyze QRS complex (present and consistent), Determine atrial rhythm or
regularity (assessing P-P interval or R-R interval), Determine ventricular rhythm or
regularity (assessing R-R interval), Determine Heart Rate, Measure the PR interval
(measurement should be constant and should be between 0.12-0.20 sec), Mea-
sure the QRS duration (measurement should be constant and should be between
0.04-0.10 sec), interpret the rhythm
3. Artifacts Wave-forms outside the heart-interference. Caused by:
Patent movement, loose or defective electrodes, improper grounding, faulty ECG
apparatus.
4. Sinus Rhythms Normal, Sinus Bradycardia, Sinus Tachycardia, Sinus Arrhytmia,
5. Normal Sinus SA node generates impulse that followed a normal pathway. heart rate fall within
Rhythms 60-100 BPM, atrial and ventricular rhythms are normal, p wave precedes every
QRS, PR interval is within 0.12-0.20, QRS is within 0.12 seconds.
6. Atrial Rhythms Atrial Dysrhythmias, Premature Atrial Contractions (PAC), Atrial Tachycardia (unifo-
cal, multifocal), Atrial Flutter, Atrial Fibrillation
7. Sinus Bradycar- SA node fires slower than normal HR (<60 bpm), rhythm is regular, P wave upright
dia features and same shape, PR is constant 0.12-0.20, QRS -normal <0.12 sec
8. Sinus Bradycar- Causes: vagal stimulation, MI, Hypoxia, Digitalis toxicity (herbal meds), Medication
dia information side ettects, normal to elite aerobically fit athletes (pumps more blood/beat)
Adverse ettects: Dizziness, weakness, syncope, diaphoresis, pallor, hypotension
Treatment: According to symptoms, atropine to speed up heart rate, pacemaker
1/5
, Basic Dysrhythmia interpretation
Study online at https://quizlet.com/_1jetji
9. Sinus Tachycar- SA node fires at a rate faster than normal, >100 bpm but conduction pathway is
dia features normal. All criteria for interpretation are the same except that the heart rate is faster.
10. Sinus Tachycar- Causes: emotionally upset, pain, fever, thyrotoxicosis (hyperthyroid), hypoxia, hy-
dia information povolemia, inhibition of vagus nerve (parasympathetic)
Adverse ettects: Angina, dizziness, hypotension, increased in cardiac workload
Treatment: Treat the cause, medications may be given (b-blockers)
11. Sinus Arrhythmia The only irregular rhythm from the sinus node and has a cyclic pattern that usually
corresponds with breathing, Rate= varies with respiratory pattern, Regularity=
irregular in a repetitive pattern, P wave= upright in most leads, same shape and
one to each QRS;P-P interval is irregular, QRS= <0.12, Cause= usually breathing
pattern but can also be heart disease, Tx= Usually non required
12. Atrial Dysrhyth- SA node fails to generate an impulse (atrial tissue takes over), Atrial nodes or
mias internodal pathways may initiate an impulse and follows the conduction pathway,
Dysrhythmias of this type are not lethal, Accessory pathway (an additional electrical
conduction pathway b/w 2 parts of the heart; may alter electrical conduction
system of the heart)
13. Premature Atri- Early ectopic beat that originates outside the SA node, Causes= atria becomes
al Contractions hyper and fire early caused by medications, catteine, tobacco, hypoxia, or heart
(PAC) Informa- disease, Adverse ettects= if freq can be a sign of impending heart failure or atrial
tion tachycardia or fibrillation, Tx= 02, omit catteine, tobacco or other stimulants. Give
digitalis or quinidine, treat heart failure
14. Premature Atri- Normal rate, usually regular in rhythm except for PAC, P waves shaped ditterently
al Contractions from a normal P wave or hidden in preceding T wave (P and T fire at same time),
(PAC) features PR interval = 0.12-0.20 sec, QRS= 0.12 sec, Produce an irregularity in the rhythm
(P-P and P-R intervals are shorter than the P-P and R-R intervals of underlying
rhythm), Have P waves that are upright (in lead II) preceding each QRS complex
but have a ditterent morphology (appearance) than the P waves of underlying
rhythm. Bigeminal, trigeminal, quadrigeminal ( N/PAC, N/N/PAC, N/N/N/PAC)
2/5
Study online at https://quizlet.com/_1jetji
1. General Rules First and most important, look at your patient. Read left to right. Apply the system-
atic approach. Avoid shortcuts and assumptions. Ask and answer each question in
the ECG analysis approach.
2. ECG Rhythm Analyze P waves (P wave is present, shape is consistent, must be before each
Analysis QRS), Analyze QRS complex (present and consistent), Determine atrial rhythm or
regularity (assessing P-P interval or R-R interval), Determine ventricular rhythm or
regularity (assessing R-R interval), Determine Heart Rate, Measure the PR interval
(measurement should be constant and should be between 0.12-0.20 sec), Mea-
sure the QRS duration (measurement should be constant and should be between
0.04-0.10 sec), interpret the rhythm
3. Artifacts Wave-forms outside the heart-interference. Caused by:
Patent movement, loose or defective electrodes, improper grounding, faulty ECG
apparatus.
4. Sinus Rhythms Normal, Sinus Bradycardia, Sinus Tachycardia, Sinus Arrhytmia,
5. Normal Sinus SA node generates impulse that followed a normal pathway. heart rate fall within
Rhythms 60-100 BPM, atrial and ventricular rhythms are normal, p wave precedes every
QRS, PR interval is within 0.12-0.20, QRS is within 0.12 seconds.
6. Atrial Rhythms Atrial Dysrhythmias, Premature Atrial Contractions (PAC), Atrial Tachycardia (unifo-
cal, multifocal), Atrial Flutter, Atrial Fibrillation
7. Sinus Bradycar- SA node fires slower than normal HR (<60 bpm), rhythm is regular, P wave upright
dia features and same shape, PR is constant 0.12-0.20, QRS -normal <0.12 sec
8. Sinus Bradycar- Causes: vagal stimulation, MI, Hypoxia, Digitalis toxicity (herbal meds), Medication
dia information side ettects, normal to elite aerobically fit athletes (pumps more blood/beat)
Adverse ettects: Dizziness, weakness, syncope, diaphoresis, pallor, hypotension
Treatment: According to symptoms, atropine to speed up heart rate, pacemaker
1/5
, Basic Dysrhythmia interpretation
Study online at https://quizlet.com/_1jetji
9. Sinus Tachycar- SA node fires at a rate faster than normal, >100 bpm but conduction pathway is
dia features normal. All criteria for interpretation are the same except that the heart rate is faster.
10. Sinus Tachycar- Causes: emotionally upset, pain, fever, thyrotoxicosis (hyperthyroid), hypoxia, hy-
dia information povolemia, inhibition of vagus nerve (parasympathetic)
Adverse ettects: Angina, dizziness, hypotension, increased in cardiac workload
Treatment: Treat the cause, medications may be given (b-blockers)
11. Sinus Arrhythmia The only irregular rhythm from the sinus node and has a cyclic pattern that usually
corresponds with breathing, Rate= varies with respiratory pattern, Regularity=
irregular in a repetitive pattern, P wave= upright in most leads, same shape and
one to each QRS;P-P interval is irregular, QRS= <0.12, Cause= usually breathing
pattern but can also be heart disease, Tx= Usually non required
12. Atrial Dysrhyth- SA node fails to generate an impulse (atrial tissue takes over), Atrial nodes or
mias internodal pathways may initiate an impulse and follows the conduction pathway,
Dysrhythmias of this type are not lethal, Accessory pathway (an additional electrical
conduction pathway b/w 2 parts of the heart; may alter electrical conduction
system of the heart)
13. Premature Atri- Early ectopic beat that originates outside the SA node, Causes= atria becomes
al Contractions hyper and fire early caused by medications, catteine, tobacco, hypoxia, or heart
(PAC) Informa- disease, Adverse ettects= if freq can be a sign of impending heart failure or atrial
tion tachycardia or fibrillation, Tx= 02, omit catteine, tobacco or other stimulants. Give
digitalis or quinidine, treat heart failure
14. Premature Atri- Normal rate, usually regular in rhythm except for PAC, P waves shaped ditterently
al Contractions from a normal P wave or hidden in preceding T wave (P and T fire at same time),
(PAC) features PR interval = 0.12-0.20 sec, QRS= 0.12 sec, Produce an irregularity in the rhythm
(P-P and P-R intervals are shorter than the P-P and R-R intervals of underlying
rhythm), Have P waves that are upright (in lead II) preceding each QRS complex
but have a ditterent morphology (appearance) than the P waves of underlying
rhythm. Bigeminal, trigeminal, quadrigeminal ( N/PAC, N/N/PAC, N/N/N/PAC)
2/5
