DYSRHYTHMIA BASIC A COMPETENCY EXAM
2026 ECG RHYTHM INTERPRETATION CORE
CONCEPTS
◉ capture. Answer: The successful conduction of an artificial
pacemaker's impulse through the myocardium, resulting in
depolarization
◉ demand pacemaker. Answer: Pacemaker that discharges only
when the patient's heart rate drops below the preset rate for the
pacemaker; also known as a synchronous or noncompetitive
pacemaker.
◉ dual chamber pacemaker. Answer: Pacemaker that stimulates the
atrium and ventricle; dual-chamber pacing is also called physiologic
pacing. They must get counseling because it hurts
◉ Fixed rate pacemaker. Answer: Pacemaker that continuously
discharges at a preset rate regardless of the patient's intrinsic
activity; also known as an asynchronous pacemaker
◉ Sensitivity. Answer: the extent to which an artificial pacemaker
recognizes intrinsic cardiac electrical activity.
,◉ Temporary Pacemaker's. Answer: transcutaneous: pads that go on
the body
transvenous: introduced into a central vein like the subclavian,
femoral, brachial, internal or external jugular vein
◉ complications of pacemaker:. Answer: bleeding, infection, MI, PE,
dysrhythmias, wires can come loose, battery changes, no MRI,
cannot do electromagnetic
for transcutaneous: hold pressure for 20 minutes and tell the patient
not to bend their legs.
◉ 12 lead ECG. Answer: Limb leads: I, II, II, AVR, AVL, AVF
Chest leads: V₁ , V₂ , V₃ , V₄ , V₅ , V₆
◉ Where are the 12 lead ECG's placed. Answer: Lead I: receives
information from R and L arms; dipolar views top of the heart
Lead II: receives information from R arm and L foot
lead III: receives information from Left leg and arm
,avR: on the Right arm
avF: on the right foot
avL: on the Left arm
◉ Normal Sinus Rhythm. Answer: rhythm: R-R and P-P intervals are
regular
rate: 60-100 bpm
P waves: positive (upright) in lead II; one precedes each QRS
complex, P waves look alike
PR Interval: 0.12-0.20 seconds and constant from beat to beat
QRS duration: 0.11 seconds or less unless abnormally conducted
◉ Sinus Arrhythmia. Answer: Rhythm: irregular and often phasic
with breathing; HR gradually increases during inspiration (shorter
R-R interval) and decreases with expiration (longer R-R interval)
rate: 60-100 bpm
, P waves: positive (upright) in lead II; one precedes each QRS
complex, P waves look alike
PR Interval: 0.12-0.20 seconds and constant from beat to beat
QRS duration: 0.11 seconds or less unless abnormally conducted
◉ Sinus Tachycardia. Answer: rhythm: R-R and P-P intervals are
regular
rate: usually between 101 to 180 bpm. upper ventricular limit may
be 220 minus the patients age.
P waves: positive (upright) in lead II; one precedes each QRS
complex, P waves look alike
PR Interval: 0.12-0.20 seconds and constant from beat to beat
QRS duration: 0.11 seconds or less
◉ Sinus Bradycardia. Answer: rhythm: R-R and P-P intervals are
regular
2026 ECG RHYTHM INTERPRETATION CORE
CONCEPTS
◉ capture. Answer: The successful conduction of an artificial
pacemaker's impulse through the myocardium, resulting in
depolarization
◉ demand pacemaker. Answer: Pacemaker that discharges only
when the patient's heart rate drops below the preset rate for the
pacemaker; also known as a synchronous or noncompetitive
pacemaker.
◉ dual chamber pacemaker. Answer: Pacemaker that stimulates the
atrium and ventricle; dual-chamber pacing is also called physiologic
pacing. They must get counseling because it hurts
◉ Fixed rate pacemaker. Answer: Pacemaker that continuously
discharges at a preset rate regardless of the patient's intrinsic
activity; also known as an asynchronous pacemaker
◉ Sensitivity. Answer: the extent to which an artificial pacemaker
recognizes intrinsic cardiac electrical activity.
,◉ Temporary Pacemaker's. Answer: transcutaneous: pads that go on
the body
transvenous: introduced into a central vein like the subclavian,
femoral, brachial, internal or external jugular vein
◉ complications of pacemaker:. Answer: bleeding, infection, MI, PE,
dysrhythmias, wires can come loose, battery changes, no MRI,
cannot do electromagnetic
for transcutaneous: hold pressure for 20 minutes and tell the patient
not to bend their legs.
◉ 12 lead ECG. Answer: Limb leads: I, II, II, AVR, AVL, AVF
Chest leads: V₁ , V₂ , V₃ , V₄ , V₅ , V₆
◉ Where are the 12 lead ECG's placed. Answer: Lead I: receives
information from R and L arms; dipolar views top of the heart
Lead II: receives information from R arm and L foot
lead III: receives information from Left leg and arm
,avR: on the Right arm
avF: on the right foot
avL: on the Left arm
◉ Normal Sinus Rhythm. Answer: rhythm: R-R and P-P intervals are
regular
rate: 60-100 bpm
P waves: positive (upright) in lead II; one precedes each QRS
complex, P waves look alike
PR Interval: 0.12-0.20 seconds and constant from beat to beat
QRS duration: 0.11 seconds or less unless abnormally conducted
◉ Sinus Arrhythmia. Answer: Rhythm: irregular and often phasic
with breathing; HR gradually increases during inspiration (shorter
R-R interval) and decreases with expiration (longer R-R interval)
rate: 60-100 bpm
, P waves: positive (upright) in lead II; one precedes each QRS
complex, P waves look alike
PR Interval: 0.12-0.20 seconds and constant from beat to beat
QRS duration: 0.11 seconds or less unless abnormally conducted
◉ Sinus Tachycardia. Answer: rhythm: R-R and P-P intervals are
regular
rate: usually between 101 to 180 bpm. upper ventricular limit may
be 220 minus the patients age.
P waves: positive (upright) in lead II; one precedes each QRS
complex, P waves look alike
PR Interval: 0.12-0.20 seconds and constant from beat to beat
QRS duration: 0.11 seconds or less
◉ Sinus Bradycardia. Answer: rhythm: R-R and P-P intervals are
regular
