Today our topic of discussion is Electrocardiogram for Rhythm.
Electrocardiogram for Rhythm
Rhythm
- Atrial rhythm measures the distance between two consecutive P-waves (P-P interval). If the distance between all the P-waves are same, the atrial rhythm is regular
- Ventricular rhythm measures the distance between the two consecutive R-waves (R-R interval)
- Sinus tachycardia-heart rate is more than 100 beats per minutes with normal PQRST waves
- Sinus bradycardia-heart rate is less than 60 beats per minutes with normal PQRST waves
- Premature atrial contraction (PAC) RR-intervals vary with a compensatory pause after the PAC
- Paroxysmal atrial tachycardia (PAT) heart rate is 150 to 250 per minutes, P-wave are difficult to recognize. QRS complexes are normal in shape
- Atrial flutter-P-waves form saw tooth pattern, there are more than one P-wave between two consecutive QRS complexes
- Atrial fibrillation-no regular P-wave, P-wave appearing as a wavy baseline
- Paroxysmal junctional tachycardia-heart rate is 150 to 220 beats per minutes, P-wave are either absent or appear inverted.
Heart Rate
- Normal heart rate is 60 to 100 beats per minutes, less than 60 beats per minutes called bradycardia and more than 100 beats per minutes called tachycardia..
- The heart rate per minute is equal to the number of large squares between the R-waves divided into 300, e.g. if there are two large squares between the R-waves 300 divided by 2 150 beats per minutes.
- Count the number of small squares between R-R intervals and divide. When the heart rhythm is irregular, count the QRS complexes in 6 seconds and multiply the number by 10 to get the patient’s heart rate per minutes (30 large block are equal to 6 second) (Fig. 29.90).
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