sinus tachycardia

Dr. Ahmad Tubaishat 1

Sinus Tachycardia

1- RHYTHM : regular 2-RATE : more than 100bpm .3- P WAVE : normal (up right ,rounded )4-PR INTERVAL : normal 5- QRS COMPLEX : normal duration 6-ST SEGMENT: isoelectric 7- T WAVE : normal ( symmetric , rounded ) 8-CONDUCTION : normal electrical path way

Dr. Ahmad Tubaishat 2

Sinus Bradycardia

Dr. Ahmad Tubaishat3

Sinus arrhythmia

1- RHYTHM : rate increased with inspiration ,decreased with expiration

2-RATE : varies between 50 -100 bpm .3- P WAVE : normal (up right ,rounded )4-PR INTERVAL : normal 5- QRS COMPLEX : normal duration 6-ST SEGMENT: isoelectric 7- T WAVE : normal ( symmetric , rounded ) 8-CONDUCTION : normal electrical path way

Dr. Ahmad Tubaishat4

Sinus Arrest

Dr. Ahmad Tubaishat 5

Atrial Flutter

Dr. Ahmad Tubaishat6

Atrial Fibrillation

Dr. Ahmad Tubaishat7

Paroxysmal Supraventricular Tachycardia (PSVT)

• 1- RATE: between (140 – 200) bpm .• 2- RHYTHM : R-R interval regular .• 3- P WAVE : absent or fused with QRS or T wave .• 4- P-R INTERVAL : absent .• 5- QRS COMPLEX : narrow < 0.06 second .• 6- T WAVE : peaked T wave .• 7- CONDUCTION : the ventricles is stimulated from some

where in the atria

Dr. Ahmad Tubaishat8

Premature Ventricular Contraction

• Arise within an ectopic focus within the ventricle (no atrial activity).

• Vent. Conduction spreads more slowly through purkinje system wide QRS

• No preceding P wave, T wave opposite direction of the QRS.• Multiform PVCs: different contours; Multifocal PVCs: different

origin• Bigeminy: one normal QRS fowled by PVC; Trigeminy: 2 sinus

QRS fowled by PVC; Quadrigeminy: 3 sinus QRS fowled by PVC• Two PVCs in row: couplet, three in row: triplet (a short run of

VT)

Dr. Ahmad Tubaishat9

Ventricular Tachycardia

Dr. Ahmad Tubaishat10

Ventricular Fibrillation

Dr. Ahmad Tubaishat 11

Junctional Rhythm

Lead II

Dr. Ahmad Tubaishat12

Premature Junctional Contraction

Ectopic impulse from a focus in the AV junction, occur

prematurely, before the next sinus impulses.

Rate Normal P wave as with junctional rhythm.QRS normal

Conduction P-R interval < .12 secs if P waves are present.

RhythmPJC's occur early in the cycle of the baseline rhythm. A full compensatory pause may occur.

Dr. Ahmad Tubaishat 13

First-degree AV block

• Prolongation of AV conduction• P wave: present and precedes each QRS• PR: constant but exceeds the upper limit (>0.2second)• Rate: 60 -100 bpm• Rhythm: regular with constant prolonged PR interval

Dr. Ahmad Tubaishat 14

Second-degree AV block, Mobitz type I

• One or more of the atrial impulses fail to reach the ventricles• Progressive prolongation of PR interval flowed by missing QRS• Rate: 60 -100 bpm• Rhythm: regular atrial, irregular ventricular

Dr. Ahmad Tubaishat 15

Second-degree AV block, Mobitz type II

• One or more of the atrial impulses fail to reach the ventricles

• Constant normal PR interval flowed by missing QRS• The block occur occasionally or in 2:1, 3:1 or 4:1 fashion• Rate: 60 -100 bpm• Rhythm: regular atrial, irregular or regular ventricular

depends on the AV block

Dr. Ahmad Tubaishat 16

Second-degree AV block, Mobitz type II

• One or more of the atrial impulses fail to reach the ventricles

• Constant normal PR interval flowed by missing QRS• The block occur occasionally or in 2:1, 3:1 or 4:1 fashion• Rate: 60 -100 bpm• Rhythm: regular atrial, irregular or regular ventricular

depends on the AV block

Dr. Ahmad Tubaishat17

Right Bundle Branch Block

Dr. Ahmad Tubaishat18

Left Bundle Branch Block