Arrhythmia RecognitionMrs. SUMI JOSEA&E VinayakaCardiac conductionELECTROCARDIOGRAM5 steps approach to arrhythmiasStep1: Is there a QRSStep2: Is there a P WaveStep3: What is the relationship between the P waves an the QRS comple!es" Step#: $alc%late rate Step5:&iscellaneo%s1) Is there a QRS (No pulse)YES NOCHAOTICFLAT LINE WIDE NARROWPEAVFAsystoleVTNo QRS & ChaoticNo QRS & Flat lineWide QRSWide QRSWide QRS & Polymorphic2) Is there a P WaveYES NOVARY CONSTANTMORPHOLOY RATE220 to 350AF JUNCTIONALInverteRR Inter!a"JUNCTIONALAtrial Fl!tterA&E VinayakaNo P & Varyin RR intervalA&E Vinayaka!)What is the relationshi" #et$een the P $aves and the QRS co%"le&es'< 0.2Normal> 0.2Io AVBConstant ?YesIIo AVB type 2NoRR intervalYesIIIoAVBNoType1 IIoPR interval PR intervalHART B!"C#nP = nQRS ?No YesConstant?1st (eree #loc)*+V Nodal (elay)First"e#ree AV $lo%k# or P& 'rolon#ation# i$ a %i$ea$e o& the e"ectrica" con%'ction $y$tem o& the heart in (hich the PR inter!a" i$ "engthene% )eyon% *+,* $econ%$+P,RIntervalIS'(e)reeheart bloc*nP + nQRS "P,Rinterval is -./2 Sec

< 0.2Normal> 0.2Io AVBConstant ?YesIIo AVB type 2NoRR intervalYesIIIoAVBNoType1 IIoPR interval PR intervalHART B!"C#nP = nQRS ?No YesConstant?A&E VinayakanPis not equal to nQRS?PR interval is constant< 0.2Normal> 0.2Io AVBConstant ?YesIIo AVB type 2NoRR intervalYesIIIoAVBNoType1 IIoPR interval PR intervalHART B!"C#nP = nQRS ?No YesConstant?A&E VinayakaIIIrd (eree heart #loc)nPis not equal to nQRS?PR intervals are not constant RR intervals are constant< 0.2Normal> 0.2Io AVBConstant ?YesIIo AVB type 2NoRR intervalYesIIIoAVBNoType1 IIoPR interval PR intervalHART B!"C#nP = nQRS ?No YesConstant?A&E VinayakaIInd (eree -y"e,I heart #loc)PR01R2SSI32 PR040516'I05 07 8P,R9 I5'2R364(R0PP2(8QRS9 $0&P42:n$%& is not e'(al to n$)R*& ? (ot) P& an && intervals are not %onstant.)Calc/latin 0eart RatesA$o%nt the n%mber o; R waves in a ?Not very accurate?Used only with very quick estimateCalc/latin 0eart Rates*cont11)B$o%nt the n%mber o; lar)e s@%ares between two consec%tive R waves an +00 , Bi- s@%ares?Very quick?Not very accurate with ast rates?Used only with regular rhythmsCalc/latin 0eart Rates *cont11)C$o%nt the n%mber o; small s@%ares between two consec%tive R waves an or1.00 , small s@%ares//?!ost accurate?Used only with regular rhythms?"ime consumingCalculating Heart Rates (cont..)D$o%nt the n%mber o; AI1 s@%ares between two consec%tive R waves in escenin) orer as 3..B15.B1..BC5B