ekg flash chart ecg characteristics example premature atrial contractions (pac) causes: normal...
TRANSCRIPT
Rh
yth
m
EC
G C
ha
ract
eris
tics
E
xa
mp
le
No
rma
l S
inu
s R
hy
thm
(NS
R)
Ra
te:
6
0-1
00
per
min
ute
Rh
yth
m:
R-
R =
P w
av
es:
Up
rig
ht,
sim
ilar
P-R
:
0.1
2 -
0 .
20
sec
on
d
&
co
nsi
sten
t
qR
s: 0
.04
– 0
.10
sec
on
d
P:q
Rs:
1
P:1
qR
s
Sin
us
Ta
chy
card
ia
Cau
ses:
��
Ex
erci
se
��
Hy
po
vo
lem
ia
��
Med
icat
ion
s
��
Fev
er
��
Hy
po
xia
��
Su
bst
ance
s
��
An
xie
ty,
Fea
r
��
Acu
te M
I
��
Fig
ht
or
Fli
gh
t
��
Co
ng
esti
ve
Hea
rt F
ailu
re
Ra
te:
> 1
00
Rh
yth
m:
R-
R =
P w
av
es:
Up
rig
ht,
sim
ilar
P-R
: 0
.12
-0
.2
0 s
eco
nd
&
co
nsi
sten
t
qR
s: 0
.04
– 0
.10
sec
on
d
P:q
Rs:
1
P:1
qR
s
Sin
us
Bra
dy
card
ia
Cau
ses:
��
intr
insi
c si
nu
s n
od
e
dis
ease
��
incr
ease
d
par
asy
mp
ath
etic
to
ne
��
dru
g e
ffec
t.
Ra
te:
<
60
Rh
yth
m:
R-
R =
P w
av
es:
Up
rig
ht;
sim
ilar
P-R
: 0
.12
-0
.2
0 s
eco
nd
&
co
nsi
sten
t
qR
s: 0
.04
– 0
.10
sec
on
d
P:q
Rs:
1P
:1q
Rs
Rh
yth
m
EC
G C
ha
ract
eris
tics
E
xa
mp
le
Pre
matu
re A
tria
l
Co
ntr
act
ion
s (P
AC
) C
ause
s:
��
no
rmal
��
exce
ssiv
e u
se o
f ca
ffei
ne,
tob
acco
, o
r al
coh
ol
��
CH
F
��
My
oca
rdia
l is
chem
ia o
r
inju
ry
��
Hy
po
kal
emia
, D
ig
tox
icit
y
��
CO
PD
Ra
te:
u
sual
ly <
10
0,
dep
end
ant
O
n u
nd
erly
ing
rh
yth
m
Rh
yth
m:
irre
gu
lar
P w
av
es:
Ear
ly &
up
rig
ht,
d
iffe
ren
t fr
om
Sin
us
PR
: 0
.12
– 0
.20
sec
on
d;
d
iffe
ren
t fr
om
Sin
us
qR
s: 0
.04
– 0
.10
sec
on
d
P:q
Rs
=
1:1
Atr
ial
Flu
tter
C
ause
s:
��
isch
emic
hea
rt d
isea
se
��
Hy
po
xia
��
Acu
te M
I ��
Dig
To
xic
ity
��
Mit
ral
or
Tri
cusp
id v
alv
e
dis
ease
��
Pu
lmo
nar
y e
mb
oli
sm
Ra
te:
A
tria
l ra
te 2
50
-35
0
V
ent
15
0 c
om
mo
n
Rh
yth
m:
Atr
ial
= R
egu
lar
V
ent
= R
eg.
or
irre
g
P w
av
es:
No
t id
enti
fiab
le
F w
av
es:
Un
ifo
rm (
saw
too
th
o
r p
ick
et f
ence
)
PR
I: n
ot
mea
sura
ble
qR
s: 0
.04
– 0
.10
sec
on
d
Atr
ial
Fib
rill
ati
on
��
Isch
emic
hea
rt d
isea
se
��
Hy
po
xia
��
Acu
te M
I
��
Dig
ital
is t
ox
icit
y
��
Mit
ral
or
tric
usp
id
dis
ease
Ra
te:
Atr
ial:
4
00
-70
0
V
ent.
16
0-1
80
/min
ute
Rh
yth
m:
Atr
ial:
irr
egu
lar;
V
ent.
: ir
reg
ula
r
P w
av
es:
No
id
enti
fiab
le P
s
f w
av
es:
may
be
seen
.
PR
I: u
nab
le t
o m
easu
re
(
No
id
enti
fiab
le P
)
qR
s: u
sual
ly n
orm
al
PA
C =
�
��
�
Rh
yth
m
EC
G C
ha
ract
eris
tics
E
xa
mp
le
Pa
rox
ysm
al
Atr
ial
Ta
chy
card
ia
Cau
ses:
��
Sam
e as
PA
Cs
Ra
te:
usu
ally
16
0-2
20
Rh
yth
m:
Reg
ula
r
P w
av
es:
dif
fer
in s
hap
e fr
om
S
inu
s P
s; u
sual
ly d
iffi
cult
t
o i
den
tify
(ra
te r
elat
ed)
PR
In
terv
al:
No
rmal
wh
en t
he
Ps
c
an b
e id
enti
fied
;
sh
ort
if
WP
W p
rese
nt
qR
s: u
sual
ly n
orm
al
Oth
er:
O
nse
t su
dd
en,
oft
en
i
nit
iate
d b
y a
PA
C
Pre
ma
ture
Ju
nct
ion
al
Co
ntr
act
ion
(P
JC
) C
ause
s:
��
Sam
e as
PA
Cs
Ra
te:
u
sual
ly <
10
0,
d
epen
dan
t o
n t
he
u
nd
erly
ing
rh
yth
m
Rh
yth
m:
irr
egu
lar
P w
av
es:
In
ver
ted
bef
ore
or
afte
r
q
Rs
or
no
t v
isib
le
PR
in
terv
al:
< 0
.12
sec
on
d w
hen
in
ver
ted
P i
s b
efo
re
qR
s
qR
s: 0
.04
– 0
.10
sec
on
d
P:q
Rs
= 1
:1 i
f P
s ar
e v
isib
le
Rh
yth
m
EC
G C
ha
ract
eris
tics
E
xa
mp
le
Ju
nct
ion
al
esca
pe
Rh
yth
m
Cau
ses:
��
hea
lth
y a
thle
te a
t re
st
��
rela
ted
to
med
icat
ion
s-
Bet
a B
lock
ers,
Cal
ciu
m
Ch
ann
el B
lock
ers,
Dig
To
xic
ity
��
or
incr
ease
d
par
asy
mp
ath
etic
to
ne
��
Acu
te I
nfe
rio
r W
all
MI
��
Rh
eum
atic
Hea
rt D
isea
se
��
Po
st-C
ard
iac
Su
rger
y
��
Val
vu
lar
Dis
ease
��
SA
No
de
Dis
ease
��
Hypoxia
Ra
te:
40-6
0
6
1 –
10
0 (
acce
lera
ted
)
Rh
yth
m:
R
egu
lar
P w
av
es:
In
ver
ted
bef
ore
or
afte
r
q
Rs
or
no
t v
isib
le
PR
in
terv
al:
< 0
.12
sec
on
d w
hen
in
ver
ted
P i
s b
efo
re
qR
s
qR
s: 0
.04
– 0
.10
sec
on
d
P:q
Rs
1
:1 i
f P
s ar
e v
isib
le
Ju
nct
ion
al
Ta
chy
card
ia
Cau
ses:
��
Sam
e as
Par
ox
ysm
al
Atr
ial
Tac
hy
card
ia (
PA
T)
Ra
te:
10
1-2
00
Sam
e as
Ju
nct
ion
al E
scap
e
Rh
yth
ms.
Su
pra
ven
tric
ula
r
Ta
chy
card
ia (
SV
T)
An
um
rell
a te
rm u
sed
wh
en u
nab
le t
o
dis
tin
gu
ish
wh
ich
rhy
thm
is
pre
sen
t.
Cau
ses:
S
ame
as S
inu
s, A
tria
l, a
nd
Jun
ctio
nal
Tac
hy
card
ia,
and
Atr
ial
Flu
tter
Rh
yth
m:
A
bso
lute
ly r
egu
lar
Ra
te:
>
15
0 p
er m
inu
te
P W
av
es:
N
ot
vis
ible
(P
RI
no
t m
easu
rab
le)
qR
s:
n
orm
al
0.0
4 –
0.1
0 s
ec
Rh
yth
m
EC
G C
ha
ract
eris
tics
E
xa
mp
le
Pre
matu
re V
entr
icu
lar
Co
mp
lex
(P
VC
) C
ause
s:
��
Gas
tric
ov
erlo
ad
��
Str
ess
��
Caf
fein
e, A
lco
ho
l,
Nic
oti
ne
��
Hea
rt D
isea
se
��
Aci
d-B
ase
Imb
alan
ce
��
Ele
ctro
lyte
Im
bal
ance
��
Cy
clic
An
tid
epre
ssan
ts
��
Hy
po
xia
��
Aci
do
sis
��
Acu
te M
I
Ra
te:
D
epen
den
t u
po
n
u
nd
erly
ing
rh
yth
m
Rh
yth
m:
R –
R �
P w
av
es:
U
sual
ly a
bse
nt,
if
p
rese
nt,
no
t as
soci
ated
w
ith P
VC
qR
s:
0.1
2 s
eco
nd
or
gre
ater
;
b
izar
re a
nd
no
tch
ed
ST
& T
: O
ften
op
po
site
in
d
irec
tio
n t
o t
he
qR
s.
Tim
ing
O
ne
on
a s
trip
= R
are
On
e in
a r
ow
=
Iso
late
d
Tw
o i
n a
ro
w =
Pai
r, c
ou
ple
t
Th
ree
in a
ro
w =
V T
ach
yca
rdia
Patt
ern
Ev
ery
oth
er =
Big
emin
y
Ev
ery
th
ird
=
Tri
gem
iny
Mo
rph
olo
gy
S
imil
ar s
hap
e =
Un
ifo
rmed
Dif
fere
nt
shap
e =
Mu
ltif
orm
ed
Lo
cati
on
R
– o
n –
T =
PV
C f
alls
on t
he
T
wav
e o
f th
e co
mp
lex
bef
ore
th
e
PV
C
PV
CP
VC
Rh
yth
m
EC
G C
ha
ract
eris
tics
E
xa
mp
le
Ven
tric
ula
r
Ta
chy
card
ia
Cau
ses:
��
Sam
e as
PV
Cs
��
R o
n T
Phen
om
enon
Ra
te:
>
10
0 p
er m
inu
te a
nd
u
sual
ly n
ot
> 2
20
Rh
yth
m:
U
sual
ly r
egu
lar
P W
av
es:
�
P w
aves
or
if
p
rese
nt,
no
t
a
sso
ciat
ed w
ith
qR
s
qR
s:
W
ide
(� 0
.12
sec
),
b
izar
re
ST
/T w
av
e: O
pp
osi
te d
irec
tio
n
o
f qR
s
A g
rou
p o
f th
ree
PV
Cs
in a
ro
w o
r
more
at
a ra
te g
reat
er t
han
10
0/
min
ute
or
more
co
nst
itu
tes
Ven
tric
ula
r T
ach
yca
rdia
.
Ven
tric
ula
r F
ibri
lla
tio
n
Cau
ses:
��
Acu
te M
yo
card
ial
Infa
rcti
on�
��
Un
trea
ted
Ven
tric
ula
r
Tac
hy
card
ia
��
Hy
po
ther
mia
��
R-o
n-T
P
VC
s
��
Ele
ctro
lyte
im
bal
ance
��
Ele
ctri
cal
sho
ck
Ra
te:
�
Rh
yth
m:
� r
egu
lari
ty,
ch
aoti
c u
nd
ula
tin
g
w
aves
P W
av
es:
�
qR
s:
�
ST
/T W
ave:
�
Org
an
ized
act
ivit
y:
�
No
Car
dia
c O
utp
ut
or
Pu
lse
Rh
yth
m
EC
G C
ha
ract
eris
tics
E
xa
mp
le
Idio
ven
tric
ula
r
Rh
yth
m
Cau
ses:
��
My
oca
rdia
l In
farc
tio
n�
��
Dig
ital
is t
ox
icit
y
��
Met
abo
lic
imb
alan
ces
��
Po
st r
esu
scit
atio
n r
hy
thm
Ra
te:
2
0-4
0 p
er m
inu
te
Rh
yth
m:
R
– R
=
P w
av
es:
N
o P
wav
es a
sso
ciat
ed
to
qR
s
qR
s:
>
0.1
2 s
ec,
no
tch
ed,
b
izar
re a
pp
eara
nce
ST
/T :
O
pp
osi
te d
irec
tio
n o
f q
Rs
Rat
e >
40
to
10
0 =
Acc
eler
ated
Asy
sto
le
Cau
ses:�
��
Ex
ten
siv
e m
yo
card
ial
dam
age �
��
Acu
te r
esp
irat
ory
fai
lure�
��
Isch
emia
or
Infa
rcti
on
��
Tra
um
atic
car
dia
c ar
rest
��
Ven
tric
ula
r an
eury
sm
��
Co
un
ters
ho
ck
��
Hy
po
xia
, H
yp
oth
erm
ia�
��
Hy
per
kal
emia
,
Hy
po
kal
emia
��
Pre
exis
tin
g a
cid
osi
s ��
Dru
g o
ver
do
se
Ra
te:
V
entr
icu
lar
rate
= 0
Rh
yth
m: �
un
less
Ps
are
pre
sen
t,
th
en r
egu
lar
or
irre
gu
lar
P w
av
es:
may
be
pre
sen
t
qR
s: �
P:q
Rs
�
Rh
yth
m
EC
G C
ha
ract
eris
tics
E
xa
mp
le
1st d
egre
e A
V B
lock
� 1
P :
1 q
Rs
� P
rolo
ng
ed
PR
I
(>
0.2
0 s
ec n
ot
> 0
.40
se
c)
2n
d d
egre
e A
V B
lock
,
Ty
pe
I
� M
ore
P w
aves t
han q
Rs
� P
RI
pro
gre
ssiv
ely
incre
ases
in a
cycle
until P
appears
w
/o q
Rs.
�
Cyclic
pa
tte
rn r
eo
ccu
rs
� R
– R
�
2n
d d
egre
e A
V B
lock
,
Ty
pe
II
More
P w
aves t
han q
Rs
� P
RI
co
nsis
ten
t �
qR
s n
orm
al or
wid
e (
bundle
bra
nch b
lock)
� R
- R�
or
R –
R =
=
n
on
-co
nd
ucte
d P
wa
ve
=
n
on
-co
nd
ucte
d P
wa
ve
Rh
yth
m
EC
G C
ha
ract
eris
tics
E
xa
mp
le
3rd
deg
ree
AV
Blo
ck
� M
ore
P w
aves t
han q
Rs
� P
no
t r/
t q
Rs
(
P t
oo
clo
se
, P
to
o f
ar)
�
PR
I v
arie
s g
rea
tly
� q
Rs n
orm
al or
wid
e
� R
– R
=
=
n
on
-co
nd
ucte
d P
wa
ve