ECG made easy...My version-02(for emergency setting)

First degree heart block
In this situation, there will be prolong PR interval(more than 3 small squares in a 25mm/sec setting). The rhythm is regular. This is caused by a block in the conduction at the AV node.

Second degree heart block-Mobitz type I
This occurs when there is progressive slowing at the AV node. The PR interval will be progressively lengthening followed by a disappearing QRS complex, meaning a P wave without a QRS complex.


Second degree heart block- Mobitz type II
One or more QRS complex are dropped with the PR intervals remaining equal.

Third degree heart block
Occurs when there is complete blockage of impulse at the AV junction or at the common bundle branch.(sometimes at bilateral bundle branch as well). The RR intervals and the P wave intervals are regular. However, the PR interval are chaotic and irregular. Basically, the P wave and R wave are like from 2 different strips.

Premature ventricular contraction
This occurs due to increase automaticity of the ventricular walls or sometimes due to reentry phenomena. The QRS complex comes earlier than expected and is often a wide complex due to its ventricular origin. A PVC that comes in every second complex is a ventricular bigemini while ventricular trigemini is when it comes in every third complex.

Idioventricular
The heart rate is around 20-40bpm. There is absence of P wave and QRS complex is widened. Idioventricular rhythm occurs when SA and AV node are not firing properly or firing slower than the ventricular pace maker.


Torsade de Pointes
It is paroxysmal(starting and stopping suddenly). The QRS complex will be wide and bizzare. Hallmark of this rhythm is the upward and downward deflection of the QRS complexes around the baseline. The term Torsade de Pointes means "twisting about the points".


Ventricular tachycardia
The rate is extremely high ranging from 100 to 250 bpm. QRS complex is wide and bizzare. Can intervene by giving amiodarone or lidocaine or cardioversion. Must be manage properly as it can soon deteriorates to ventricular fibrillation. Pulseless ventricular tachycardia requires defibrillation.


Ventricular fibrillation
VF is a chaotic rhythm originating from the ventricles resulting in no cardiac output. Requires immediate defibrillation and ACLS protocols.

Asystole/Ventricular standstill
Occurs when there is no more electrical activity in the heart. When this occurs, remember to increase the magnification of the cardiac monitoring to exclude fine ventricular fibrillation.



Premature junctional contraction
PJC arises from irritable focus at the AV junction. Characteristic includes absent or inverted P wave and also a shortened PR interval.

Junctional rhythm/junctional escape rhythm
The junctional rhythm occurs when the impulse originates from the AV junction-AV node and the bundle of His. The rate of the junctional rhythm is about 40-60 bpm. There will b absence of P wave or an inverted P wave. Normally has narrow QRS complex.

Accelerated junctional rhythm
Junctional rhythm with a rate of more than 60 bpm but less than 100 bpm.

Junctional tachycardia
Junctional rhythm with a rate of more than 100bpm.

Any mistakes please inform me.^^