1 / 55

Normal ECG: Rate and Rhythm

Normal ECG: Rate and Rhythm. Read chapters 4 and 22. ECG Interpretation*. Standardization Rate RR interval Heart rate Rhythm PP interval P wave width, height, shape, etc. PR interval QRS width (and height) axis R wave progression abnormal Q waves ST segment T waves

leal
Download Presentation

Normal ECG: Rate and Rhythm

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Normal ECG: Rate and Rhythm • Read chapters 4 and 22

  2. ECG Interpretation* • Standardization • Rate • RR interval • Heart rate • Rhythm • PP interval • P wave • width, height, shape, etc. • PR interval • QRS • width (and height) • axis • R wave progression • abnormal Q waves • ST segment • T waves • QT interval • U waves *See Chapter 22

  3. ECG Interpretation • Univ. of Wisconsin Medical School • http://www.fammed.wisc.edu/pcc/ecg/

  4. The Normal ECG • Normal = normal sinus rhythm

  5. Rate • R-R interval • Is it regular? • What is the heart rate? • 300, 150, 100, 75, 60, 50 • 300 / (# of large boxes) • 1500 / (# of small boxes) • Count the number of cardiac cycles in 10 seconds and multiple by 6.

  6. Rate • Bradycardia • less than 60 bpm • Tachycardia • greater than 100 bpm

  7. Rate • P-P interval

  8. Rhythm • P wave • PR interval • QRS

  9. 4. P Wave • Lead II and aVR • Positive in II • Negative in aVR • < 2.5 mm in amplitude • < 0.12 sec. in width

  10. Normal P Wave Normal direction of atrial depolarization aVR? II? Figures 4-2 and 4-3

  11. Abnormal P Wave Direction of atrial depolarization with junction rhythm aVR? II? This is an example of a retrograde conduction

  12. P wave • The same direction as QRS • Only one P wave in front of QRS • Do all the P waves look alike?

  13. 5. PR interval • 0.12 - 0.20 seconds

  14. 6. QRS Complex • What is the width? (less than 0.10 seconds) • Do all the QRS waves in the same lead look alike? • R wave progression • Axis • Abnormal Q waves (infarction)

  15. QRS Complex Q waves

  16. Normal QRS • Two phases • brief phase; depolarization of ventricular septum • longer phase; depolarization of both ventricles but the left is larger

  17. First Phase • Depolarization of ventricular septum

  18. Second Phase • Depolarization of both ventricles but the left is larger

  19. Precordial Leads V6 V1

  20. Normal QRS V6? V6? V1? V1? Fig. 4-6

  21. Normal QRS V1 V6

  22. Normal QRS • Septal r wave • Septal q wave

  23. 6. QRS Complex • R wave progression

  24. Normal R Wave Progression Transition Zone?

  25. R Wave Progression Transition Zone?

  26. Transition Zone • Figure 4-7

  27. Early & Delayed Transition V1 V2 V3 V4 V5 V6 • Figure 4-7

  28. 6. QRS Complex • What is the electrical axis? • normal • left axis deviation • right axis deviation • extreme axis deviation

  29. 7. St Segment • ST segment elevation or depression • (see chapters 8 & 9)

  30. 8. T Wave • Normally positive where QRS wave is positive • V3- V6 and II,but negative in aVR • Abnormally tall T waves

  31. Practice • ECG Library • http://www.ecglibrary.com/ecghome.html • ECG: The Art of Interpretation • http://www.12leadecg.com/full/

  32. Normal

  33. Not normal PR interval - Mobitz Type II block

  34. Not normal LAD, R wave progression RBB w/inferior MI

  35. Not normal - First degree block, left atrial enlargement, left bundle branch block, & inferior MI

  36. Not normal Atrial fibrillation

  37. Normal

  38. Not normal Junctional rhythm

  39. Not normal LAD, late R wave progression Acute MI

  40. Not normal Premature ventricular contractions

  41. Not normal Ventricular tachycardia: note fast rate and wide bizarre QRS.

  42. Normal

  43. Not normal Second degree AV block - type II

  44. Not normal RAD, R wave progression

  45. Not normal Third degree AV block

More Related