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ECG Rhythm recognition. LEARNING OUTCOMES. To recognise and understand the ‘Normal’ heart rhythm and what it represents. To perform a step by step basic rhythm strip analysis. To recognise common cardiac arrhythmias. Conduction system of the heart. Normal sinus rhythm. 7 Questions to ask.
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LEARNING OUTCOMES. • To recognise and understand the ‘Normal’ heart rhythm and what it represents. • To perform a step by step basic rhythm strip analysis. • To recognise common cardiac arrhythmias.
7 Questions to ask. • Is the rhythm fast or slow? • Are all the P waves alike? • Are all the QRS complexes alike? • Is there a P wave in front of every QRS? • Is the PR interval constant or does it vary? • Is the PR interval too short or too long? • Is the QRS complex widened?
Common Rhythms? Tachycardia Bradycardia AF Heart Blocks 12 lead ECG may be required to confirm a diagnosis.
Common Rhythms. Atrial Fibrillation Atrial Flutter
First degree heart block Second degree heart block
Complete heart Block/Third degree heart block. Look back at the conduction picture and consider where these blocks are!
Ectopic beats. Atrial Ectopic - Premature atrial conduction Ventricular Ectopic - Premature ventricular conduction.
Discuss possible causes of a cardiac arrhythmia. What symptoms may your patient present with if they experience a change is heart Rhythm?
POP QUIZ! • Which stage of Normal sinus rhythm represent ATRIAL DEPOLARISATION? • What does the T wave on ECG represent? • Describe how to measure HR on 12 Lead ECG. • Which Heart Block presents with a prolonged P-R interval? • How can you tell the difference between an atrial or a ventricular premature conduction? • What HR may be on the cardiac monitor if patient is in PEA? • What is the normal length of time for the P-R interval? • What does the term Paroxysmal mean? • There is a prize for the winning team!!
Further reading and references. • J. R. Levick (2003) 4th ed. An introduction to cardiovascular Physiology. • ECG Interpretation made incredibly easy.(2011) 5th ed - Available as PDF online. • http://www.youtube.com/cardiacconduction • http://www.nhlbi.nih.gov/health/health-topics/topics/arr