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Module2 How To Analyze Rhythm

This document outlines the steps for analyzing cardiac rhythms on an ECG: 1. Calculate the heart rate by counting R waves over 6 seconds and multiplying by 10 or using the box method 2. Determine if the rhythm is regular by examining R-R intervals 3. Assess P waves for presence, morphology, and relationship to the QRS complex 4. Measure the PR interval 5. Measure the QRS duration When these steps are applied to the provided rhythm strip, the summary is a normal sinus rhythm with a rate of 90-95 bpm and normal P waves, PR interval, and QRS duration.

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Takpire DrMadhukar
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109 views13 pages

Module2 How To Analyze Rhythm

This document outlines the steps for analyzing cardiac rhythms on an ECG: 1. Calculate the heart rate by counting R waves over 6 seconds and multiplying by 10 or using the box method 2. Determine if the rhythm is regular by examining R-R intervals 3. Assess P waves for presence, morphology, and relationship to the QRS complex 4. Measure the PR interval 5. Measure the QRS duration When these steps are applied to the provided rhythm strip, the summary is a normal sinus rhythm with a rate of 90-95 bpm and normal P waves, PR interval, and QRS duration.

Uploaded by

Takpire DrMadhukar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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ECG Rhythm Interpretation

Module II

How to Analyze a Rhythm

1 www.similima.com
Course Objectives

• To recognize the normal rhythm of the


heart - “Normal Sinus Rhythm.”
• To recognize the 13 most common
rhythm disturbances.
• To recognize an acute myocardial
infarction on a 12-lead ECG.

2 www.similima.com
Learning Modules

• ECG Basics
• How to Analyze a Rhythm
• Normal Sinus Rhythm
• Heart Arrhythmias
• Diagnosing a Myocardial Infarction
• Advanced 12-Lead Interpretation
3 www.similima.com
Rhythm Analysis

• Step 1: Calculate rate.


• Step 2: Determine regularity.
• Step 3: Assess the P waves.
• Step 4: Determine PR interval.
• Step 5: Determine QRS duration.
4 www.similima.com
Step 1: Calculate Rate
3 sec 3 sec

• Option 1
– Count the # of R waves in a 6 second
rhythm strip, then multiply by 10.
– Reminder: all rhythm strips in the Modules
are 6 seconds in length.
Interpretation? 9 x 10 = 90 bpm
5 www.similima.com
Step 1: Calculate Rate

R wave

• Option 2
– Find a R wave that lands on a bold line.
– Count the # of large boxes to the next R
wave. If the second R wave is 1 large box
away the rate is 300, 2 boxes - 150, 3
boxes - 100, 4 boxes - 75, etc. (cont)
6 www.similima.com
Step 1: Calculate Rate
3 1 1
0 5 0 7 6 5
0 0 0 5 0 0

• Option 2 (cont)
– Memorize the sequence:
300 - 150 - 100 - 75 - 60 - 50

Interpretation? Approx. 1 box less than


100 = 95
7
bpm www.similima.com
Step 2: Determine regularity
R R

• Look at the R-R distances (using a caliper or


markings on a pen or paper).
• Regular (are they equidistant apart)?
Occasionally irregular? Regularly irregular?
Irregularly irregular?
Interpretation? Regular
8 www.similima.com
Step 3: Assess the P waves

• Are there P waves?


• Do the P waves all look alike?
• Do the P waves occur at a regular rate?
• Is there one P wave before each QRS?
Interpretation? Normal P waves with 1 P
wave for
9
every QRS
www.similima.com
Step 4: Determine PR interval

• Normal: 0.12 - 0.20 seconds.


(3 - 5 boxes)

Interpretation? 0.12 seconds


10 www.similima.com
Step 5: QRS duration

• Normal: 0.04 - 0.12 seconds.


(1 - 3 boxes)

Interpretation? 0.08 seconds


11 www.similima.com
Rhythm Summary

• Rate 90-95 bpm


• Regularity regular
• P waves normal
• PR interval 0.12 s
• QRS duration 0.08 s
Interpretation? Normal Sinus Rhythm
12 www.similima.com
End of Module II
How to Analyze a Rhythm
Proceed to Module II Practice Quiz
on WebCT

13 www.similima.com

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