ECG Rhythm Interpretation
Module III
Normal Sinus Rhythm
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ECG Rhythm Interpretation: Normal Sinus Rhythm and Arrhythmias, Slides of Cardiology
A part of an ecg rhythm interpretation module on docsity.com. It focuses on normal sinus rhythm, its parameters, and the formation of arrhythmias. Various types of arrhythmias, including those arising from problems in the sa node, atrial cells, av junction, and ventricular cells.
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2011/2012
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ECG Rhythm Interpretation
Module III
Normal Sinus Rhythm
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.
Normal Sinus Rhythm (NSR)
- Etiology: the electrical impulse is formed in the SA node and conducted normally.
- This is the normal rhythm of the heart; other rhythms that do not conduct via the typical pathway are called arrhythmias.
NSR Parameters
- Rate 60 - 100 bpm
- Regularity regular
- P waves normal
- PR interval 0.12 - 0.20 s
- QRS duration 0.04 - 0.12 s
Any deviation from above is sinus tachycardia, sinus bradycardia or an arrhythmia Docsity.com
SA Node Problems
The SA Node can:
- fire too slow
- fire too fast
Sinus Bradycardia Sinus Tachycardia
Sinus Tachycardia may be an appropriate response to stress.
Atrial Cell Problems
Atrial cells can:
- fire occasionally from a focus
- fire continuously due to a looping re-entrant circuit
Premature Atrial Contractions (PACs)
Atrial Flutter
Atrial Cell Problems
Atrial cells can also:
- fire continuously from multiple foci or fire continuously due to multiple micro re-entrant “wavelets”
Atrial Fibrillation
Atrial Fibrillation
Teaching Moment
Multiple micro re- entrant “wavelets” refers to wandering small areas of activation which generate fine chaotic impulses. Colliding wavelets can, in turn, generate new foci of activation.
Atrial tissue
Ventricular Cell Problems
Ventricular cells can:
- fire occasionally from 1 or more foci
- fire continuously from multiple foci
- fire continuously due to a looping re-entrant circuit
Premature Ventricular Contractions (PVCs) Ventricular Fibrillation
Ventricular Tachycardia
End of Module III
Normal Sinus Rhythm
Proceed to Module III Practice Quiz on WebCT