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E C G Part 2

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This document provides steps for analyzing an ECG rhythm strip: 1) Calculate the heart rate by counting R waves over 6 seconds and multiplying by 10 or finding boxes between R waves. 2) Determine regularity by examining R-R interval distances. 3) Assess P waves for presence, uniformity, and rate. 4) Measure the PR interval, which should be 0.12-0.20 seconds. 5) Measure the QRS duration, which should be 0.04-0.12 seconds.

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ECG Rhythm Interpretation Module II How to Analyze a 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.
Learning Modules ECG Basics How to Analyze a Rhythm Normal Sinus Rhythm Heart Arrhythmias Diagnosing a Myocardial Infarction Advanced 12-Lead Interpretation
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.
Step 1: Calculate Rate 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 b.p.m. 3 sec 3 sec
Step 1: Calculate Rate 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) R wave
Step 1: Calculate Rate Option 2 (cont) Memorize the sequence: 300 - 150 - 100 - 75 - 60 - 50 Interpretation? 300 150 100 75 60 50 Approx. 1 box less than 100 = 95 b.p.m
Step 2: Determine regularity 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 R R
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 every QRS
Step 4: Determine PR interval Normal: 0.12 - 0.20 seconds. (3 - 5 boxes) Interpretation? 0.12 seconds
Step 5: QRS duration Normal: 0.04 - 0.12 seconds. (1 - 3 boxes) Interpretation? 0.08 seconds
Rhythm Summary Rate 90-95 b.p.m Regularity regular P waves normal PR interval 0.12 s QRS duration 0.08 s Interpretation? Normal Sinus Rhythm

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E C G Part 2

  • 1. ECG Rhythm Interpretation Module II How to Analyze a Rhythm
  • 2. 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.
  • 3. Learning Modules ECG Basics How to Analyze a Rhythm Normal Sinus Rhythm Heart Arrhythmias Diagnosing a Myocardial Infarction Advanced 12-Lead Interpretation
  • 4. 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.
  • 5. Step 1: Calculate Rate 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 b.p.m. 3 sec 3 sec
  • 6. Step 1: Calculate Rate 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) R wave
  • 7. Step 1: Calculate Rate Option 2 (cont) Memorize the sequence: 300 - 150 - 100 - 75 - 60 - 50 Interpretation? 300 150 100 75 60 50 Approx. 1 box less than 100 = 95 b.p.m
  • 8. Step 2: Determine regularity 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 R R
  • 9. 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 every QRS
  • 10. Step 4: Determine PR interval Normal: 0.12 - 0.20 seconds. (3 - 5 boxes) Interpretation? 0.12 seconds
  • 11. Step 5: QRS duration Normal: 0.04 - 0.12 seconds. (1 - 3 boxes) Interpretation? 0.08 seconds
  • 12. Rhythm Summary Rate 90-95 b.p.m Regularity regular P waves normal PR interval 0.12 s QRS duration 0.08 s Interpretation? Normal Sinus Rhythm