The SA node has an inherent rate of __-__bpm.
60-100
The AV node has an inherent rate of __-__bpm.
40-60
The perkinje fibers in the ventricles have an inherent rate of __-__bpm.
20-40
The "ready" or "resting" state.
polarization
The "firing" state or contraction.
depolarization
The return to "rest".
repolarization
The transportation of K, Na, and Ca into/out of the cardiac cell result in _____ formation.
Impulse
To determine the rate of a regular EKG strip, you can divide ___ by the number of large boxes or divide ___ by the number of small boxes.
300, 1500
To determine an approximate rate for an irregular EKG strip, count the number of QRS or P complexes in a ___ second strip and multiply by ___.
6, 10
The ___ ___ represents atrial contraction on an EKG strip.
P wave
The ___ ___ ___ represents the time taken for the inpulse to travel from the SA to AV node. Ideally 0.12-0.20 seconds.
PR Interval
The ___ complex represents ventricular contraction.
QRS
The ___ segment represents the time between ventricular contraction and repolarization; this is when the ventricles completely empty. Ideally is <0.12 seconds.
ST
The ___ ___represents ventricular repolarization.
T wave
Rhythm: regular
Rate: 60-100
P-waves: present/upright, w/QRS
PRI: 0.12-0.20
QRS: <0.12
Normal sinus rhythm
Rhythm: irregular
Rate: 80 or less
P-waves: present/upright, w/QRS
PRI: 0.12-0.20
QRS: <0.12
Sinus arrhythmia
There is no true NSR; everyone will have slight arrhythmias due to _____.
breathing
Rhythm: slightly irregular
Rate: 60-100
P-waves: present/upright, w/QRS
PRI: 0.12-0.20, slightly varies
QRS: <0.12
wandering pacemaker (WAP)
Rhythm: unpredictable
Rate: 80 or less
P-waves: present/upright, w/QRS
PRI: 0.12-0.20
QRS: <0.12
Sinus pause / arrest
Rhythm: regular
Rate: less than 60
P-waves: present/upright, w/QRS
PRI: 0.12-0.20
QRS: <0.12
Sinus bradycardia
Rhythm: regular
Rate: greater than 100 (100-160)
P-waves: present/upright, w/QRS
PRI: 0.12-0.20
QRS: <0.12
Sinus Tachycardia
Rhythm: an early beat
Rate: unpredictable
P-waves: present/upright, w/QRS, different shape
PRI: 0.12-0.20
QRS: <0.12
Premature atrial contractions (PACs)
Rhythm: regular
Rate: 150-250
P-waves: present/upright, w/QRS, rides on T wave
PRI: 0.12-0.20 (if seen)
QRS: <0.12
*Will only break to sinus rhythm.
Paroxsysmal atrial tachycardia (PAT)
Rhythm: atrial = regular, ventriclar = regular/irregular
Rate: atrial = 250-350, ventricular = 2:1, 3:1, 4:1, varies
P-waves: flutter waves, more P's than QRSs, "sawtooth"
PRI: unable to measure
QRS: < 0.12
Atrial flutter
Rhythm: irregular
Rate: atrial = chaotic, ventricle = variable ("uncontrolled" if >100)
P-waves: none seen
PRI: unable to measure
QRS: <0.12
Atrial fibrillation
Rhythm: regular
Rate: 40-60
P-waves: inverted before + after QRS, or not seen
PRI: < 0.12 if inverted before QRS
QRS: <0.12
Junctional rhythm
Rhythm: regular
Rate: 60-100
P-waves: inverted before + after QRS, or not seen
PRI: < 0.12 if inverted before QRS
QRS: <0.12
*pharmacologically increased rate
Accelerated junctional
Rhythm: regular
Rate: 100-180
P-waves: inverted before + after QRS, or not seen
PRI: < 0.12 if inverted before QRS
QRS: <0.12
Junctional tachycardia
Rhythm: an early beat
Rate: unpredictable
P-waves: inverted before + after QRS, or not seen
PRI: < 0.12 if inverted before QRS
QRS: <0.12
*Can be surrounded by sinus or junctional rhythm
Premature Junctional contractions (PJCs)
Rhythm: regular
Rate: 60-100
P-waves: present/upright, w/QRS
PRI: >0.20
QRS: <0.12
First degree heart block
Rhythm: atrial = regular, ventricular = irregular
Rate: variable; "grouped beatings"
P-waves: present/upright, more Ps than QRSs
PRI: widens with conducted beats
QRS: <0.12
Second degree heart block, type 1 (Mobitz I, Whenkebach)
Rhythm: atrial = regular, ventricular = regular/irregular
Rate: variable, "grouped beatings"
P-waves: present/upright, more Ps than QRSs
PRI: remains constant with conducted beats
QRS: <0.12
Second degree heart block, type 2 (Mobitz II, Classical)
Rhythm: regular
Rate: SA = 60-100, AV = 40-60, below = 20-40
P-waves: present/upright, no relation to QRS
PRI: unable to measure
QRS: <0.12 if rate >40, >0.12 if rate <40
Third degree heart block (complete heart block, AV dissociation)
Rhythm: an early beat
Rate: unpredictable
P-waves: none
PRI: unable to measure
QRS: >0.12, wide and bizarre
*T wave always opposite QRS
Premature ventricular contractions (PVCs)
PVCs that occur every other beat.
Bigeminy
PVCs that occur every third beat.
Trigeminy
Two PVCs that occur back to back.
Pairs
Three or more PVCs that occur back to back.
Bursts
PVCs that are identical; one "hotspot".
Unifocal
PVCs that manifest differently on EKG; more than one "hotspot
Multifocal
Rhythm: regular
Rate: 150-250 (may be as low as 101)
P-waves: none
PRI: unable to measure
QRS: >0.12
Venticular tachycardia (VT, V-tac)
Rhythm: irregular
Rate: none
P-waves: none
PRI: unable to measure
QRS: none
*fine or coarse
Ventricular fibrillation (VF, V-fib)
Rhythm: regular, slows over time
Rate: 20-40
P-waves: none
PRI: unable to measure
QRS: >0.12
Idioventricular rhythm ("dying heart")
Rhythm: none
Rate: none
P-waves: none
PRI: unable to measure
QRS: none
*always check in a second lead
Asystole