Download EKG Interpretation

EKG
Interpretation
EKG Interpretation
Sequence
Regular or Irregular
Rate
P wave
PR interval (normal 0.12-0.20)
QRS (less than 0.12)
ST segment
T wave
Ectopic beats
Regularity of the QRS
complexes
Heart rate (HR)
1500/small boxes= most precise HR calculation for
regular rhythms
Countdown method:

300 – 150 – 100 – 75 – 60 - 50
6 second method (irregular rhythms):
Images: http://www.emergencyekg.com/graphics/Interactive_06.gif
http://research.vet.upenn.edu/smallanimalcardiology/ECGTutorial/DeterminingHeartRate/tabid/4959/Default.aspx
Waveforms, Intervals,
Segments, and Complexes
(Lead II)
P wave:
PR interval:
.12-.20sec
>5 boxes for PR is heart
block
QRS complex:
<.12sec
ST segment:
T wave:
Ectopic Beats:
Sinus Tachycardia
Regular rhythm
 Rate >100

Sinus Bradycardia
Regular rhythm
 Rate <60

Premature atrial contraction (PAC)
Usually has regular underlying rhythm
 Early atrial contraction causes early P
wave
 P wave usually abnormal in size, shape or
direction and can be hidden in preceding T
wave
 May initially have rate suppression after
this beat

Premature atrial contraction (PAC)
Atrial Flutter
Regular or irregular
 Rate: atrial 250-400, ventricular varies
 P waves: Sawtooth deflections

Atrial Fibrillation
Irregularly irregular, difficult to assess with
tachycardia
 Rate: Varies, Rapid Ventricular Rate (RVR)
is > 100 bpm, Rate Control is < 100 bpm
 P waves: fibrillatory

Premature Ventricular Contraction
(PVC)
Underlying rhythm regular
 No P wave associated with the PVC
 Early wide QRS (>0.12)
 May be in sequence (ex: couplet, triplet,
bigeminy, trigeminy)

Ventricular Tachycardia (VT)
Regular rhythm
 Rate 140-250
 No P wave associated with VT
 QRS wide (>0.12)

Ventricular Fibrillation
No rhythm – P wave and QRS wave
absent
 No rate
 Wavy irregular deflections of various sizes
and shapes seen

Pacemakers
Paced beat will have “pacer spike” on EKG
 Can be 100% paced
 If underlying rate is greater then pacer
maker settings the pace maker will be
inhibited and you will only see the
underlying rhythm on EKG
 Can be mixed paced beats and native
rhythm
 A-V paced (both atria and ventricle are
paced, will have two pacer spikes per
QRS)

Pacemakers
CASE STUDIES