https://ecgvn.com/en/tags/ecg-rhythm-analysis/ Recent content in Ecg Rhythm Analysis on ECG Library – LITFL Basics Hugo en-us Tue, 01 Oct 2024 00:00:00 +0000 https://ecgvn.com/en/posts/ecg-rhythm-evaluation/ Tue, 01 Oct 2024 00:00:00 +0000 https://ecgvn.com/en/posts/ecg-rhythm-evaluation/ <p>The rhythm is best analyzed by looking at a rhythm strip. On a 12 lead ECG this is usually a 10 second recording from Lead II.</p> <ul> <li>Confirm or corroborate any findings in this lead by checking the other leads.</li> <li>A longer rhythm strip, recorded perhaps recorded at a slower speed, may be helpful.</li> </ul> <hr> <h4 id="7-step-approachto-ecg-rhythm-analysis">7 step approach to ECG rhythm analysis</h4> <h5 id="1-rate"><strong>1. Rate</strong></h5> <ul> <li>Tachycardia or bradycardia?</li> <li>Normal rate is 60-100/min.</li> </ul> <hr> <h5 id="2-pattern-of-qrs-complexes"><strong>2. Pattern of QRS complexes</strong></h5> <ul> <li>Regular or irregular?</li> <li>If irregular is it regularly irregular or irregularly irregular?</li> </ul> <hr> <h5 id="3-qrs-morphology"><strong>3. QRS morphology</strong></h5> <ul> <li><strong>Narrow complex</strong>: sinus, atrial or junctional origin.</li> <li><strong>Wide complex</strong>: ventricular origin, or supraventricular with aberrant conduction.</li> </ul> <hr> <h5 id="4-p-waves"><strong>4. P waves</strong></h5> <ul> <li><strong>Absent</strong>: sinus arrest, atrial fibrillation</li> <li><strong>Present</strong>: morphology and PR interval may suggest sinus, atrial, junctional or even retrograde from the ventricles.</li> </ul> <hr> <h5 id="5-relationship-between-p-waves-and-qrs-complexes"><strong>5. Relationship between P waves and QRS complexes</strong></h5> <ul> <li><strong>AV association</strong> (may be difficult to distinguish from isorhythmic dissociation)</li> <li><strong>AV dissociation</strong> <ul> <li>*complete:*atrial and ventricular activity is always independent.</li> <li><em>incomplete:</em> intermittent capture.</li> </ul> </li> </ul> <hr> <h5 id="6-onset-and-termination"><strong>6. Onset and termination</strong></h5> <ul> <li><strong>Abrupt</strong>: suggests re-entrant process.</li> <li><strong>Gradual</strong>: suggests increased automaticity.</li> </ul> <hr> <h5 id="7-response-to-vagal-manoeuvres"><strong>7. Response to vagal manoeuvres</strong></h5> <ul> <li><strong>Sinus tachycardia</strong>, <strong>ectopic atrial tachydysrhythmia</strong>: gradual slowing during the vagal manoeuvre, but resumes on cessation.</li> <li><strong>AVNRT</strong> or <strong>AVRT</strong>: abrupt termination or no response.</li> <li><strong>Atrial fibrillation</strong> and <strong>atrial flutter</strong>: gradual slowing during the manoeuvre.</li> <li><strong>VT</strong>: no response.</li> </ul> <hr> <h4 id="differential-diagnosis">Differential Diagnosis</h4> <p><em>Follow links below for examples of individual rhythms.</em></p> https://ecgvn.com/en/posts/ecg-exam-template/ Tue, 03 May 2022 00:00:00 +0000 https://ecgvn.com/en/posts/ecg-exam-template/ <p>The following headings and prompts can be used as template for ECG-based exam questions.</p> <p>Amjid Rehman (@<a href="https://x.com/amjidrehman">amjidrehman</a>) has made an easy interactive online template ‘<a href="https://productivemedic.com/ecg/">ECG made easier</a>‘ based on the template structure outlined</p> <h4 id="ecg-type-and-recording">ECG type and recording</h4> <ul> <li>12 lead vs rhythm strip, rate (normal 25 mm/s)</li> <li>Calibration (5mm wide, 10mm high = 1mV)</li> <li>Unusual leads – right, posterior, lead grouping format</li> </ul> <hr> <h4 id="rate"><strong><a href="https://litfl.com/ecg-rate-interpretation/">Rate</a></strong></h4> <ul> <li>normal 60 – 100/min</li> <li>tachy/bradycardia (SA node) vs –arrhythmia (not SA node)</li> <li>method: 300/RR interval (large squares) or number of QRS complexes x 6 (if 25mm/s)</li> </ul> <hr> <p><a href="https://litfl.com/wp-content/uploads/2018/08/ECG-RATE-rhythm-strip-10-seconds-300-1500-rules-ECG.png"><img alt="ECG RATE rhythm strip 10 seconds 300 1500 rules ECG" loading="lazy" src="https://litfl.com/wp-content/uploads/2018/08/ECG-RATE-rhythm-strip-10-seconds-300-1500-rules-ECG-1024x532.png"></a></p>