MADE EASY 5 MINUTE - ECG INTERPRETATION MODULE II

A heart rhythm that originates in the sinoatrial node and is normally conducted is called a Normal Sinus Rhythm. The characteristics of a normal sinus rhythm are a regular rate between 60-100 beats per minute, a narrow complex, preceded by a P-wave where all the complexes look the same.

ANALYZE A RHYTHM 

Rhythm Analysis: 

Step 1: Calculate rate

Step 2: Determine regularity

Step 3: Assess the P wave

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

Remember: All rhythm strips in the modules are 6 second in length.

Interpretation?" 9x10 = 90 bpm

Option 2

Find a R wave that lands on a blod 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 

STEP 2: DETERMINE REGULARITY

Look at the R-R distances (using a caliper or marking on a pen or paper)

Regular (are they equidistant apart)?, Occasionally irregular?, Regularly irregular? Irregularly irregular?

Interpretation? Regular

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 bpm

REGULARITY : regular

P WAVES : normal

PR interval : 0.12 s

QRS duration : 0.08 s

Interpretation? NORMAL SINUS RHYTHM

Prepared and Presented by

Akshaya Srikanth, Dr.S.Chandra Babu*

Pharm.D Internee, *Asst.Prof of Medicine

RIMS, Kadapa, India