Sinus Tachycardia

Rhythm

Regular

Rate

Fast (> 100 bpm)

P Wave

Normal, may merge with T wave at very fast rates

PR Interval

Normal (0.12-0.20 sec)

QRS

Normal (0.06-0.10 sec)

Notes

QT interval shortens with increasing heart rate

Sinus Bradycardia
Rhythm

Regular

Rate

Slow (< 60 bpm)

P Wave

Normal

PR Interval

Normal (0.12-0.20 sec)

QRS

Normal (0.06-0.10 sec)

Sinus Arrhythmia
Rhythm

Irregular, varying with respiration

Rate

Normal (60-100 bpm) and rate may increase during inspiration

P Wave

Normal

PR Interval

Normal (0.12-0.20 sec)

QRS

Normal (0.06-0.10 sec)

Notes

Heart rate frequently increases with inspiration, decreasing with

expiration

Sinus Arrest
Rhythm

Irregular due to pause

Rate

Normal to slow

P Wave

Normal

PR Interval

Normal (0.12-0.20 sec)

QRS

Normal (0.06-0.10 sec)

Notes

Pause time is not an integer multiple of the P-P interval

Premature Atrial Complex

Rhythm

Irregular

Rate

Usually normal but depends on underlying rhythm

P Wave

Premature, positive and shape is abnormal

PR Interval

Normal or longer

QRS

0.10 sec or less

Wandering Atrial Pacemaker

Rhythm

May be irregular

Rate

Normal (60-100 bpm)

P Wave

Changing shape and size from beat to beat (at least three diffferent
forms)

PR Interval

Variable

QRS

Normal (0.06-0.10 sec)

Supraventricular Tachycardia

Rhythm

Regular

Rate

Fast (150-250 bpm)

P Wave

Merged with T wave

PR Interval

Normal (0.12 sec)

QRS

Normal (.10 sec)

Atrial Flutter
Rhythm

Regular or irregular

Rate

Fast (250-350 bpm) for Atrial, but ventricular rate is often slower

P Wave

Not observable, but saw-toothed flutter waves are present

PR Interval

Not measureable

QRS

Normal (0.06-0.10 sec)

Atrial Fibrillation
Rhythm

Irregular

Rate

Very fast (> 350 bpm) for Atrial, but ventricular rate may be slow,
normal or fast

P Wave

Absent - erratic waves are present

PR Interval

Absent

QRS

Normal but may be widened if there are conduction delays

Paroxysmal Atrial Tachycardia

Rhythm

Regular

Rate

100-200 bpm

P Wave

abnormal; not always visible

PR Interval

varies, may be unmeasureable

QRS

.04-.10

Junctional Escape Rhythm

Rhythm

Regular

Rate

Slow (40-60 bpm)

P Wave

Present before, during (hidden) or after QRS, if visible it is

inverted

PR Interval

Not measurable

QRS

Normal (0.06-0.10 sec)

Accelerated Junctional Rhythm

Rhythm

Regular

Rate

Normal (60-100 bpm)

P Wave

Present before, during (hidden) or after QRS, if visible it is

inverted

PR Interval

Not measurable

QRS

Normal (0.06-0.10 sec)

Junctional Tachycardia
Rhythm

Regular

Rate

Fast (100-180 bpm)

P Wave

Present before, during (hidden) or after QRS, if visible it is

inverted

PR Interval

Absent or short

QRS

Normal (0.06-0.10 sec)

Premature Junctional Complex

Rhythm

Regular with premature beats

Rate

The underlying rate

P Wave

Present before, during (hidden) or after QRS, if visible it is

inverted

PR Interval

Absent or short

QRS

Normal (0.06-0.10 sec)

First Degree Heart Block

Rhythm

Regular

Rate

The underlying rate

P Wave

Normal

PR Interval

Prolonged (>0.20 sec)

QRS

Normal (0.06-0.10 sec)

Notes

A first degree AV block occurs when electrical impulses moving

through the Atrioventricular (AV) node are delayed (but not
blocked). First degree indicates slowed conduction without missed
beats

Second Degree Heart Block Type I

Rhythm

Irregular but with progressively longer PR interval lengthening

Rate

The underlying rate

P Wave

Normal

PR Interval

Progressively longer until a QRS complex is missed, then cycle

repeats

QRS

Normal (0.06-0.10 sec)

Second Degree Heart Block Type II

Rhythm

Regular (atrial) and irregular (ventricular)

Rate

Characterized by Atrial rate usually faster than ventricular rate

(usually slow)

P Wave

Normal form, but more P waves than QRS complexes

PR Interval

Normal or prolonged

QRS

Normal or wide

Third Degree Heart Block

Rhythm

Regular, but atrial and ventricular rhythms are independent

Rate

Characterized by Atrial rate usually normal and faster than

ventricular rate

P Wave

Normal shape and size, may appear within QRS complexes

PR Interval

Absent: the atria and ventricles beat independently.

QRS

Normal, but wide if junctional escape focus

Premature Ventricular Complex

Rhythm

Irregular

Rate

The underlying rate

P Wave

Absent

PR Interval

Not measurable

QRS

Wide (> 0.10 sec), bizarre appearance

Notes

Two PVCs together are termed a couplet while three PVCs in a

row with a fast rhythm is ventricular tachycardia

Ventricular Tachycardia
Rhythm

Regular

Rate

Fast (100-250 bpm)

P Wave

Absent

PR Interval

Not measurable

QRS

Wide (>0.10 sec), bizarre appearance

Torsade de Pointes
Rhythm

Irregular

Rate

Fast (200-250 bpm)

P Wave

Absent

PR Interval

Not measurable

QRS

Wide (>0.10 sec), bizarre looking

Ventricular Fibrillation
Rhythm

Highly irregular

Rate

Unmeasurable

P Wave

Absent

PR Interval

Not measurable

QRS

None

Notes

EKG tracings is a wavy line

Idioventricular Rhythm
Rhythm

Regular

Rate

Slow (20-40 bpm)

P Wave

Absent

PR Interval

Not measurable

QRS

Wide (>0.10 sec), bizarre appearance

Accelerated Idioventricular Rhythm

Rhythm

Regular

Rate

50-120 bpm

P Wave

Absent

PR
Interval

Not measurable

QRS

Wide (>0.10 sec),

bizarre looking

Asystole
Rhythm

Not present

Rate

Absent

P Wave

Absent

PR Interval

Absent

QRS

Absent

Ventricular Standstill
Rhythm

absent

Rate

none

P Wave

can have P waves without QRS complex

PR Interval

Absent

QRS

Absent