Learning Ventricular Rhythms

Learning Ventricular Rhythms : 

Learning Ventricular Rhythms Galveston College EMS 2009

Premature Ventricular Contractions : 

Premature Ventricular Contractions An irritable focus within the ventricles fires prematurely to initiate a single ectopic complex.

T Wave Configuration with PVCs : 

T Wave Configuration with PVCs A B

Typical Examples of PVC Configuration : 

Typical Examples of PVC Configuration A B C D

Typical Examples of PVC Configuration : 

Typical Examples of PVC Configuration E F G H

Compensatory Pause : 

Compensatory Pause

Interpolated PVC : 

Interpolated PVC

Unifocal PVCs : 

Unifocal PVCs

Multifocal PVCs : 

Multifocal PVCs

R on T Phenomenon : 

R on T Phenomenon Ectopic A exhibits R on T phenomenon; Ectopic B does not.

PVCs Occurring as a Couplet (Pair) : 

PVCs Occurring as a Couplet (Pair)

PVCs Occurring in a Run : 

PVCs Occurring in a Run

Patterns of Grouped Beating : 

Patterns of Grouped Beating

Premature Ventricular Contractions : 

Premature Ventricular Contractions Regularity: Ectopics will disrupt regularity of underlying rhythm Rate: Depends on underlying rhythm and number of ectopics P Wave: Not preceded by a P wave; dissociated P waves may be seen near PVC PRI: Since the ectopic comes from a lower focus, there will be no PRI QRS: Wide and bizarre; .12 seconds or greater; T wave is usually in opposite direction from R wave

Premature Ventricular Contractions : 

Premature Ventricular Contractions

Ventricular Tachycardia : 

Ventricular Tachycardia A single irritable focus within the ventricles fires very rapidly, thus overriding higher sites for control of the heart.

Ventricular Tachycardia : 

Regularity: Usually regular; can be slightly irregular Rate: Usually 150-250 beats/min; less than 150 is called slow VT; over 250 is called Ventricular Flutter P Wave: Not preceded by P waves; dissociated P waves may be seen PRI: None QRS: Wide and bizarre; .12 sec. or greater Ventricular Tachycardia

Ventricular Tachycardia : 

Ventricular Tachycardia

Ventricular Fibrillation : 

Ventricular Fibrillation Multiple foci in the ventricles become irritable and generate uncoordinated, chaotic impulses that cause the heart to fibrillate rather than contract.

Ventricular Fibrillation : 

Ventricular Fibrillation Regularity: Rate: P Wave: PRI: QRS: Totally chaotic with no discernible waves or complexes }

Ventricular Fibrillation : 

Ventricular Fibrillation

Idioventricular Rhythm : 

Idioventricular Rhythm Absence of a higher pacemaker allows the much slower ventricles to assume control of the heart.

Idioventricular Rhythm : 

Regularity: Usually regular (it can be unreliable since it is such a low site) Rate: 20-40 beats per minute; can drop below 20 beats per minute P Wave: None PRI: None QRS: Wide and bizarre; .12 seconds or greater Idioventricular Rhythm

Idioventricular Rhythm : 

Idioventricular Rhythm

Asystole : 

Asystole There is no electrical pacemaker to initiate electrical flow. The heart has lost its electrical activity.

Asystole : 

Asystole Regularity: Rate: P Wave: PRI: QRS: Straight line indicates absence of electrical activity }