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Chapter 5 Rhythm Strip Interpretation and Sinus Rhythms Learning Outcomes 51 Explain the process of evaluating ECG tracings and determining the presence of dysrhythmias 52 Describe the criteria used for classification of dysrhythmias, including rhythm, rate, P wave configuration, PR interval measurement, and QRS duration measurementRationale 1 Normal sinus rhythm is defined as regular rhythm with a rate of 60 to 100 beats per minute The PR and QRS measurements are normal, 012 to 0 second and 006 to 010 second respectively Rationale 2 The rhythm is regular, which is not a characteristic of sick sinus syndrome Rationale 3 The rate is too fast for sinus bradycardiaSinus bradycardia is discussed including the ECG criteria, causes and symptoms when a part of sick sinus syndrome (SSS)
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Sinus bradycardia rhythm 6 second strip
Sinus bradycardia rhythm 6 second strip-Sinus Rhythms are aptly named due to the locus of stimulation being the SA (sinoatrial) node With Sinus Bradycardia the locus of stimulation is the same as normal sinus rhythm, just now the rate will be less than 60 bpm Recall that "brady" means slow The only difference between sinus bradycardia and normal sinus rhythm is the rate• Cycles/6 second strip 10 = Rate • When there are 10 large squares between similar waves, the rate is 30/minute Sinus Rhythm origin is the SA Node ("Sinus Node"), normal sinus rate is 60 to 100/minute • Rate more than 100/min = Sinus Tachycardia (page 68) • Rate less than 60/min = Sinus Bradycardia (page 67)




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2906 · Sinus Tachycardia Originates from the SA node Atrial and ventricular rates are the same and are between 100 and 150 beats per minute Increased heart rate could be normal response to recent exercise Sinus tachycardia can cause low cardiac output Patient may complain of heart fluttering or palpitations Criteria for rhythm, P wave morphology, PR interval, and QRS duration and morphology are the same as in sinus rhythm and sinus bradycardiaNote The rate of a Normal Sinus Rhythm is beats per minute;The following rhythm strips are for your practice We suggest you practice with these prior to taking the post test (All strips are sixsecond strips unless otherwise indicated) Rhythm Strip #1 ECG Criteria Heart rate
· This rhythm strip tracing shows an atrial tachyarrhythmia (atrial flutter/tachycardia) that suddenly terminates The tachycardia is followed by a 34second pause and then sinus bradycardia The combination of a tachycardia that is suddenly followed by a bradycardia is characteristic of tachybrady syndromeAssume each strip is a 6 second strip Passing is 80% 1 Identify the following rhythm a Asystole b Ventricular fibrillation c Atrial fibrillation d Torsade de pointes 2 What is the most appropriate treatment for this patient?Rate and Rhythm Sinus Bradycardia and Sinus Tachycardia Watch later Share Copy link Info Shopping Tap to unmute If playback doesn't begin shortly, try restarting your device Up next
Basic Dysrhythmias Sinus Arrhythmias Basic Rhythm Strip Interpretation6 Cardiac physiology 10 The P wave 13 The PR interval 15 The QRS complex 18 The ST segment The T wave 22 Determining the rate 24 Myocardial Infarction 27 Sinus Rhythm (SR) 29 Sinus Bradycardia (SB) 31 Sinus Tachycardia (ST) 33 Atrial Tachycardia 34 Atrial Fibrillation (AF) 36 Atrial Flutter 38 Junctional Escape RhythmBradycardia sinus bradycardia is seen in a skipped rhythm, Causes are second and third degree AV block, sinoatrial block and arrest termed sinus node dysfunction enabling quicker appraisal of heart rate based on a 6second strip the procedure is as follows Obtain a printed strip of sufficient length, covering more than 6 seconds,




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To determine if the atrial rate is regular or irregular, measure the distance between two consecutive PP intervals Use a point from one P wave to the same point on the next P wave · basic rhythm strip review 1 rhythm strip review 2 measuring intervals 3 measuring intervals 4 sinus rhythms 5 normal sinus rhythm 6 sinus arrhythmia 7 sinus tachycardia 8 sinus bradycardia 9 sinus pause 10 sinus arrest 11 atrial rhythms 123012 · We cannot use the guestimation method here, because this is not a 6second strip In fact, it's about a 3second strip, so that would put us around 60bpm which would just be normal sinus rhythm so you can see why this method is not as accurate, and on a test, you'd have gotten this question wrong if you used that method




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C) Sinus bradycardirrest 2 Identify on rrest 3 Systematically evaluate each rhythm for the following criteria a) Rate, b) Rhythm Regular/irregular,Identify on rrest 3 Systematically evaluate each rhythm for the following criteria a) Rate, b) Rhythm Regular/irregular,Sinus bradycardia ECG, causes & management Definition of sinus bradycardia Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate is slower than 50 beats per minute ECG criteria follows Regular rhythm with ventricular rate slower than 50 beats per minute Pwaves with constant morphology preceding every QRS complex




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0118 · Sinus rhythm refers to the pace of your heart beat that's set by the sinus node, your body's natural pacemaker A normal sinus rhythm means your heart rate is within a normal range · Even people who are physically fit can experience sinus bradycardia Bradycardia is often indicative of low blood pressure, pulmonary edema and congestion, abnormal rhythm, discomfort in the chest, shortness of breath, lightheadedness, and/or confusion On the other hand, symptomatic bradycardia should be attended to with the ACLS SurveyHowever, from a cardiologist or EP perspective, this is coarse atrial fibrillation (pseudo flutter waves changing morphology and rate) 32 Sinus Tachycardia



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Sinus bradycardia is characterized by sinus rhythm with heart rates below normal for age (see Fig 165) Slow heart rates can be observed during sleep or at times of high vagal tone When there is significant sinus bradycardia, a slow junctional escape rhythm or a slow atrial rhythm originating from an ectopic focus can be presentWhen assessing the rhythm strip, the nurse takes care first to identify the underlying rhythm (eg, sinus rhythm, sinus arrhythmia) Then the PR interval is assessed for the possibility of an AV block AV blocks occur when the conduction of the impulse through the AV0807 · A 6second strip is made up of 30 big boxes Each big block is 02 seconds in duration, so 5 big blocks is equal 1 second in total duration (2 x 5 = 1), meaning you would need a total of 30 big boxes to make a 6second strip Once you know you are dealing with a 6 second strip, you count the number of QRS complexes within those 6 seconds and multiply by 10 For example, if we count 5 QRS complexes within a 6 second strip,




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