Ventricular Rhythms

Premature ventricular complex (PVC)

Rate= dependant on underlying rhythm
Rhythm= irregular, because of premature complex
P waves= usually absent
PR interval= none
QRS duration= greater than 0.12 seconds; wide and bizarre; T wave usually in opposite
direction of QRS wave
Full compensatory pause= if the normal beat following a PVC occurs when
expected
Fusion beat= a result of an electrical impulse from a supraventricular site
discharging at the same time as an ectopic site in the ventricles
Couplet= 2 sequential PVCs
Runs or Bursts= 3 or more sequential PVCs, known as ventricular
tachycardia
Bigeminal PVCs (Ventricular bigeminy) = every other beat is a PVC
Trigeminal PVCs (Ventricular trigeminy) = every third beat is a PVC
Quadrigeminal PVCs (Ventricular quadrigeminy) = every forth beat is a PVC
Uniform PVCs= PVCs that look the same in the same lead and originate from
the same anatomic site
Multiformed PVCs= PVCs that appear different from one and other in the same
lead
Interpolated PVC= a PVC occurring without interfering with the normal cardiac
cycle, does not have a full compensatory pause
R-on-T PVC= occurs when the R wave of the PVC falls on the T wave of the
preceding beat
Ventricular escape beat
Rate= dependant on underlying rhythm
Rhythm= dependant on underlying rhythm with a pause
P waves= usually absent
PR interval= none
QRS duration= greater than 0.12 seconds; wide and bizarre; T wave usually in opposite
direction of QRS wave
Ventricular escape rhythm (Idioventricular)
Rate= 20-40 beats a minute
Rhythm= regular
P waves= usually absent
PR interval= none
QRS duration= greater than 0.12 seconds; wide and bizarre; T wave usually in opposite
direction of QRS wave
Accelerated idioventricular rhythm

Rate= 60-100 beats a minute

Rhythm= regular
P waves= usually absent
PR interval= none
QRS duration= greater than 0.12 seconds; wide and bizarre; T wave usually in opposite
direction of QRS wave
Ventricular tachycardia
Rate= 101-250 beats a minute
Rhythm= regular
P waves= usually absent
PR interval= none
QRS duration= greater than 0.12 seconds; wide and bizarre; difficult to differentiate
between the QRS and T wave
Monomorphic= having the same shape
Polymorphic= varying in shape
Torsades de pointes
Rate= 150-300 beats a minute
Rhythm= regular or irregular
P waves= usually absent
PR interval= none
QRS duration= greater than 0.12 seconds; gradual alteration in amplitude and direction of
the QRS complex
Ventricular fibrillation (V-Fib)
Rate= unable to determine
P waves= unable to determine
PR interval= unable to determine
QRS duration= unable to determine
Fine= ventricular fibrillation with low amplitude waves (less than 3 mm)
Coarse= waves that are more easily visible (greater than 3 mm)
Asystole
Rate= no ventricular activity
Rhythm= unable to determine
P waves= unable to determine
PR interval= unable to determine
QRS duration= absent
Pulseless electrical activity (PEA)
Rate= underlying rhythm
Rhythm= underlying rhythm
P waves= underlying rhythm

PR interval= underlying rhythm

QRS duration= underlying rhythm
***No palpable pulse***