RHY T HM CHEAT SHE E T

initial question answer additional question rhythm diagnosis

Is this sinus rhythm AND is the Sinus rhythm

1 N Y
heart rate < 100 bpm?
FIRST QUICK VIEW

Can you recognize a rhythm at

Is the rhythm normal and if not, whats the basic rhythm?

2 N Y
a glance?

Pacemaker

In case of rhythm switch go back and evaluate the second rhythm

QRS duration > 0.1 s Ventricular tachycardia
RAPID AND REGULAR

Atrial tachycardia with BBB

QRS duration 0.1 s Sinus tachycardia

3 Is the rhythm rapid & regular? N Y
Atrial tachycardia

Atrio-ventricular reentry tachycardia (AVRT)

AV nodal reentry tachycardia (AVNRT)

P preceding QRS? Upper junctional rhythm

Are the P waves neg. in II, III
4 N Y
and aVF?
P following QRS? Lower junctional rhythm

QRS totally irregular?

ZOOM IN TO P WAVE

Are the P waves absent or

5 N Y
QRS regular? Mid junctional rhythm
doubtful?
AF + 3rd deg. AV block (AVB)

PR constant? 2nd deg. AVB Mobitz type II

6
Is the rhythm replaced?

Are there too many P waves? N Y PR varying, QRS regular 3rd deg. AV block

PR varying, QRS irregular 2nd deg. AVB Mobitz type I

7 Do you see a rhythm switch? N Y Which ones?

preceding premature P? Supraventricular premature beat (SPB)

8 Do you see premature beats? N Y
no preceding premature P? Ventricular premature beat (VPB)
BASIC RHYTHM INTERRUPTED
Is the rhythm disturbed?

following ventricular
Compensatory pause
premature beat?

after termination of TC? Preautomatic pause

Do you see a remarkable empty pause SA (sinoauricuar) block

9 N Y
pause?
containing premature P? Supraventricular premature beat + AV block

terminated by a QRS with a

Escape beat

of the QRS complexes

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