Sinus Bradycardia Sinus Tachycardia

Regularity Regular Regularity Regular

Atrial/P wave and ventricular/QRS complex both
Heart Rate Less than 60 bmp Heart Rate
>100BPM
Normal and consistent shape; always in front of the
P-Wave Consistent and 1 before each QRS complex P-Wave
QRS, but may be buried in the preceding T wave
PR Interval 0.12 to 0.20 seconds and consistent PR Interval 0.12 to 0.20 seconds and consistent
QRS Complex <0.12 seconds and consistent QRS Complex <0.12 seconds and consistent
Lower metabolic needs; vagal stimulation; medications;
SNS stimulation; MI; Hypoxia; pulmonary problem;
Cause idiopathic sinus node dysfunction; and coronary artery Cause
Fever; Exresice
disease
Threat the cause; Beta-blocker - such as Metoprolol;
Treatment Atropine if symptomatic Treatment
Calcium channel blockers, such as Verapamil.

Proxysmal Supraventricular Tachycardia Atrial Flutter

Cartoon Cartoon
Heart Area* Heart Area*

Regular; but may be irregular because of a change in the

Regularity Regular Regularity
AV conduction.
Atrial rate ranges between 250 and 400 bpm;
Heart Rate >130 BPM Heart Rate ventricular rate usually ranges between 75 and 150
bpm.
Saw-toothed shape; these waves are referred to as F
P-Wave May be present but hard to see P-Wave
waves
PR Interval Poorly visible PR Interval None
QRS Complex < 0.12 Wide QRS Complex Narrow
Chronic obstructive pulmonary disease, pulmonary
Cause Stimulations; caffeine; hypoxia; heart disease; or normal Cause hypertension, valvular disease, thyrotoxicosis, an open
heart surgery
Adenosine rapid push 6mg/ saline. HR may stop. Cardioversion; Anticoagulation (if dysrhythmia has
Treatment Digitals; Beta Blockers; Calcium Channel Blocker; Treatment lasted longer than 48 hours); Beta-blockers; Calcium
Cardioversion Channel blockers; Digitalis

Atrial Fibrillation Premature Ventricular Contractions

Cartoon Cartoon
Heart Area* Heart Area*

Regularity Highly irregular Regularity Irregular due to early QRS

Atrial rate is 300 to 600 bpm; ventricular rate is usually
Heart Rate Heart Rate Depends on the underlying rhythm
120 to 200 bpm in untreated atrial fibrillation.
No discernible P waves; Replaced by fine fibrillatory
P-Wave P-Wave Visibility of the P wave depends on the timing of PVC
waves
If the P wave is in front of the QRS, the PR interval is less
PR Interval Cannot be measured PR Interval
than 0.12 seconds
Duration is 0.12 seconds or longer; shape is bizarre and
QRS Complex <0.12 seconds and consistent QRS Complex
abnormal.
Chronic obstructive pulmonary disease, pulmonary
Hypoxia; MI; Hypokalemia; Low Magnesium; Caffeine;
Cause hypertension, valvular disease, thyrotoxicosis, an open Cause
Stimulants; Stress
heart surgery
Cardioversion; Antocoagulants; Digitals; Beta Blockers
Treatment Treatment Lidocaine; Amiodarone or Sotalol (but not for long time)
and Calcium Channel Blockers

Ventricular Tachycardia Ventricular Fibrillation

Cartoon Cartoon
Heart Area* Heart Area*

Regularity Usually regular Regularity Cannot be determined

Heart Rate Ventricular rate is 100 to 200 bpm Heart Rate Cannot be determined
P-Wave Very difficult to detect P-Wave None
PR Interval Very irregular, if P waves are seen PR Interval None
Duration is 0.12 seconds or more; bizarre, abnormal Irregular, undulating waves without recognizable QRS
QRS Complex QRS Complex
shape complexes
Coronary artery disease; Untreated VT,
Hypoxia; MI; Hypokalemia; Low Magnesium; Caffeine; cardiomyopathy, valvular heart disease, several
Cause Cause
Stimulants; Stress proarrhythmic medications, acid–base and electrolyte
abnormalities, and electrical shock
CPR (given while prep for defib) and Defibrillation;
Cardioversion (if the pt has a pulse); Amiodarone (if the
Epinephrine (after unsuccessful debrillation);
Treatment pt has a pulse); Lidocaine; If no pulse, then immediate Treatment
Amiodarone; lidocaine, or possibly magnesium (ASAP
CPR and defibrillation.
after the third defibrillation)

Asytole

Regularity NONE
Heart Rate NONE
P-Wave NONE
PR Interval NONE
QRS Complex NONE
Cause Profound Cardiac or other damage; Hypoxia
CPR; Epinephrine: 1 mg IV/IO push every 3 to 5 min.
Vasopressin: One dose of vasopressin (40 units IV) is
Treatment acceptable in place of first or second dose of
epinephrine. Defibrillation will not work ,
initiate HIGH QUALITY CPR stat