Cardiac Rhythm Interpretation

Cardiac Rhythm Interpretation

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These are the images used in this course. Click on any of the thumbnails to enlarge the image.

EKG

Holter Monitor

Schematic diagram of normal sinus rhythm for a human heart as seen on ECG

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Figure 1-1. Electrical cells and mechanical cells

Figure 1-2. Electrical conduction system of the heart

Figure 1-3. Innervation of the heart

Figure 1-4. Standard graph paper measurements. A Graph paper. B Enlargement of one square of graph paper.

Figure 1-5. Electrocardiogram wave patterns produced by electrical activity in the heart.

P Wave

Figure 1-6. EKG wave, segment, and internal definitions

Electrocardiograph waves, segments, and intervals

Figure 1-7. Regular rhythm

Figure 1-8. Irregular rhythm

Figure 1-9. Calculation of heartbeat rate

Figure 1-10. Electrocardiograph waves, segments, and intervals

Figure 1-11. QRS complexes

Figure 1-12. Normal sinus rhythm

Figure 1-13. Sinus bradycardia

Figure 1-14. Sinus tachycardia

Figure 1-15. Wandering pacemaker

Figure 1-16. Premature atrial contraction (PAC).

Figure 1-17. Atrial tachycardia.

Figure 1-18. Atrial flutter

Figure 1-19. Atrial fibrillation (slow).

Figure 1-20. Atrial fibrillation (rapid).

ECG showing a ventricular premature contraction.[ Source – Wikipedia, Author – James Heilman, MD].

Figure 1-21. Premature junctional contractions (PJC).

ECG showing sinus bradycardia. — ECG showing sinus bradycardia. By Jaskeerat (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

ECG showing sinus tachycardia — ECG showing sinus tachycardia By Jaskeerat (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

By Sinusbradylead2.JPG: James Heilman, MD derivative work: Mysid (using Perl and Inkscape) (This file was derived from Sinusbradylead2.JPG:) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons

Sinus Tachycardia. By James Heilman, MD (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

Wandering Pacemaker. By Jer5150 (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

Premature Atrial Contraction. By Chikumaya (My Own Work) [Public domain], via Wikimedia Commons

Atrial Flutter. By James Heilman, MD (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons

Atrial Fibrillation. By James Heilman, MD (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

First Degree Heart Block. By Michael Rosengarten BEng, MD.McGill [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

Figure 1-22. First degree (incomplete) heart block

Second-Degree Heart Block:Mobitz Type I. By James Heilman, MD (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

Figure 1-23. Wenckebach (second-degree heart block/Mobitz Type I).

Second degree heart block type 2. By James Heilman, MD (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

Figure 1-24. Classical second-degree heart block (Mobitz Type II).

Complete Heart Block (Third-Degree). By James Heilman, MD (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

Figure 1-25. Complete heart block

Figure 1-26. Frequent premature ventricular contractions.

Figure 1-27. Runs of premature ventricular contractions.

Figure 1-28. Multifocal premature ventricular contractions.

Figure 1-29. Runs of PVCS with short run of V Tachycardia.

Figure 1-30. R-on-T phenomenon ending in ventricular fibrillation.

Lead_II_rhythm_ventricular_tachycardia_Vtach_VT. By Glenlarson (Own work) [Public domain], via Wikimedia Commons

Figure 1-31. Ventricular tachycardia.

De-Rhythm_ventricular_fibrillation_(CardioNetworks_ECGpedia). By CardioNetworks: Googletrans [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

Figure 1-32. Ventricular fibrillation (fine).

Figure 1-33. Ventricular fibrillation (coarse).

De-Rhythm idioventricular (CardioNetworks_ECGpedia)By CardioNetworks: Googletrans (CardioNetworks: De-Rhythm_idioventricular.png) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons — By CardioNetworks: Googletrans (CardioNetworks: De-Rhythm_idioventricular.png) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

Figure 1-34. Idioventricular rhythm.

Lead II rhythm generated systole. By Glenlarson (Own work) [Public domain], via Wikimedia Commons

Figure 1-35. Asystole (cardiac standstill).

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Distance Learning Course

This course is intended for use by nursing and medical professionals, and those in training for those professions.

"Cardiac Rhythm Interpretation" was originally developed by the U.S Army Medical Department, to help train their medical personnel. It has been reformatted by the Brookside Associates for wider distribution.

While this material may be very useful to students of the health sciences, completion of this course does not imply competence or certification.

Non-Medical Visitors

I welcome visitors to this site who have no nursing or medical background. I understand you might be considering a healthcare career, or are seeking information for yourself or a family member. Or you may simply be curious.

I'm glad you're here.

But while you're here, please remember that this material is focused on training students in the healthcare professions.

Limitations

The information provided through this site is from a variety of sources, but primarily the U.S. Army Medical Department.

1. The Brookside Associates does not necessarily endorse or agree with all of the clinical opinions expressed, as those opinions belong to the authors.

2. The information provided in this course was believed by its' authors to be reasonably accurate and reliable when it was first published. Since then, scientific knowledge and clinical experience has expanded. Consequently, some of the opinions expressed here may be out of date, or would be phrased differently if written today.

3. Throughout the history of medicine, some of what was once believed to be correct, has later been shown to be incorrect.

4. References to military settings or military medical procedures may not be applicable to civilian situations.

All of these limitations should be considered in reviewing the contents of this website.

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