EKG For Sleep lab.

Abdul Alraiyes MD

Electrocardiogram ECG “EKG”

PQRST

PR interval

PR interval

T wave

PQRST

PQRST

PQRST

Axis

Axis

Axis

Sinus Rhythm

Sinus Bradycardia

Sinus tachycardia

Atrioventricular delay

Atrioventricular delay

1st degree heart block

PR

PP PR RR

Characterized by a fixed and prolonged PR interval (>0.20 seconds)

2nd degree heart block type IMobitz I

P

R

P

P P

R R

•Progressive prolongation of the P-R interval•The QRS duration is normal and the P is upright and uniform•The P-R interval gets longer until an impulse is not conducted due to the refractory state of the bundle of His

2nd degree heart block type IIMobitz II

P

R

P

R R

P

P P P

P

R

This is defined by most beats conducted with a constant PR interval (either normal or prolonged)Occasionally there is an atrial contraction without a subsequent ventricular contraction.

3d degree heart block Complete HB

P

R

P P P P P

RRR R

Characterized by complete AV dissociation because the atria and ventricles are each controlled by separate pacemakers

Bundle Branch Block

Bundle Branch Block

P

R

P P P P

RRR R

Sinus Pause

P P P

RRR

Sinus pause is a delay of activation within the atria for a period between 1.5 and 3 seconds to which the previous sinus interval is not a harmonic.

What is the difference?

Premature contractions and escape rhythm

Premature Ventricular Contractions “PVC”

QRS complex >0.12 seconds Sinus P wave often obscured by the QRS, ST segment or T wave of the PVC

Multifocal PVC

QRS complex >0.12 seconds Sinus P wave often obscured by the QRS, ST segment or T wave of the PVC

PVC

PVC

Junctional rhythm

Inverted P wave

Accelerated Junctional rhythm

Inverted P wave

Tachycardia

Supraventricular Tachycardia

QRS complex <0.12 seconds Sinus P wave often obscured by the QRS

Atrial Fibrillation

Inability to count the atrial rhythm characterized by indeterminate p waves. The complex is described as IRREGULARLY IRREGULARHigh short term RR interval variation Lack of visible p waves

Atrial Flutter

Sawtooth atrial waveforms

Nonsustained ventricular tachycardia

More than 3 consecutive premature ventricular complexes (with QRS width >0.12 sec) Last no more than 6 seconds and terminate spontaneously Average rate of the entire episode greater than or equal to 100 beats/min.

Ventricular fibrillation

Questions?

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