EKG

STUDY PACKET

(661) 822-8600

21012 White Pine Dr. Tehachapi, CA 93561

21012 White Pine Dr. Tehachapi CA 93561

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SA Node Rate = 80-100 Atrial Nodes = 60-80

AV Node/Junctional = 40-60 Ventricular Nodes =20-40

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A

B

C

D

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E

F

G

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H

I

J TYPES OF JUNCTIONAL CONDUCTION

K

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L

M

N

O

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P

Q

R

S

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T

U

V

W

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X

Y

Z

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AA

BB

CC

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DD

EE

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In BBB, one ventricle contracts slightly later than the

other, causing two “joined QRS’s to appear on the EKG

The diagnosis of BBB is based primarily on the width and

appearance of the QRS. Ask these three questions.

1. Is the QRS wide (> 0.12 seconds)

2. Look for R and R’(prime) (only in V1 and V2 or V5

and V6)

3. Look on the right (V1 or V2) or left side (V5 and V6)

of the heart.

This is generally accurate for the basic right and left

bundle branch blocks.

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Are these right or left BBB?

Fig 1

Fig 2

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EKG Study Packet Answer Key

a. Normal Sinus Rhythm (NSR) b. Sinus Brady c. Sinus Tach d. Sinus Rhythm w/ PAC (look for the inverted P wave. Upright P waves generally are above the

baseline. e. Re-Entry SVT ( No P waves, narrow complex ) f. Atrial Fibrillation ( No regular Ps, variable rate and fibrillatory baseline) Irregularly irregular g. Atrial Flutter (sawtooth pattern) h. Wandering Atrial Pacemaker (WAP) If HR< 100 If HR > 100 = Multifocal Atrial Tach (MAT)

varying Pwave morphology, no dominant pacemaker i. Junctional Rhythm.~ 60 bpm inverted P waves j. Types of junctional conduction (retrograde Pwave conduction comes before, during or after QRS) k. Junctional Tach @ 110 bpm inverted P waves l. Sinus Rhythm W/ PVC m. Sinus Rhythm W/ multifocal PVC’s n. Monomorphic V-Tach o. Polymorphic V-Tach (Probably normal QT) p. Polymorphic V-Tach / Torsades de Points ( Prolonged QT) q. Polymorphic V-Tach / Torsades de Points r. Fine V-Fib s. Coarse V-Fib t. Coarse V-Fib that goes into asystole after a defibrillatory shock u. 1st Degree AV block PR interval > .20ms or one large box v. 1st Degree AV block w. 2nd Degree type I AV block (PR interval gets progressively longer & drops a beat) x. 2nd Degree type I AV block y. 2nd Degree type II AV block More P’s than QRS’s z. 2nd Degree type II AV block aa. 3rd Degree AV block (complete AV disassociation) no fixed PR interval bb. 3rd Degree AV block cc. Asystole dd. ST Elevation (STEMI ) ee. ST segment depression (Non STEMI ) with a PJC

Figure 1 RBBB in V1 & V2

Figure 2 LBBB in V5 & V6