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• FOR MORE FREE MEDICAL POWERPOINT PRESENTATIONS VISIT WEBSITE
•www.medicalppt. blogspot.com
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ECG Rhythm Interpretation Module III Normal Sinus Rhythm
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Course Objectives • To recognize the normal rhythm of the heart - “Normal Sinus Rhythm.” • To recognize the 13 most common rhythm disturbances. • To recognize an acute myocardial infarction on a 12-lead ECG.
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Learning Modules • • • • • •
ECG Basics How to Analyze a Rhythm Normal Sinus Rhythm Heart Arrhythmias Diagnosing a Myocardial Infarction Advanced 12-Lead Interpretation
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Normal Sinus Rhythm (NSR) • Etiology: the electrical impulse is formed in the SA node and conducted normally. • This is the normal rhythm of the heart; other rhythms that do not conduct via the typical pathway are called arrhythmias.
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NSR Parameters 60 - 100 bpm • Rate • Regularity regular normal • P waves • PR interval 0.12 - 0.20 s 0.04 - 0.12 s • QRS duration Any deviation from above is sinus tachycardia, sinus bradycardia or an arrhythmia
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Arrhythmia Formation Arrhythmias can arise from problems in the: • Sinus node • Atrial cells • AV junction • Ventricular cells
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SA Node Problems The SA Node can: • fire too slow • fire too fast
Sinus Bradycardia Sinus Tachycardia
Sinus Tachycardia may be an appropriate response to stress.
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Atrial Cell Problems Atrial cells can: • fire occasionally from a focus • fire continuously due to a looping re-entrant circuit
Premature Atrial Contractions (PACs) Atrial Flutter
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Teaching Moment • A re-entrant pathway occurs when an impulse loops and results in selfperpetuating impulse formation.
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Atrial Cell Problems Atrial cells can also: • fire continuously Atrial Fibrillation from multiple foci or Atrial Fibrillation fire continuously due to multiple micro re-entrant “wavelets”
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Teaching Moment Multiple micro reentrant “wavelets” refers to wandering small areas of activation which generate fine chaotic impulses. Colliding wavelets can, in turn, generate new foci of activation.
Atrial tissue
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AV Junctional Problems The AV junction can: • fire continuously Paroxysmal due to a looping Supraventricular re-entrant circuit Tachycardia • block impulses AV Junctional Blocks coming from the SA Node
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Ventricular Cell Problems Ventricular cells can: • fire occasionally from 1 or more foci • fire continuously from multiple foci • fire continuously due to a looping reentrant circuit
Premature Ventricular Contractions (PVCs) Ventricular Fibrillation Ventricular Tachycardia
For more presentations www.medicalppt.blog
End of Module III Normal Sinus Rhythm Proceed to Module III Practice Quiz on WebCT
For more presentations www.medicalppt.blog
• FOR MORE FREE MEDICAL POWERPOINT PRESENTATIONS VISIT WEBSITE
•www.medicalppt. blogspot.com
For more presentations www.medicalppt.blog
•www.medicalppt. blogspot.com
For more presentations www.medicalppt.blog
ECG Rhythm Interpretation Module III Normal Sinus Rhythm
For more presentations www.medicalppt.blog
Course Objectives • To recognize the normal rhythm of the heart - “Normal Sinus Rhythm.” • To recognize the 13 most common rhythm disturbances. • To recognize an acute myocardial infarction on a 12-lead ECG.
For more presentations www.medicalppt.blog
Learning Modules • • • • • •
ECG Basics How to Analyze a Rhythm Normal Sinus Rhythm Heart Arrhythmias Diagnosing a Myocardial Infarction Advanced 12-Lead Interpretation
For more presentations www.medicalppt.blog
Normal Sinus Rhythm (NSR) • Etiology: the electrical impulse is formed in the SA node and conducted normally. • This is the normal rhythm of the heart; other rhythms that do not conduct via the typical pathway are called arrhythmias.
For more presentations www.medicalppt.blog
NSR Parameters 60 - 100 bpm • Rate • Regularity regular normal • P waves • PR interval 0.12 - 0.20 s 0.04 - 0.12 s • QRS duration Any deviation from above is sinus tachycardia, sinus bradycardia or an arrhythmia
For more presentations www.medicalppt.blog
Arrhythmia Formation Arrhythmias can arise from problems in the: • Sinus node • Atrial cells • AV junction • Ventricular cells
For more presentations www.medicalppt.blog
SA Node Problems The SA Node can: • fire too slow • fire too fast
Sinus Bradycardia Sinus Tachycardia
Sinus Tachycardia may be an appropriate response to stress.
For more presentations www.medicalppt.blog
Atrial Cell Problems Atrial cells can: • fire occasionally from a focus • fire continuously due to a looping re-entrant circuit
Premature Atrial Contractions (PACs) Atrial Flutter
For more presentations www.medicalppt.blog
Teaching Moment • A re-entrant pathway occurs when an impulse loops and results in selfperpetuating impulse formation.
For more presentations www.medicalppt.blog
Atrial Cell Problems Atrial cells can also: • fire continuously Atrial Fibrillation from multiple foci or Atrial Fibrillation fire continuously due to multiple micro re-entrant “wavelets”
For more presentations www.medicalppt.blog
Teaching Moment Multiple micro reentrant “wavelets” refers to wandering small areas of activation which generate fine chaotic impulses. Colliding wavelets can, in turn, generate new foci of activation.
Atrial tissue
For more presentations www.medicalppt.blog
AV Junctional Problems The AV junction can: • fire continuously Paroxysmal due to a looping Supraventricular re-entrant circuit Tachycardia • block impulses AV Junctional Blocks coming from the SA Node
For more presentations www.medicalppt.blog
Ventricular Cell Problems Ventricular cells can: • fire occasionally from 1 or more foci • fire continuously from multiple foci • fire continuously due to a looping reentrant circuit
Premature Ventricular Contractions (PVCs) Ventricular Fibrillation Ventricular Tachycardia
For more presentations www.medicalppt.blog
End of Module III Normal Sinus Rhythm Proceed to Module III Practice Quiz on WebCT
For more presentations www.medicalppt.blog
• FOR MORE FREE MEDICAL POWERPOINT PRESENTATIONS VISIT WEBSITE
•www.medicalppt. blogspot.com
For more presentations www.medicalppt.blog
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