The document describes various types of tachyarrhythmias and bradyarrhythmias based on their rate, rhythm, QRS width, and other features. Tachyarrhythmias are categorized as narrow complex or wide complex, and further divided into regular or irregular rhythm. Narrow complex rhythms include sinus tachycardia, atrial flutter, supraventricular tachycardia, junctional rhythm, atrial fibrillation, atrial flutter with variable block, and multifocal atrial tachycardia. Wide complex rhythms include ventricular tachycardia, SVT with aberrancy, ventricular fibrillation, and torsades de pointes. Bradyarrhythmias include sinus bradycard

1. Rhythm Recognition
Andey bin Rahman

2. Tachyarrhythmia
Narrow
complex
Regular
• SVT
• Sinus tachycardia
• Atrial flutter
• Junctional rhythm
Irregular
• Atrial fibrillation
• Atrial flutter with variable
block
• Multifocal atrial
tachycardia
Wide
complex
Regular
• Ventricular tachycardia
• SVT with aberancy
Irregular
• Atrial fibrillation with
preexcitation
• AF with aberrancy
• Ventricullar fibrillation
• Torsades de pointes

3. Narrow Complex

4. Sinus Rhythm

5. Sinus Tachycardia

6. Atrial Flutter
Rate A: 300 V:<150
Rhythm Regular
QRS Narrow
Feature sawtooth

7. Supraventricular Tachycardia
Rate >150
Rhythm Regular
QRS Narrow
Feature P not visible

8. Junctional rhythm
Rate 40-60
Rhythm Regular
QRS Narrow
Feature P not visible,
inverted or after QRS

9. Atrial fibrillation
Rate A: 600 V:variable
Rhythm irregular
QRS Narrow
Feature Irregularly irregular

10. Atrial flutter with variable block
Rate A: 300 V:<150
Rhythm Irregular
QRS Narrow
Feature sawtooth

11. Multifocal Atrial Tachycardia
Rate Variable
Rhythm Irregular
QRS Narrow
Feature 3 or more P waves
that differ in polarity
(up/down),
shape, and size

12. Wide complex

13. Ventricular Tachycardia
Rate >150
Rhythm Regular
QRS wide
Feature No visible p

14. SVT with aberancy

15. Ventricular fibrillation
Rate Very fast
Rhythm Irregular
QRS bizarre
Feature no recognizable P,
QRS, or T waves

16. Torsades de pointes
Rate V: 150-200
Rhythm Irregular
QRS QRS complexes display
“spindle-node” pattern
Feature no recognizable P &T
waves, prolong QT before
occurence

17. Bradyarrhythmia

18. Bradyarrhythmia
Sinus
Bradycardia
1st degree
Heart block
2nd degree
Heart block
(Mobitz 1)
2nd degree
Heart block
(Mobitz 2)
3rd degree
Heart block

19. Sinus Bradycardia

20. 1st degree Heart block
• P-R Interval > 200msec (5 small box)
• No dropped beat

21. 2nd degree heart block , Mobitz 1 (Wenckebach)
• Progressive prolongation of P-R intervals
• P-P intervals constant
• Dropped beat
• PR interval is longest immediately before the dropped beat
• PR interval is shortest immediately after the dropped beat

22. 2nd degree HB Mobitz II
• Intermittent non-conducted P waves without progressive prolongation of the PR interval
• PR interval in the conducted beats remains constant
• P-P constant
• RR interval surrounding the dropped beat(s) is an exact multiple of the preceding RR
interval

23. 3rd degree HB (complete HB)
• complete absence of AV conduction (AV dissociation)
• Perfusing rhythm is maintained by a junctional or ventricular escape rhythm

24. Pulseless Electrical Activity (PEA)
• presence of coordinated
electrical activity in
myocardium but no detectable
cardiac output
• formerly known as EMD
(electromechanical dissociation)

25. Asystole

26. Arrest rhythm
• VF
• VT
• PEA
• Asystole

27. Thank you