Ventricular Rhythms ECG Interpretation
Introduction Part 1
- Rhythms are often named according to the origin of the electrical activity in the heart or the structure where the problem is occurring.
- Ventricular Rhythms are aptly named due to the locus of stimulation being the ventricles (Purkinje network).
- Dysrhythmias in this category occur as a result of either a failure of the higher (faster) pacemakers within the heart or an abnormal locus of stimulation within the ventricles is occurring at a faster rate than the other pacemaker sites and thus takes over as the pacemaker of the heart.
- Remember, the fastest electricity in the heart (regardless of location) will dictate the heart rate.
Introduction Part 2
- Each rhythm in this category will share unique morphologic features which separate them from other rhythms.
- Other than Asystole and Ventricular Fibrillation which are unique even within this category, the remaining ventricular rhythms typically present without P waves and will display a wide, bizarre QRS complex (measuring 0.12 seconds or greater).
- After learning the unique features just described, it is simply a matter of recalling the heart rate range associated with the dysrhythmia.
Chart of Types
Ventricular Rhythms
(no P wave, wide - bizarre QRS if present)| Rhythm | Rate |
| Asystole | 0 |
| Agonal | less than 20 bpm |
| Idioventricular | 20-40 bpm |
| Accelerated Idioventricular | 40-100 bpm |
| *Ventricular Tachycardia | > 100 bpm |
| *Ventricular Fibrillation | Electrical Chaos |
Authors and Sources
Authors and Reviewers
- ECG heart rhythm modules: Thomas O'Brien.
- ECG monitor simulation developer: Steve Collmann
-
12 Lead Course: Dr. Michael Mazzini, MD.
- Spanish language ECG: Breena R. Taira, MD, MPH
- Medical review: Dr. Jonathan Keroes, MD
- Medical review: Dr. Pedro Azevedo, MD, Cardiology
- Last Update: 11/8/2021
Sources
-
Electrocardiography for Healthcare Professionals, 6th Edition
Kathryn Booth and Thomas O'Brien
ISBN10: 1265013470, ISBN13: 9781265013479
McGraw Hill, 2023 -
Rapid Interpretation of EKG's, Sixth Edition
Dale Dublin
Cover Publishing Company -
EKG Reference Guide
EKG.Academy -
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Aaron Reed
Create Space Independent Publishing -
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN -
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG
Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429 - Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH
-
ECG Reference Guide
PracticalClinicalSkills.com
