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)
RhythmRate
Asystole0
Agonalless than 20 bpm
Idioventricular20-40 bpm
Accelerated Idioventricular 40-100 bpm
*Ventricular Tachycardia > 100 bpm
*Ventricular FibrillationElectrical Chaos
*Only two rhythms that are treated with defibrillation.



Authors and Sources

Authors and Reviewers


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






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