1. Basic Rhythm Recognition

2. You can narrow down most rhythms to within 3 possibilites based on rate (fast, slow, normal), regularity (regular, irregular), and width (narrow, wide).

3. Fast
Normal
Slow
Regular
Sinus Tach
SVT
A flutter (regular conduction)
VT (with pulse)
Normal Sinus
Accelerated Junctional
A flutter
Sinus Brady
Complete block
Ventricular/Junctional escape
Irregular
A fib with RVR
A flutter (variable conduction)
Multifocal atrial tachycardia
Sinus Arrhythmia
Afib/flutter
Sinus with PVC/PACs
Wandering atrial pacemaker
Afib/flutter SVR
2nd degree blocks

4. Evaluate p waves -Are they present? -How do they relate to the QRS?
-Are they all the same?

5. Multifocal Atrial Tachycardia: Irregularly irregular with rate above 100 and 3 or more different p wave morphologies

6. Atrial fibrilation with rapid ventricular response: Tachycardic and irregularly irregular. Variable R-R interval. P waves largly absent.

7. Evaluate the QRS complex
Is is wide or narrow?
Wide QRS can be a ventricular rhythm
Any of these rhythms can be aberrantly conducted (bundle branch block)

8. 3rd degree AV block (complete heart block) with ventricular escape vs aberrantly conducted junctional escape rhythm.

9. 2nd degree AV block type 1 (Wenkiebach or Mobitz 1): Variable PR interval that prolongs with each beat leading to non conducting P wave

10. Nonsustained Ventricular Tachycardia terminating with sinus tachycardia with frequent aberrantly conducted PACs vs PVCs

11. Atrial flutter with variable conduction and slow ventricular response