Rhythm Analysis

RHYTHM ANALYSIS

• Calculate rate
  Step 1: ➔

• Determine regularity
  Step 2: ➔

• Assess the P waves
  Step 3: ➔

• Determine PR interval
  Step 4: ➔

• Determine QRS duration
  Step 5: ➔

STEP 1: CALCULATE RATE

• Regular

  • Find a R wave that lands on a bold line
    • large box / 300
  • Find a R wave that lands on a bold line
    • small box / 1500

• Irregular

  • Count number of QRS in 6 seconds x 12 = QRS in 30 big boxes x 12 = rate
  • second = 5 big boxes

STEP 2: DETERMINE REGULARITY

• R R

Look at the R-R distances (using a caliper or markings on a pen or paper)

• Regular (are they equidistant apart)?
• Occasionally irregular?
• Regularly irregular?
• Irregularly irregular?

Interpretation Regular

STEP 3: ASSESS THE P WAVES

• Are there P waves?
• Do the P waves all look alike?
• Do the P waves occur at a regular rate?
• Is there one P wave before each QRS?

Interpretation

Normal P waves with 1 P wave for every QRS

STEP 4: DETERMINE PR INTERVAL

• Normal: 0.12 - 0.20 seconds
  • (boxes 5 - 3)

Interpretation

0.12 seconds

STEP 5: QRS DURATION

• Normal: 0.04 - 0.12 seconds
  • (boxes 3 – 1)

Interpretation

0.08 seconds

RHYTHM SUMMARY

• Rate: 90-95 bpm
• Regularity: regular
• P waves: normal
• PR interval: 0.12 s
• QRS duration: 0.08 s

Interpretation

Normal Sinus Rhythm

NSR PARAMETERS

• 60 - 100 bpm

• regular

• normal

• 0.12 - 0.20 s

• 0.04 - 0.12 s

• Rate

• Regularity

• P waves

• PR interval

• QRS duration

Any deviation from above is sinus tachycardia, sinus bradycardia or an arrhythmia