Multifocal PVC

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Ventricular Bigeminy

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Atrial Fibrillation (Afrib): Atrial activity is fast (400-600 atrial beats/min) and poorly defined; may see course (amplitude >0.5mm) or fine (amplitude <0.5mm) undulations or no atrial activity at all. Ventricular rate/response is irregularly irregular and may be fast (HR >100 bpm, indicates inadequate rate control), moderate(HR = 60-100 bpm), or slow. May see isoelectric line variance.

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1st Degree AV Node Block: PR>0.20 sec,may be physiologic in younger patients with high vagal tone and in well-trained athletes.Rarely symptomatic and no treatment is usually required, but further investigation may be indicated when it accompanies another heart disorder or appears to be caused by drugs

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2nd Degree AV Node Block Mobitz 1 (Wenckebach): increasing PR interval until a QRS complex is dropped, usually benign may be present in endurance athletes. Will produce a regularly irregular rhythm on manual exam of pulses.

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2nd Degree AV Node Block Mobitz 2: QRS dropped without any progressive increase in PR interval (i.e., PR interval is constant but still >0.20 sec). May produce an irregularly irregular rhythm on manual exam of pulses.

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3rd Degree AV Node Block Complete heart block: atria and ventricles are electrically dissociated from each other (P waves and QRS complexes occur independent of each other). P-P normal and R-R normal however P-R variable. May see wide QRS complex. Serious condition, most often due to myocardial ischemia/infarction may deteriorate into Vfib, asystole and sudden cardiac death

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S-T Elevation

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Ventricular Tachycardia (VTach)

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Ventricular Fibrillation (VFib)

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