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Cardiac Emergencies | Inherent Pacemakers

Inherent Pacemaker Rates of the Heart

“Foci” or the focus: where electrical impulses start, Organized rhythm is required for perfusion

Complexes: blocks of rhythms

Isoelectric line: midline on an ECG, up is depolarizing, down in repolarizing

Normal Sinus rhythm: (NSR) originates in the uppermost node, the SA (Sino Atrial)node, rate is usually between 60 and 100 beats per minute
nsr

 

 

 

AV Junction: if SA or atria fail, the junctional node starts. Usually 40-60 beats per min. (no P-wave will show on the chart)

junction
Junctional Rhythms: any rhythm starting in the AV Node or the AV Junction

 

 

 

 

Ventricular: If SA, atria and AV junction fail, bundle branches and purkinje fibers, 20-40 beats/min

venricular

 

 

 

 

 

V-Fib: Totally unorganized, causes the heart to quiver

vfib

 

 

 

 

 

 

V-Tac: wide rhythms, electrical impulses starting from the lower bundles

vtach

 

 

 

 

 

 

A-Fib: Abnormal heart rhythm

afib

 

 

 

 

 

PVC: Premature Ventricular Contraction. Will show as a big fat wave in the middle of all the regular complexes

pvc
Trigeminy: PVC one out of every three contractions
Bigeminy: PVC one out of every two contractions
Unifocal PVC: one focal point is firing

 

Multifocal PVC: multiple focal points are firing The EKG is just showing the electrical impulses. This is not proof that the heart is, in fact, beating. Check the pulse, there may be no mechanical capture of the electrical signal.

mfpvc

 

 

 

 

 

 

PEA: Pulseless electrical activity

pea

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