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




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)

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







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








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








A-Fib: Abnormal heart rhythm







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

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.








PEA: Pulseless electrical activity


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