Thoracic Key

Uh-oh! Forgot to measure the QT interval! DESCRIPTION The QT interval is the distance from the start of the QRS to the end of the T wave, and is best…

Normal sinus rhythm, atrial sensed and ventricular paced Atrioventricular (AV) paced rhythm DESCRIPTION Although technically not an arrhythmia, it is probably worthwhile learning to recognize when a pacemaker is present,…

Rapid supraventricular tachycardia DESCRIPTION A narrow complex rhythm which is fast, usually over 160 and sometimes even over 200 beats per minute. Generally P waves are buried in T waves…

Premature atrial complex Blocked premature atrial complex (PAC) (again!) DESCRIPTION The first part of this is easy: if the beat is early it’s premature! The harder part (there always is…

DESCRIPTION You will see no rhythm at all – just a flat line. Actually, real asystole is almost never a perfect flat line: there is usually some baseline wander from…

Junctional rhythm with AV dissociation DESCRIPTION A junctional, or “nodal” rhythm (more confusing, redundant terminology) arises in the atrioventricular (AV) junction (or node, as you guessed) instead of in the…

DESCRIPTION Just a chaotic squiggle. It can be a coarse squiggle (“coarse ventricular fibrillation”) or a fine squiggle (“fine ventricular fibrillation”). There is a subtle (so subtle nobody except aging…

DESCRIPTION This is a wide complex rhythm which has no preceding P waves, originating from the ventricles, with a rate under 100 but over 60. Why isn’t it ventricular tachycardia…

DESCRIPTION An irregular rhythm with no P waves preceding the QRS complexes essentially defines atrial fibrillation. If the ventricular response to the atrial fibrillation is slow enough, you can see…

DESCRIPTION This is really a pumped-up version of the wandering atrial pacemaker. From a descriptive perspective, it’s as if you took the meandering professor from our last example and gave…