DESCRIPTION

This, technically, isn’t an arrhythmia at all, but needs to be included simply because it’s very important to be able to call something “normal” if it really is!

The key is that it’s regular, that it’s between a rate of 60 and 100, and most importantly, that every QRS is preceded by a P wave at the proper interval. The complexes may be wide or narrow, but they must have a preceding P wave.

The rhythm is regular, nice P waves, not too fast, not too slow, and as Dr. Goldilocks1 would say, “Just right!”

HABITAT

This rhythm may be found anywhere, and actually may be seen inhabiting most cardiac monitors, which might make one wonder why that patient is being monitored in the first place. It usually means the patient is in some kind of equilibrium with the world: not too hot, not frightened, not in pain, not suffering from bad heart failure, breathing comfortably … in short, at least by the monitor, doing all right.

CALL

“Can I take this patient off telemetry?”

RESEMBLANCE TO OTHER ARRHYTHMIAS

It’s regular, so it could be confused with any other rhythm that’s regular, but the key is that there’s a P wave in front of every QRS and the rate is 60–100. A junctional rhythm is regular but has no P waves.

CARE AND FEEDING

Just keep up what you’re doing! We don’t want to speed things up or slow things down. So avoid excitement, avoid pain, don’t burn your tongue on hot coffee – in short, just do what your mother told you to do.

1 Dr. Goldilocks was a famous electrophysiologist at New York University in the late 1980s.

Stay updated, free articles. Join our Telegram channel

Join