1. Atrial & Ventricular Dysrhythmia
Ahmad Thanin

2. Objective
Define the characteristics of atrial and ventricular arrhythmia.
Relate the ECG features to the relevant physiological processes
Develop reasoning skill that will enable you to explain some of the
less commonly observed ECG abnormalities
Identify potential pathways of care for the person presenting with a
variety of ECG changes.

3. QRS Complex
Normal QRS: less than 3
small boxes ( less than 0.12
seconds), Narrow QRS.
Abnormal QRS: more than 3
small boxes (more than 0.12
seconds), Wide QRS.

4. Normal Sinus Rhythm

5. Atrial Dysrhythmia
Sinus Tachycardia.
Sinus Bradycardia.
Junctional Rhythm.
SVT.
Atrial Flutter.
Atrial Fibrillation

6. Sinus Tachycardia

7. Sinus Bradycardia

8. Junctional Rhythm
Characteristics:
Narrow QRS always.
Absent of P wave, or
Inverted P Wave, or
Present P Wave but PR Interval less than 3 small boxes (less than
0.12 Seconds.
Inverted P Wave comes after QRS.

9. Junctional Rhythm – Cont.
Absent Inverted PR Interval less
than 0.12 seconds
Inverted after QRS

10. Types of Junctional Rhythms
Junctional
•Heart Rate 40 – 60 Beat per minute.
Accelerated
Junctional
•Heart Rate 60 – 100 Beat per minute
Junctional
Tachycardia
•Heart Rate above 100 Beat per minute

11. Supra Ventricular Tachycardia – SVT

12. Atrial Flutter – SAW Teeth

13. Atrial Fibrillation

14. Ventricular Dysrhythmia
Idioventricular Rhythms
Ventricular Tachycardia.
Ventricular fibrillation.
Torsade's DE points

15. Idioventricular Rhythms
Characteristics:
Wide QRS always.
Absent of P wave always.
Heart Rate 20 – 40 BPM

16. Ventricular Tachycardia
Always check pulse with this Rhythm

17. Ventricular Fibrillation
Don’t Delay SHOCK
Don’t waste the time for checking Pulse. Pulse always absent

18. Torsade's DE points

19. Time for Questions and Discussion

20. Thank You