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Ventricular Rhythms ECG Interpretation #315

Introduction Part 1

  • Rhythms are often named according to the origin of the electrical activity in the heart or the structure where the problem is occurring.
  • Ventricular Rhythms are aptly named due to the locus of stimulation being the ventricles (Purkinje network).
  • Dysrhythmias in this category occur as a result of either a failure of the higher (faster) pacemakers within the heart or an abnormal locus of stimulation within the ventricles is occurring at a faster rate than the other pacemaker sites and thus takes over as the pacemaker of the heart.
  • Remember, the fastest electricity in the heart (regardless of location) will dictate the heart rate.

Introduction Part 2

  • Each rhythm in this category will share unique morphologic features which separate them from other rhythms.
  • Other than Asystole and Ventricular Fibrillation which are unique even within this category, the remaining ventricular rhythms typically present without P waves and will display a wide, bizarre QRS complex (measuring 0.12 seconds or greater).
  • After learning the unique features just described, it is simply a matter of recalling the heart rate range associated with the dysrhythmia.

Chart of Types

Ventricular Rhythms

(no P wave, wide - bizarre QRS if present)
Agonalless than 20 bpm
Idioventricular20-40 bpm
Accelerated Idioventricular 40-100 bpm
*Ventricular Tachycardia > 100 bpm
*Ventricular FibrillationElectrical Chaos
*Only two rhythms that are treated with defibrillation.

Authors and Sources

Authors and Reviewers


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