If symptomatic, look for underlying causes and reduce heart rate if elevated. Treatment: None required if asymptomatic. Premature Atrial Complexes (PACs) (rate varies irregular rhythm) What is the length of the PR interval? Usually not discernable.Is there a P wave before each QRS? Are P waves upright and uniform? Usually not discernable, especially at the high rates (becomes hidden in the QRS).What is the rate? Atrial: 150-250 bpm ventricular: 150-250 bpm.Treatment: Vagal maneuvers or adenosine if stable electrical cardioversion if unstable. Supraventricular Tachycardia (> 150 bpm, regular rhythm) What is the length of the PR interval? Not discernable.Is there a P wave before each QRS? Are P waves upright and uniform? Normal P waves are absent.What is the rhythm? Irregularly irregular.What is the rate? Atrial: 350-400 bpm ventricular: variable.Treatment: Rate control (slow ventricular rate to 80-100 beats/minute) with digoxin, beta-adrenergic blockers, or calcium channel blockers (diltiazem) What is the length of the PR interval? Not measurableĪtrial Fibrillation (rate varies always irregular).

Is there a P wave before each QRS? Are P waves upright and uniform? Normal P waves are absent flutter waves (f waves) (sawtooth pattern) are present.What is the rhythm? Atrial: regular ventricular: may be irregular.

What is the rate? Atrial: 250-400 bpm ventricular: variable.

Treatment: Cardioversion = treatment of choice antiarrhythmics (procainamide) to convert the flutter diltiazem, verapamil, digitalis, or a beta blocker (metroprolol) to slow the ventricular rate heparin to reduce incidence of thrombus formation. The four most common atrial arrhythmias are described here.Ītrial Flutter (rate varies usually regular saw-toothed) Atrial tissues or internodal pathways may initiate an impulse instead.

Do all QRS complexes look alike? What is the length of the QRS complexes? Yes 0.06-0.12 seconds (1½ to 3 small squares)Ītrial rhythms occur when the sinoatrial (SA) node fails to generate an impulse.

What is the length of the PR interval? 0.12-0.20 seconds (3-5 small squares).

Is there a P wave before each QRS? Are P waves upright and uniform? Yes Yes.

What is the rhythm? Irregular (varies more than 0.08 sec).

What is the rate? 60-100 beats per minute.

Treatment: Sinus arrhythmia typically is asymptomatic and does not require treatment but may be reduced by avoiding caffeine and other stimulants.įive steps to identify this heart rhythm: Tachycardia with wide QRS complexes - consider anti-arrhythmics, such as procainamide, amiodarone, or sotalol.

Treatment: Tachycardia with narrow QRS complexes - consider vagal maneuvers, adenosine, beta blocker (metoprolol), calcium channel blocker (diltiazem), or synchronized cardioversion. The PTT signal should be calibrated before analysis to avoid erroneous interpretation of its physiological meaning.Sinus rhythms have five common variations. The PPG and ECG signals not designed for the PTT evaluation may contain unwanted artifacts. We apply an approach based on the de-shape method to visualize, quantify and validate this sawtooth artifact. We report a novel constant oscillatory pattern in the PTT signal and identify this pattern as a sawtooth artifact. All data sets include recordings of PPG and ECG using a commonly deployed patient monitor. This is a retrospective clinical study using two databases: one containing 35 subjects who underwent laparoscopic cholecystectomy, another containing 22 subjects who underwent spontaneous breathing test in the intensive care unit. We test an off-the-shelf integrated photoplethysmography (PPG) and electrocardiogram (ECG) monitoring device for its ability to yield a reliable pulse transit time (PTT) signal. We hypothesize that this calibration issue for a secondary analysis may become an important source of artifacts in patient monitor data. However, in this setup the data calibration issue is often not discussed and, rather, implicitly assumed, while the clinical monitors might not be designed for the data analysis purpose. It is increasingly popular to collect as much data as possible in the hospital setting from clinical monitors for research purposes.

Saw tooth pattern ecg