10 Common EKG Heart Rhythms

For nursing students preparing for the NCLEX, understanding EKG heart rhythms is crucial. An EKG measures the heart's electrical activity and is essential for diagnosing arrhythmias, which are disturbances in the heart's normal rhythm. The following insights are vital: 1. Five Steps to EKG Interpretation: It's important to analyze EKG strips in a specific order: Rate, P Waves, P:QRS, QRS, and PR Interval. For instance, determining the ventricular rate involves counting the R waves on a six-second strip and multiplying by 10, or dividing 300 by the number of large squares between R waves or P waves. 2. Common Rhythms: Recognizing rhythms like Sinus Tachycardia, with a heart rate over 100 bpm, and Sinus Bradycardia, with a rate under 60 bpm, is essential. In Sinus Tachycardia, P Waves precede each QRS complex, and the PR interval and QRS complex are normal. Sinus Bradycardia, originating from the sinus node, has similar features but with a slower rate. 3. Interpreting Specific Rhythms: For Premature Atrial Contraction, you'll see premature and abnormal-looking P waves, while Atrial Flutter is characterized by a regular atrial rhythm with a rate of 250 to 400 beats/minute and a sawtooth P wave configuration. 4. Additional Aspects: Check for P Waves and their morphology (upward, smooth, rounded), and ensure a 1:1 relationship between P wave and QRS complex. The QRS complex should be 0.06 – 0.12 seconds wide, and the PR Interval should be between 0.12 – 0.20 seconds. 5. Rate Analysis: The heart rate can be calculated by counting the number of QRS complexes in a six-second interval and multiplying by 10. This approach is less reliable if the rate is irregular. In summary, mastering EKG interpretation involves understanding specific rhythms and their characteristics, such as rate, rhythm regularity, P wave morphology, and intervals. Consistent practice and familiarity with these concepts are key to success on the NCLEX.