Arranged by

Hosam Ghanem ,MD

Damascuss university , Mars , 2006

Before you go through this breaf review ,please have a look to Alagha algorythm of arrhythmias.

During this review try to diagnose before you see it written

Normal sinus rhythm

Sinus bradycardia

Sinus tachycardia

Wandering pacemaker

Atrial flutter

Atrial fibrillation

Junctional rhythm

Premature ventricular contraction

Time interval between normal R peaks is a multiple of R-R intervals

Wide ventricular complexesRate> 120/min

Ventricular tachycardia

Ventricular fibrillation

Pacer rhythm

Wide ventricular complexes preceded by pacemaker spikeRate is the pacer rhythm

P-wave precedes each QRS-complex but PR-interval is > 0.2 s

First-degree atrioventricular block

Intermittently skipped ventricular beat

Second-degree atrioventricular block

P-P interval normal and constant,QRS complexes normal, rate constant, 20 - 55 /min

Third-degree atrioventricular block

RIGHT BUNDLE-BRANCH BLOCKQRS duration greater than 0.12 sWide S wave in leads I, V5 and V6

LEFT BUNDLE-BRANCH BLOCKQRS duration greater than 0.12 sWide S wave in leads V1 and V2, wide R wave in V5 and V6

LEFT ATRIAL HYPERTROPHYWide, notched P wave in lead IIDiphasic P wave in V1

RIGHT ATRIAL HYPERTROPHY

Tall, peaked P wave in leads I and II

RIGHT VENTRICULAR HYPERTROPHYLarge R wave in leads V1 and V3

Large S wave in leads V6 and V6

LEFT VENTRICULAR HYPERTROPHYLarge S wave in leads V1 and V2

Large R wave in leads V6 and V6