So the first rhythm that we'll be speaking about is what we call a normal sinus rhythm. Now a normal sinus rhythm has a P wave. The P wave is close to the QRS complex, it is regular. The QRS complex is narrow and there is a p for every QRS complex. So a normal sinus rhythm has a heart rate typically between 60 and 100 beats per minute. Now let's just break this down.

We do see a P wave. The P wave is close to the QRS complex. The QRS complex is nice and narrow. And we also see a T wave which represents the repolarization of the heart. You'll notice the rhythm looks really nice and keep in mind the rate should be between 60 and 100 beats per minute. So the next one we'll talk about is sinus bradycardia sinus bradycardia is a heart rate of less than 50 beats per minute.

As you can see, we do have a regular rhythm. The QRS complex is narrow. The P wave is close to the QRS complex. There is a P wave for every QRS complex, and the P wave remains in the same spot for every QRS complex. by answering these questions, we can identify this as sinus bradycardia. Also, keep in mind that we can't call anything sinus in nature unless we see a P wave.

Now, how do we know how fast the heart is actually beating just by looking at a picture of a cardiac cycle. So most pictures that we'll be seeing, or all pictures that we'll be seeing today is going to be a six second snapshot of that cardiac rhythm. So with that said, the easiest way for us to determine how fast the heart is beating is let's go ahead and count those are waves. Now the our waves are the peak of the QRS complex. If we can count those and multiply them by 10, then we should get how many beats per minute, the heart is actually beating. Fantastic.

Sounds like you're catching on. So now let's talk about sinus tachycardia. sinus tachycardia is extremely easy to identify. It has a heart rate of somewhere over 100 beats per minute, up until about 149 beats per minute, and I'll explain that just a little bit further later. But let's break this down by asking ourselves the same six questions. Ready?

Let's begin. Is it fast or slow? Is it regular? Or is it irregular? Is your QRS complex narrow or is it wide? Do you see a P wave?

Is there a P wave for every QRS complex? And is the P wave in the same spot for every QRS complex? If you've answered those questions correctly, you've correctly identified sinus tachycardia. Nice work. Now, the next thing I'd like to talk about is going to be SVT or supraventricular tachycardia. Let's break those words down super just means up.

Ventricular is actually the bottom of the heart. So this this heart rate is originating above the ventricles. So super ventricular tachycardia. tachycardia just means the heart is beating fast. So here's how to identify lsvt. SVT is typically a heart rate of greater than 150 beats per minute, all the way up to about 200 to 300 beats per minute, but don't hold me to that.

Sometimes we see them faster and sometimes we see them a little bit slower. But the main thing to identify with SVT is the absence of a P wave. So the heart is just beating so fast that the P wave gets buried. In the QRS complex, and what you're actually seeing here are the T waves, the repolarization period of the heart just trying to catch up to itself, because it's beating so fast. So let's ask ourselves the same six questions. I know redundant, Rodney, right.

But the more redundant I am, I think the better you'll catch on here. So let's ask those questions. Is it fast? Or is it slow? Is it regular? Or is it irregular?

Do you see a P wave? Hmm. Is the QRS complex, narrow, or is the QRS complex wide? Now if we don't see a p way, we can't ask ourselves any more of those questions. So basically, what this is telling us is, we don't have a P wave, but we can't prove one is there so we can't use the word sinus anymore. So we will call this SVT or super ventricular tachycardia.

Now we have to backpedal a little bit here because we truly can't hold us rhythm SPT until we rule out two other arrhythmias that can actually hide within itself or within the svt. I know it's a little confusing. But once again, we're not going to call this true SVT until we can rule out to other arrhythmias. Any idea what those two other words me Azhar, I'll give you a hand. They're both narrow complex tachycardia is any idea. Alright, so we have a fib and a flutter, and we'll talk about a fib and a flutter here in just a second.

So, a fib is a narrow complex tachycardia. Typically, it is an irregular rhythm. The QRS complex is nice and narrow. And you'll notice here, you don't see a P wave, you see a bunch of squiggly lines so there's really no discernible P wave. And again, the rhythm is irregular. So how identify this as by simply using just a couple of different words or phrases.

Narrow, your regular, no discernible P wave. That pretty much tells us that this is a fib. So here's what's happening with a fib. The top of the heart is quivering or fibrillation, just as it says. And then the QRS complexes are firing whenever they want to whenever they think that they're getting information from the P wave, but they're actually becoming confused at this point. Now, a fib is one of the most common arrhythmias that most people have in the world today.

It's very treatable, and it's usually benign, all the bad things can happen with it, but that's a whole nother class. So once we've identified a fib, we can move on to help ourselves identify a flutter. To me a flutter is one of the most beautiful rhythms that that you can actually see on an EKG tracing or a cardiac monitor. So what's happening with a flutter here, you can tell the QRS complex is nice and narrow. Now with a flutter The rhythm could be irregular, or it could be irregular. But regardless, the QRS complex is nice and narrow.

What you'll see are these sawtooth patterns, and you can see them here. So you can either have two or three sawtooth marks in between each QRS complex. So basically how I like to identify a flutter is, I think of it as a butterfly flapping its wings, flap, flap, flap, flap, flap, flap, and then you get your QRS complex will have been tricky. The response between those flapping wings, it's extremely easy to identify a flutter. And again, it's one of the most beautiful rhythms that I like to watch. So, again, just as a reminder, we can't call SVT true SVT until we rule out a fib, or a flutter.

Now, how do you rule it out? Well, that's not in this course. You'll have to visit me at a later time to talk about the treatments and modalities for determining a fib a flutter When we think it's SVT but that's another class