CARDIAC WAVEFORMS

DESCRIPTION APPEARANCE DURATION (SEC) POSSIBLE VARIATIONS (PATHOLOGICAL)

P wave: atrial depolarization. Upright, rounded 0.06 – 0.12 Atrial conduction disturbance

PR interval: impulse spread from atria to Beginning of P wave 0.12 – 0.20 Disturbance in AV node, bundle of His, or bundle
Purkinje fibers, immediately before – beginning of QRS branches. May also be in atria.
ventricular contraction

QRS interval: ventricular depolarization Beginning to end of 0.06 – 0.10 Disturbance in bundle branch conduction or ventricles.
(contraction) – systole. QRS complex.

ST Segment: time between ventricular Isoelectric (flat). N/A Ischemia, injury, infarction
depolarization and repolarization – diastole.

T wave: ventricular repolarization. Upright. N/A Electrolyte imbalances, ischemia, infarction.

QT interval: entire electrical depolarization Beginning of QRS 0.34 – 0.43 Drugs, electrolyte imbalances, changes in HR. Usually
and repolarization of the ventricles. complex to end of T affects repolarization.
wave.
 CARDIAC RHYTHMS
Pattern Rate and Rhythm P wave PR interval QRS Complex
Normal Sinus 60 – 100 beats/min, reg Normal Normal Normal

Sinus bradycardia <60 beats/min, reg Normal Normal Normal

Sinus tachycardia >100 beats/min, reg Normal Normal Normal

Pattern Rate and Rhythm P wave PR interval QRS Complex
Sinus arrhythmia 60 – 100 beats/min, Normal Not greater than 0.20 Normal
irregular

ATRIAL RHYTHMS
Premature atrial contraction (PAC) 60-100 beats/min, Abnormal shape Normal or variable Normal (usually)
irregular

Paroxysmal supraventricular tachycardia (SVT) 150-200 beats/min, regular Abnormal, may be Variable Normal (usually)
hidden
Pattern Rate and Rhythm P wave PR interval QRS Complex
Atrial flutter Atrial: 250-350 beats/min, Sawtooth shape Variable Normal (usually)
regular
Vent: >100 beats/min,
irregular

Atrial fibrillation Atrial: 350 – 600 Chaotic, fibrillatory Not present Normal (usually)
beats/min, irregular
Vent: >100 beats/min,
irregular or any rate
Pattern Rate and Rhythm P wave PR interval QRS Complex
AV BLOCKS
st
1 degree heart block Normal and regular Normal >0.20 sec, constant Normal

2nd degree heart block, Type 1 (Mobitz I, Atrial: normal, regular Normal Progressively lengthened Normal width, pattern of
Wenckebach) Vent: slower, irregular one non-conducted QRS

2nd degree heart block, Type II (Mobitz II) Atrial: Normal and regular More P waves than Normal or prolonged Widened, preceded by two
or irregular QRS or more P waves
Vent: slower and regular or
irregular
Pattern Rate and Rhythm P wave PR interval QRS Complex
3rd degree heart block Vent: 20-40 beats/ min, Normal, but no None. PR interval not Normal or widened, no
regular connection with related to QRS, more P connection with P waves
QRS waves than QRS

Junctional rhythms 40 – 140 beats/min, regular Inverted (may be Variable Normal (usually)
hidden)

VENTRICULAR RHYTHMS
Premature ventricular contraction (PVC) 60 – 100 beats/min, None Not present Wide and distorted
irregular
Pattern Rate and Rhythm P wave PR interval QRS Complex
Ventricular tachycardia (V tach) 100 – 250 beats/min, None None Wide and distorted
regular or irregular

Ventricular fibrillation (V fib) Not measurable and Absent Not present Not measurable
LIFE THREATENING irregular