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Stable And Unstable Tachycardia

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sinus tachycardia

RULES FOR SINUS TACHYCARDIA

REGULARITY R-R intervals are regular, overall rhythm is regular.
RATE The rate is over 100 bpm but usually less than 170 bpm.
P WAVE There is one P wave in front of every QRS. The P waves appear uniform.
PR INTERVAL Measures between 0.12 and 0.20 seconds in duration. PRI is consistent.
QRS Measures less than 0.12 seconds.

atrial flutter

RULES FOR ATRIAL FLUTTER

REGULARITY The atrial rate is regular. The ventricular rate will usually be regular, but only if the AV node conducts the impulses in a consistent manner. Otherwise, the ventricular rate will be irregular.
RATE The atrial rate is normally between 250-350. Ventricular rate depends on conduction through the AV node to the ventricles.
P WAVE The P waves will be well defined and have a “sawtooth” pattern to them.
PR INTERVAL Due to the unusual configuration of P waves, the PRI is not measured with atrial flutter.
QRS Measures less than 0.12 seconds.

atrial fibrillation

RULES FOR ATRIAL FIBRILLATION (A-FIB)

IRREGULAR NARROW COMPLEX TACHYCARDIA = A-FIB

REGULARITY The R-R intervals are irregular; therefore, overall rhythm is irregularly irregular. The ventricles conduct from different atrial foci causing the irregularity.
RATE Atrial rate usually exceeds 350. If the ventricular rate is between 60 and 100 bpm, this is known as “controlled” A-Fib. If the ventricular rate is more than 100, it is considered A-Fib with Rapid Ventricular Response (RVR), also known as uncontrolled A-Fib.
P WAVE Due to the atria firing so rapidly from multiple foci, there are no obvious P waves in the rhythm. The baseline appears chaotic because the atria are fibrillating, therefore no P waves are produced.
PR INTERVAL Because there are no P waves, PRI cannot be measured.
QRS Measures less than 0.12 seconds.
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