EKG Quick Reference Chart

Rhythm

Route
P Wave PR Interval

QRS

Rate
Rate

Rhythm
Regularity

Normal Sinus
Sinus Bradycardia

Normal
Normal

0.12-0.20
0.12-0.20

<0.12
<0.12

60-100
<60

Regular
Regular

Sinus Tachycardia

Normal

0.12-0.20

<0.12

>100, usually
100-150

Regular

No

Atrial Pause

Looks like SR but drops a complex Normal or

slow

Irregular

Saw
tooth

Regular or
Irregular

Depends on
length and
frequency
Dependant
on
ventricular
rate

Atrial Flutter

None

<0.12

Atrial rate
250-400

Life
Threatening
No
Dependant
on Cause

Causes
Normal Finding
Sleep, inactivity, athletic, vagal
tone, drugs, MI, K+, respiratory
arrest
Caffeine, exercise, fever, anxiety,
heart failure, drugs, pain, hypoxia,
hypotension, volume depletion
Elderly, digoxin toxicity, MI,
rheumatic fever
Valvular heart disease, MI, CHF,
pericarditis

Atrial Fibrillation

Wavy
None
unident
ifiable

<0.12

Atrial rate
>400

Irregular

Junctional
Rhythm

INVERT
ED
before
or after
QRS or
absent
INVERT
ED
before
or after
QRS or
absent
INVERT
ED
before
or after
QRS or
absent
Pointed
or
hidden
in T

<0.12

<0.12

40-60

Regular

<0.12

<0.12

60-100

Regular

Dependant
on
ventricular
rate

Digoxin toxicity, damage to AV

node

<0.12

<0.12

>100

Regular

Dependant
on
ventricular
rate

Same as SVT

Immeasur
able

<0.12

150-250

Regular

Dependant
on rate and
patient
ability to
tolerate

Caffeine, CHF, fatigue, hypoxia,

mitral valve disease, altered
pacemaker in heart

Accelerated
Junctional
Rhythm

Junctional
Tachycardia

Supraventricular
Tachycardia

Dependant
on
ventricular
rate
Dependant
on
ventricular
rate

Heart disease, pulmonary disease,

emotional stress, excessive
alcohol or caffeine
Electrical impulse not arriving
from SA node, AV node fires at
inherent rate

Idioventricular
Rhythm

None

None

20-40

Regular

Yes

Digoxin toxicity, acute MI

150-250

Regular

Yes, may
have pulse

MI, ischemia, digoxin toxicity,

hypoxia, acidosis, K+, BP

None

>0.11
wide and
bizarre
>0.11
wide and
bizarre
None

Ventricular
Tachycardia

None

None

Ventricular
Fibrillation

None

None

Yes, no
pulse

Follow PVC, VT, most common

cause of sudden death

None

None

None

Yes

1 AV Block

Possibl
e
Normal

Irregular, vary
in size, shape
and height
No QRS

Asystole

>0.20

<0.12

Varies

Usually Not

2 AV Block Type I

Normal

Varies:
progressiv
ly
prolonged

<0.12

Varies

2 AV Block Type
II

Normal

Consistent Normal or
normal or wide
prolonged

Usually slow

Regular or
irregular
Regularly
irregular: QRS
dropped after
progressively
prolonged PRI
Regular or
irregular;
occasionally
dropped QRS

Follows VT/VFib, acidosis, hypoxia,

K+, hypothermia, drug overdose
First sign of increasing AV block

3 AV Block

Normal

No
Wide
relationshi
p between
PR & QRS

Slow

Regular

Usually Not

Acute inferior MI, digoxin toxicity,

vagal stimulation, conduction
system disease

Dependant
on overall
ventricular
rate, may
progress to
3 AV Block
Yes:
pacemaker
needed

BBB, anterior MI, lesions of

conduction system

Atria and ventricles beat

independently, digoxin or K+
toxicity, acute MI, ischemic heart
disease

Premature Atrial
Contractions

Premature
Junctional
Contractions

Premature
Ventricular
Contractions

Yes,
PAC P
wave
shaped
differe
nt
Inverte
d
before
or after
QRS or
absent
None

May differ <0.12

from
underlying
rhythm

Rate of
underlying
rhythm

PAC
complexes
come early

No

Coffee, tea, alcohol, CHF,

emotions, fatigue, fever, hypoxia,
mitral valve disease

<0.12

<0.12

Rate of
underlying
rhythm

PJC make it
irregular

No

Vagal tone, stress, caffeine,

alcohol, heart failure, digoxin
toxicity, K+

N/A

>0.11
wide and
bizarre

Dependant
on
underlying
rhythm

Irregular due
to premature
beat

Depends on
frequency
and how
close to T
wave

Ventricular irritability, hypoxia,

K+, Ca, MI, digoxin toxicity,
anxiety