Welch Allyn Means ECG Physicians Manual for CP Series Electrocardiographs - User Manual - Manual (Page 49)

MEANS Physicians Manual
Welch Allyn
49
3.13 Group 10: Irregular rhythms with 0.15 < P/QRS

0.9 and PR range

30 ms
First, a test is made on the alternation of RR intervals with and without a P wave to rule out a
bigeminal rhythm due to sinus rhythm with atrial or AV junctional premature complexes. If a
bigeminal rhythm is found the program halts. If not, tests are performed on each RR interval
in which no P wave has been detected. If the interval is shortened, a premature
supraventricular complex is assumed; if it is prolonged, an AV junctional escape is assumed.
The shortened or prolonged RR intervals are deleted after they have been analyzed and the
program continues with the logic for rhythms with constant PR intervals.
Say: “bigeminy: sinus rhythm with alternate premature supraventricular complexes”
if: P/QRS ratio

0.4
and test bigeminy passed
Say:
“premature supraventricular complexes”
if: test PSVC passed
and test bigeminy failed
Say:
“AV junctional escapes, cause? eg SA block or AV block?”
if: test escape passed
and test bigeminy failed
Say:
“consider premature supraventricular complexes”
if: test bigeminy failed
and test PSVC failed
and test escape failed