Welch Allyn Means ECG Physicians Manual for CP Series Electrocardiographs - User Manual - Manual (Page 50)

MEANS Physicians Manual
Welch Allyn
50
3.14 Group 11: Irregular rhythms with 0.15 < P/QRS

0.9 and PR range > 30 ms
If the number of P waves is small, no further specification of the atrial rhythm is given.
Otherwise, it is tested whether there exists a second degree AV block of the Wenckebach
type. Three conditions should be met for this test to pass: (1) the maximal RR interval should
exceed the minimal RR interval by at least 40%, (2) the RR interval preceding the longest RR
interval should be shorter than the one following the longest RR interval, and (3) the shortest
PR interval should be found in the longest RR interval. If this test fails, a distinction is to be
made between AV dissociation and sinus rhythm with ectopic complexes of supraventricular
origin.
Say: “undetermined atrial rhythm with block and/or interference in the AV junction”
“consider atrial fibrillation”
if: P/QRS ratio < 0.3
Say:
“sinus rhythm with second degree AV block, type I (Wenckebach)”
if: P/QRS ratio  0.3
and test Wenckebach passed
Say:
“undetermined atrial rhythm with block and/or interference in the AV junction”
if: PR range > 120 ms
Say:
“supraventricular escapes, cause? eg AV block, SA block?”
if: 60 < PR range  120 ms
and heart rate < 50 BPM
Say:
“consider supraventricular escapes, cause? eg AV block, SA block?”
if: 30 < PR range

60 ms
and heart rate < 50 BPM
Say:
“premature atrial complexes”
if: 60 < PR range

120 ms
and heart rate

50 BPM
Say:
“consider premature atrial complexes”
if: 30 < PR range

60 ms
and heart rate

50 BPM
Say:
“sinus bradycardia”
if: heart rate < 50 BPM
Say:
“sinus rhythm”
if: 50

heart rate < 100 BPM
Say:
“sinus tachycardia”
if: heart rate

100 BPM