The ECG Course

Adam  Thompson,  EMT-­‐P,  BAS  

Chapter  12  Ectopy  &  Aberrancy  

Premature Complexes

Premature Atrial Contraction

•  Rate:  Determine  underlined  rate  •  Rhythm:  Irregular  •  P  wave:  Present,  may  be  different  w/  PAC  •  P:QRS  raJo:  1  to  1  •  PR-­‐interval:  Normal,  may  vary  w/  PAC  •  QRS  Width:  <  120  ms  (0.12  sec)  

Premature Junctional Contraction

•  Rate:  Determine  underlying  rhythm  •  Rhythm:    Irregular  •  P  wave:  none,  antegrade,  or  retrograde  •  P:QRS  raJo:  1:1  or  retrograde  •  PR-­‐interval:  None,  short,  or  retrograde  •  QRS  Width:  <  120  ms  (0.12  sec)  

Premature Ventricular Contraction

•  Rate:  Determine  underlying  rhythm  •  Rhythm:    Irregular  •  P  wave:  None  with  PVC  •  P:QRS  raJo:  None  •  PR-­‐interval:  None  •  QRS  Width:  >  120  ms  (0.12  sec)  WIDE  

Ectopy

Terms  to  remember  

•  Bigeminy    -­‐  Every  other  beat  

•  Trigeminy  –  Every  third  beat  

•  Quadrigeminy  –  Every  fourth  beat  

•  Mul:focal  –  Different  shapes  (morphologies)  

•  Unifocal  –  Same  shape  (morphology)    

Ectopy

Ectopy

Ectopy

Ectopy

Ectopy

Escape Beats

Junctional Escape Beat

•  Rate:  Determine  underlying  rhythm  •  Rhythm:    Irregular  •  P  wave:  none,  antegrade,  or  retrograde  •  P:QRS  raJo:  1:1  or  retrograde  •  PR-­‐interval:  None,  short,  or  retrograde  •  QRS  Width:  <  120  ms  (0.12  sec)  

Ventricular Escape Beat

•  Rate:  Determine  underlying  rhythm  •  Rhythm:    Irregular  •  P  wave:  None  with  PVC  •  P:QRS  raJo:  None  •  PR-­‐interval:  None  •  QRS  Width:  >  120  ms  (0.12  sec)  WIDE  

Aberrancy

Aberrency

Ectopy & Aberrancy

Ectopy & Aberrancy

Ectopy & Aberrancy

Ectopy & Aberrancy

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