Identify Rhythm, hr, regular,diogenes, qqrs duration normal?
Reading File
Here is a systematic analysis of this ECG:
ECG Analysis
1. Rhythm
Non-sinus tachycardia — as annotated on the image. There are no clearly visible discrete P waves before each QRS, or if present they are retrograde/hidden within the QRS/ST segment. This is consistent with a junctional or re-entrant supraventricular tachycardia (SVT).
The handwritten annotation confirms: ① Non-sinus, ③ SVT.
2. Heart Rate (HR)
The annotation shows the calculation:
HR = 300 ÷ 1.6 ≈ 187–190 bpm (written as ~180+ bpm)
Using the large-box method: there are approximately 1.6 large boxes between R-R intervals → 300 ÷ 1.6 ≈ ~188 bpm.
3. Regular or Irregular?
Regular — the annotation confirms ② Regular. The R-R intervals appear uniform throughout the strip, which is characteristic of SVT (AVNRT or AVRT).
4. Diagnosis
SVT — as annotated ③. Given:
- Non-sinus origin
- Regular rhythm
- Rate ~188 bpm
- Narrow QRS (see below)
Most likely AVNRT (AV nodal re-entrant tachycardia), the most common form of SVT.
5. QRS Duration — Normal?
Yes — QRS duration appears narrow/normal (< 120 ms). The QRS complexes are tall and narrow without obvious bundle branch block morphology. Narrow QRS + regular + fast rate + non-sinus = classic narrow-complex SVT.
Summary Table
| Parameter | Finding |
|---|---|
| Rhythm | Non-sinus (SVT — likely AVNRT) |
| Heart Rate | ~188 bpm |
| Regular? | Yes — regular |
| Diagnosis | SVT |
| QRS Duration | Normal (narrow, < 120 ms) |
Key teaching point: Regular, narrow-complex tachycardia at ~150–250 bpm without clear sinus P waves = SVT until proven otherwise. Vagal maneuvers or adenosine are first-line to terminate and confirm the diagnosis.
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