How emergency clinicians determine regular vs. irregular

April 14th, 2015
by reuben in arrhythmia, ecg

Cardiologists use calipers. Intensivists write little marks on a page and march them across. Emergency providers fold the ECG in half and hold it up to the light. Or the sun.


Fold the tracing in half. Hold up to the light.
















Now align the QRS complexes. The rhythm is regular.

2 regular rhythm overlap
















Here is another example.

3 irregular rhythm prelim fold

















Irregular. Cannot line up QRS complexes.

4 irregular rhythm overlap




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Responses to “How emergency clinicians determine regular vs. irregular”

  1. I do the same to detect dynamic ischaemic changes (if in doubt). Put an earlier ECG on an XR lightbox or on a white part of a computer screen. Line up a QRS complex from your latest ECG with a QRS complex from the previous ECG on the lightbox and compare the ST segments or T wave. It might raise your index of suspicion in that particular patient.

    evertgips at

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