The New York State Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This course has been awarded 1.5 contact hours.

Electrocardiograms Made Easy! is a series of three courses comprised of: Basic EKG Interpretations, Interpreting Abnormal Atrial Rhythms, and Interpreting Ventricular Dysrhythmias.

This final course of the series will discuss ventricular dysrhythmias, many of which need immediate intervention or are not supportive of life. It builds from the previous concepts learned from Basic EKG Interpretations and Interpreting Abnormal Atrial Rhythms. In learning about ventricular dysrhythmias, we will advance the concepts related to electrical physiology and the electrocardiogram, focusing on different rhythm presentations, and the mechanical and electrical process involved. To achieve this, the pathophysiology behind differing dysrhythmias will be presented, allowing conceptualization of the mechanical/electrical processes occurring in the dysfunctional cardiac cycle. This assumes that the learner is competent in the basic electrocardiogram principles. If needed please refer to the first two courses in this series.

Cardiovascular disease is composed of heart disease and cerebrovascular accidents (strokes).  Respectively they are the leading and third leading cause of death in the United States.  Together they account for the death of more than 1.3 million Americans each year (Centers for Disease Control and Prevention [CDC], n.d.).  More broadly, 80 million Americans (almost one third of the population) suffer from some form of cardiovascular disease (CDC, n.d.).  With tightening purse strings, the impact of cardiovascular diseases on healthcare resources is astounding.  The Center for Disease Control and Prevention (CDC) estimates that in 2008 the cost of cardiovascular disease to the economy was over $448 billion (CDC, n.d.).  So what does this mean to me?

As active participants in healthcare you will undoubtedly come in contact with the 1 in 4 Americans who have cardiovascular disease. This contact may be in any setting, from an emergency department, surgical ward, rehabilitation or your own family home. So it is important to be familiar with and understand the basics of one of the easiest, most cost-effective, non-invasive tests performed to assess cardiac function: the Electrocardiogram. It is important to be able to interpret electrocardiograms in order for the skilled Registered Nurse to initiate timely interventions.

Content Outline

• Ventricular dysrhythmia etiology
• Ventricular dysrhythmias
  1. Premature ventricular contraction (PVC)
  2. Idioventricular rhythm
  3. Accelerated idioventricular rhythm
  4. Ventricular tachycardia
  5. Ventricular fibrillation
  6. Asystole
• Pacemaker rhythms
• Atrioventricular blocks (AV blocks)
  1. First-degree block
  2. Second-degree block type I
  3. Second-degree block type II
  4. Third-degree block (complete heart block)

Course Objectives

Upon the completion of this course the learner will be able to:

• Identify dysrhythmias not supportive to life
• Identify which rhythm indicates a block and requires immediate intervention
• Explain why a P wave may not be visible