Pediatric ECGs: Difference between revisions

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|+ Distinguishing tachyarrhythmias in infants
|+ Distinguishing tachyarrhythmias in infants
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! Sinus tachycardia
! style="width:200px" | Sinus tachycardia
! SVT
! style="width:200px" | SVT
! Atrial flutter
! style="width:200px" | Atrial flutter
! VT
! style="width:200px" | VT


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| History
| valign="top" | History
| Sepsis, fever, hypovolaemia, etc.
| valign="top" | Sepsis, fever, hypovolaemia, etc.
| Usually otherwise normal
| valign="top" | Usually otherwise normal
| Most have a normal heart
| valign="top" | Most have a normal heart
| Many with abnormal heart
| valign="top" | Many with abnormal heart


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| Rate
| valign="top" | Rate
| Almost always <230 b/min
| valign="top" | Almost always <230 b/min
| Most often 260–300 b/min
| valign="top" | Most often 260–300 b/min
| Atrial 300–500 b/min. Vent. 1:1 to 4:1 conduction
| valign="top" | Atrial 300–500 b/min. Vent. 1:1 to 4:1 conduction
| 200–500 b/min
| valign="top" | 200–500 b/min


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| R-R interval variation
| valign="top" | R-R interval variation
| Over several seconds may get faster and slower
| valign="top" | Over several seconds may get faster and slower
| After first 10–20 beats, extremely regular
| valign="top" | After first 10–20 beats, extremely regular
| May have variable block (1:1, 2:1, 3:1) giving different ventricular rates
| valign="top" | May have variable block (1:1, 2:1, 3:1) giving different ventricular rates
| Slight variation over several beats
| valign="top" | Slight variation over several beats


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| P wave axis
| valign="top" | P wave axis
| Same as sinus almost always visible P waves
| valign="top" | Same as sinus almost always visible P waves
| 60% visible P waves, P waves <em>do not</em> look like sinus P waves
| valign="top" | 60% visible P waves, P waves <em>do not</em> look like sinus P waves
| Flutter waves (best seen in LII, LIII, aVF, V<sub>1</sub>)
| valign="top" | Flutter waves (best seen in LII, LIII, aVF, V<sub>1</sub>)
| May have sinus P waves continuing unrelated to VT (AV dissociation), retrograde P waves, or no visible P waves
| valign="top" | May have sinus P waves continuing unrelated to VT (AV dissociation), retrograde P waves, or no visible P waves


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| QRS
| valign="top" | QRS
| Almost always same as slower sinus rhythm
| valign="top" | Almost always same as slower sinus rhythm
| After first 10–20 beats, almost always same as sinus
| valign="top" | After first 10–20 beats, almost always same as sinus
| Usually same as sinus, may have occasional beats different from sinus
| valign="top" | Usually same as sinus, may have occasional beats different from sinus
| Different from sinus (<em>not</em> necessarily ‘wide’)
| valign="top" | Different from sinus (<em>not</em> necessarily ‘wide’)


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