Agonal Rhythm - Course # 315-6


  • This is a life-threatening dysrhythmia. Agonal rhythm is often the last ordered semblance of organized electrical activity in the heart prior to death.
  • Heart rate is less than 20 bpm, without P waves and a wide, bizarre QRS complex.
  • The rate is often so slow, that on a singular six-second rhythm strip it will be impossible to determine whether the rhythm is regular or irregular. There must be at lest three complexes on the tracing to make this call. Many times there will only be one or two complexes captured on the tracing.
ventricular ecg image 111

Practice Strip

  • Analyze this tracing using the five steps of rhythm analysis.
  • Compare your answers with the answers on the next slide.

ventricular ecg image 112


  • Rhythm: Cannot determine (only two complexes)
  • Rate: 20 (using the six-second technique)
  • Rate: 14 (using the 1500 technique – 110 small boxes/1500)
  • P Wave: absent
  • PR interval: n/a
  • QRS: Wide and bizarre 0.20 sec
  • Interpretation: Idioventricular Rhythm
ventricular ecg image 112b

315 Agonal Rhythm - Course # 315-6