This page provides an introduction to ventricular rhythms and links to training materials on this website.
When the ventricles handle the pacemaking role,
they can be observed on EKG tracings.
This website and related websites provide training, practice drills and quizzes
related to ventricular rhythms.
There are several type of ventricular rhythms:
- Accelerated Idioventricular Rhythm
- Idioventricular Rhythm
- Premature Ventricular Complex
- Premature Ventricular Complex - Bigeminy
- Premature Ventricular Complex - Trigeminy
- Premature Ventricular Complex - Quadrigeminy
- Ventricular Fibrillation
- Ventricular Tachycardia
- Ventricular Tachycardia Monomorphic
- Ventricular Tachycardia Polymorphic
- Torsade de Pointes
Ventricular Rhythm Types
Accelerated Idioventricular Rhythm
Accelerated idioventricular rhythm occurs when three or more ventricular escape beats appear in a sequence. Heart rate will be
50-100 bpm. The QRS complex will be wide (0.12 sec. or more).
Asystole is the state of no cardiac electrical activity and no cardiac output. Immediate action is required.
Idioventricular rhythm is a slow rhythm of under 50 bpm. It indicates that then ventricles are producing escape beats.
Premature Ventricular Complex
Premature ventricular complexes (PVCs) occur when a ventricular site generates an impulse. This happens
before the next regular sinus beat. Look for a wide QRS complex, equal or greater than 0.12 sec. The QRS complex
shape can be bizarre. The P wave will be absent.
Premature Ventricular Complex - Bigeminy
Premature Ventricular Complex - Trigeminy
Premature Vent. Complex: Quadrigeminy
Ventricular fibrillation originates in the ventricles and it chaotic. No normal EKG waves are present. No heart rate can be
observed. Ventricular fibrillation is an emergency condition requiring immediate action.
A sequence of three PVCs in a row is ventricular tachycardia. The rate will be 120-200 bpm. Ventricular
Tachycardia has two variations, monomorphic and polymorphic. These variations are discussed separately.
Ventricular Tachycardia Monomorphic
Monomorphic ventricular tachycardia occurs when the electrical impulse originates in one of the ventricles.
The QRS complex is wide. Rate is above 100 bpm.
Ventricular Tachycardia Polymorphic
Polymorphic ventricular tachycardia has QRS complexes that very in shape and size. If a polymorphic ventricular tachycardia
has a long QT Interval, it could be Torsade de Pointes.
Torsade de Pointes
Torsade de Pointes is a special form of ventricular tachycardia. The QRS complexes vary in shape and amplitude and
appear to wind around the baseline.