Rate and Rhythm | Atrial Fibrillation and Atrial Flutter
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- Опубликовано: 22 янв 2025
- www.gofundme.c...
Ninja Nerds,
Join us for our Electrocardiogram (ECG) playlist. During this lecture we will continue on rate and rhythm and discuss atrial fibrillation and atrial flutter. Download the template below to follow along and learn how to calculate rate, interpret rhythm, and observe for any abnormalities within this real 12-lead ECG strip.
ECG strip: Jason Winter @ ECG Educator
DOWNLOAD the Atrial Fibrillation and Atrial Flutter templates to learn while you watch!
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Your videos are ever so useful! Just wish you could make the pointer more visible. Sometimes it's difficult to keep track of where you are pointing 😅
Agree
couldnt agree more about the pointer
god yes, i thought i was missing something
Agree
agree
Honestly, I am currently in PA school right now in our Cardio module learning about EKG through ZOOM due to COVID-19, these videos are literally SAVING me from a lot of headaches because I did not understand what our professor was talking about. THANK YOU for making learning EKG fun and totally understandable. I WILL CONTINUE to donate and support your gofundme page since I will be on this page for other modules as well. It looks like these EKG videos are pretty new, and it couldn't' have come at a better time. THANK YOU SO MUCH and continue to post during these trying times. They say doctors save lives, well you save our lives or any future health care by sharing your amazing knowledge with us
If anyone is wondering how he got 300 for the atrial rate for A-fib, the pointer is by V1. 7:25 - 7:33
Thank you
Thank you so much. I was really struggling
Thank you 😊
These videos have first helped me to get introduced to a particular topic, and incredibly these same videos further my basic understanding into a more broad and thus useful tool to care for patients. Two Ninja thumbs up!
After so much of hunting finally found this ninja nerd science ... its really really useful .. ur patience ur diagrams, thank u sooo much pls don’t stop ur good work
It's awesome to finally see this series
I have a final about this next week. Thanks for being there as always.
Thank you so much for the video I’m studying for my ACSM CES exam and I need the review the last time I learned a EKG was 7 years ago. This is refreshing
Can’t stop watching your videos
i already searched for so many ecg videos and these are definitely THE BEST! Thank you so much :)
difficult to follow where you're pointing at
wish the cursor could be bigger and you can zoom in the particular place during your explaining
But really thank you!!!!
yes
same
Your ECG videos are the BEST, thank you 🙏🏻
so far your videos...are one of the best...helping a lot students...to understand the pathophys of many subjects...
I learned so much this is the best way to teach this honestly
You could make videos analyzing X-rays. To interpret them is very difficult sometimes too.
Best one Wallah❤🙏
Very clear explanations!!! Thanks a lot 🙏🏻🙏🏻🙏🏻
It would be awesome if you could project those EKG's on the whiteboard so we could follow you easier. I'm a VERY visual person and watching you draw things is SO helpful!
Dang it can be so hard to see where he is writing/pointing i.e. at 7:21
Great Lecture! My only comment is that when you are showing a point on the graph that is small it is sometimes difficult to see where you are.
You are wonderful , please keep doing this !
Best explanation ever 👏🏻
That fresh vid great quality dude keep up with the great work
You are amazing, the way you understand and explain is so fabulous. Would you please explain the physiology of fatigue and pain! Any tips will be greatly appreciated regarding those physiology. Thank you.
Loved the explanation. Thank you.
THE POINTERSSSS! Love the video but wished I could track where you're poiting at!
At 7:24 you are saying the distance between this fibulatory wave and this fibulatory wave. But nothing can be seen on the screen. Which wave are you saying.
when you are measuring the fib rate, I don't see where you are pointing to determine rate is over 300. please help is so confusing thank you but I love your work is super awesome.
Best videos ever on the subject! Just would like to understand what cause the AF to occur?
Watch his video on arrhythmias. I think he said it's Eads or Dads. Not sure. But has to do with trigger activity
Great to know because I have been suffering with this for 20 years😖
1. Rate: normal, tachycardia, bradycardia
2. Rhythm
- R-R interval: regular, irregular (almost always a fib, multifocal atrial tachycardia, ectopic rhythm like some aberrant conduction like PAC PVC)
- P wave: sinus (II +, aVR -)[if inverted: lead misplaced, dextrocardia, ectopic rhythm], ectopic (atrial ectopic rate > 60 abnormal p wave or retrograde), junctional (AV node rate 40-60 might be retrograde p wave too cause might be SA node damage), idioventricular (Purkinje fibers rate 20-40 looks like PVC also it might be accelerated to a rate of 60), if irregular and no distinguishable p wave look for fibrillatory waves in V1 or II then it's a fib. If not sure about II look at III avf, saw tooth abnormal p wave is atrial flutter F wave
- P -> QRS: AV association, heart block, AV dissociation (if no p wave then it is dissociation), Ratio of p to qrs 3:1 (dissociation) or 1:1 (association)
- QRS: narrow, wide (VT, junctional rhythm, aberrant conduction down the bundle branch system)
Remember rate means ventricular rate
Rate
60 100 normal
100 150 tachycardia
150 250 SVT
250 350 flutter (Atrial or ventricular)
350 450 fibrillation (Atrial or ventricular)
Ventricular flutter almost always progresses to ventricular fibrillation
Irregular rhythm narrow QRS and fibrillatory waves in II V1 no p wave = a fib
A fib has rate of 350 450, we ar talking about atrial rate here
P wave like Saw tooth = flutter
Ratio of p to qrs 3:1 or 1:1
Most common ratio is 2:1
Typical a flutter = Saw tooth is upward in V1 and downward in II III avf
Thank you so much for these videos.
I will wait for your next lesson
i love the work u guys do. U guys have helped me a lot throughout the years. just a quick favor. Could you talk more about skeletal and integuementary. Skeletal, specifically the physiology of like functions as well as ossification
Where did the Lead II strip from the top right come from? Is that a strip from the same ECG? Why is it different than the ECG recording on the left?
Thankyou somuch for This masterpiece video thankyou very much
awesome 👏🏼 please make more videos about ecg ❤️
I love your teaching, this one however is hard to follow
Hi, question? Why in the Atrial flutter slide the rate between the 10sec strip and 6sec strip is so different? 150 vs 70? Thanks!!!!
I think that the lead II 10sec strip is actually from a different ECG and that's why the rhythms are so different. I mean, in the left ECG there is regular rhythm while in the 10sec strip it's clearly irregular. They're definitely from different patients/recordings.
Im wondering because the lead ll measurement is 70 but that looks like a 6 sec strip not a 10 . So how did we multiply it by 10?
It's a different ECG. When it's a 6 second strip you multiply by 10. When it's a 10 second strip you multiply by 6.
I got a question, why did he say the ratio is 1:1, not like 1:3 or 3:1 in 12:50? Thanks
Keep it up guys awesome content
Thank you so much, sir.
Woow best explanation
12:30 I thought this would be 2:1 aflutter..?
It iss, i guess he made a mistake
Usually a ventricular HR of 150/min is indicative of 2:1 a flutter and a ventricular HR of 300/min is indicative of a 1:1 flutter
You're the best!
Pointer wasn’t very easy to keep up with. Need to use something different. Great video’s.
I have just been diagnosed with Atrial Flutter so this is really interesting. Thanks.
@Anonymous alien I used an Apple watch, which has a single lead ECG function. I recorded my heart playing up during exercise. I can always see my heart rate go up on my Garmin heart monitor. I gave the recording to my cardiologist for diagnosis. I'm now booked in for an ablation.
Would be nice if you would sometimes speak of the treatment aswell
Thank you 😊
Is it not a rate of around 110? 6 second strip x10 for a 60 second rate?
thank youuuu but i have qs why there is two rates one is 150 and the other is 70 ???
looks like they are 2 different example strips count the large boxes on both you will see the rate difference in the R-R.
Can you please point out where you are by moving the pointer 😮
So great .. thank u
Sir is it possible that an ECG of atrial fibrillation the rate will be brady?
AWESOME thank you ❤
are the t waves hidden in the sawtooth waves for the second example??
7:31 where are you pointing at ?
AMMAZING!!!
Hi, thank you so much for this lecture, it helped me a lot as a new cath lab nurse! And would you be so kind to answer my questions please? :D If we go to A-fib ecg: Yes, the ventricular rate is 66 bpm, and it's not atrial rate because we are counting the R wave there. Then at the end A-fib is around 350 to 450 bpm, but in identifying the P-wave, there was none. How can we really determine if it's Afib? There should be P waves, isn't it? And what will be the correct HR of the patient we are currently assessing if he/she has AFib? Sorry for my silly questions. :D Thank you!
very useful video...please put a bigger pointer
Very useful 👌 make ur marker visible i find very difficult to trace that
can you please explain one more time around 7:30 why it is 300 bpm A.Fib , i thought you count how many boxes between R.R interval....for Rate...as you did to other EKG
The atrial rate is P to P which would be 300 beats/min. The ventricular rate is from R wave to R wave which is variable.
Thank you for quick reply....and so the Rate...we are talking about A.Fib is depending on P.P then...thus when we r taking about V.Fib then we use RR...is that corrected....thank you in advance....
As good as possible
Can't see anything on ECG. Please do something.
Very difficult to see your cursor on P wave , qrs, lead 2 etc . Help if larger or a different color
very easy to understand video,but its also difficult to understand if you can't see what is being pointed at.
What does it mean to have 2:1 AV conduction ?
Means 2 p waves to every 1 R wave.
On the second one, i would diagnose it as atrial flutter with Variable AV conduction ratio cause its not consistent at all in lead 2
Sir, how to calculate atrial flutter and fibrillation rate ? Any formula
so good 😭why do i bother using other resources
why are you not using 6 second rythm strip? how do we know when to use 6 or 10 second rythm strip? in previous video you explained bc there are 6 second rythm strip,, here's also the same,,
I have a question ??? In lead ll , theres a different strip but that looks like a 6 sec strip not a 10 .So how did we come up with 7 into 10??? I hope u respond
@Ninja Nerd, I can't see the pointer! :'( Love your videos..please solve it.
yea, you didn't explain how to calculate the atrial rate for atrial flutter
Plz when u marking its not seen clear ( on ecg strip )
For a flutter example, is the separate lead Ii only strip from the same patient? I was confused by 1:1 in 12 lead and 3:1 on the separate strip...?
Thanks sir😊
Atrial fibrillation can be seen even at 100bpm?
I don't get it, why is the first ECG not Atrial flutter? Atrial flutter with variable conduction? Isn't that the saw toothed pattern in V1 after the QRS?
Couldn’t see the pointer some of the times. But great job explaining.
THANK YOU
Can you compute the QT interval when the rhythm is atrial flutter?
good video
How do I enroll at Ninja Nerd University?
Support his patreon account.
Thank you sir
thank you
love! thank you!
Always love your videos but at several areas, I couldn't see where you were pointing to, so it interrupts focus
Thanks for the videos, they are amazing. But I didn't understand, you show LEFT ECG with HR 150 (after every P appears QRS complex, AV association, R-R is regular, so it means rhythm is sinus tachy) and the RIGHT ECG with AV dissociation, ventricular rhythm 70 bts/min, and atrial rhythm close to 300. So, I didn`t understand where on LEFT ECG is atrial flutter ( ok, i see sharp P-waves = F-waves, but there is AV association and HR is 150). Thanks for your answer!
Thanks
How am I supposed to see when there's no cursor?
Why is lead 2 6sec rate diff from R wave *6 ( 70 and 150)
Bundle branch system? You mean bundle of his?
literally just in timee
Thanks a lot! :)
I was really struggling to find his pointer.
Hi Ninja Nerd, I am from Ethiopia and Year 1 Internal Medicine resident. I keep watching your Videos they are the best in internet by far to this day from the videos I watch. please would you release videos on Hypo/Hypernatremia?
Thank you!!!!!!!
Are you saying “Saul tooth” instead of saw tooth
תודה!!
What is it when your heart beats rapidly 3 or 4 times then pauses. Then does it again then pauses. Then does it again then pauses