Welch Allyn Cardioperfect Workstation, PEDMEANS ECG Interpretation Module - Physicians - User Manual - Manual (Page 33)

CardioPerfect Workstation
PEDMEANS ECG Interpretation Module Physicians Manual
DIR 80015051 Rev. C 33 / 55
Adaptation of statements
The program classifies the non-dominant complexes before it classifies the rhythm, assuming both
classifications do not interfere. However, in the presence of atrial fibrillation, atrial flutter, atrial
tachycardia, second degree AV block, or advanced AV block a detailed classification of non-dominant
complexes is considered too difficult. Any statement on sequences, doublets or isolated non-dominant
complexes will then be replaced with the general statement:
“premature ventricular complexes or aberrantly conducted complexes”
3.6 Group 3: Rhythms with atrial flutter or tachycardia
In atrial flutter the atrial activity is represented in the ECG by regular, saw-tooth like oscillations (F
waves) which occur at rates between 220 and 400 beats per minute (BPM). The measurement part of
the program contains a routine for the detection of F waves. If F waves are detected, but the rate of
the atrial activity is less than 220 BPM, a classification of atrial tachycardia is made.
Say: “atrial tachycardia”
if: atrial rate

220 BPM
Say:
“atrial flutter”
if: atrial rate > 220 BPM
Say:
“with second degree AV block at variable conduction ratio”
if: rate variation > 30%
Say:
“with second degree AV block at N:1 conduction ratio”
if: rate variation

30%
and atrial rate is an integer multiple N of ventricular rate
Say:
“with complete AV block”
if: rate variation

30%
and atrial rate is not an integer multiple of ventricular rate
and heart rate < LLN
Say:
“with block or interference in the AV junction”
if: rate variation

30%
and atrial rate is not an integer multiple of ventricular rate
and heart rate

LLN
In the presence of atrial flutter without the characteristic saw-tooth appearance, F waves may be
mistaken for P waves by the program. If the shortest PP interval found is shorter than 270 ms,
corresponding with an atrial rate exceeding 220 BPM, atrial flutter may still correctly be classified.
Say: “atrial flutter with advanced AV block”
if: shortest PP interval < 270 ms
and rate variation

30%
Say:
“atrial flutter with second degree AV block at variable conduction ratio”
if: shortest PP interval < 270 ms
and rate variation > 30%