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
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!
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!!!!
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
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
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
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!
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.
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.
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.
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
@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.
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
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.
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!
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!
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
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....
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
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
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?
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,,
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
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 😊
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
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!
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
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
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
You could make videos analyzing X-rays. To interpret them is very difficult sometimes too.
Can’t stop watching your videos
i already searched for so many ecg videos and these are definitely THE BEST! Thank you so much :)
I have a final about this next week. Thanks for being there as always.
so far your videos...are one of the best...helping a lot students...to understand the pathophys of many subjects...
Your ECG videos are the BEST, thank you 🙏🏻
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
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.
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!
I learned so much this is the best way to teach this honestly
Dang it can be so hard to see where he is writing/pointing i.e. at 7:21
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.
THE POINTERSSSS! Love the video but wished I could track where you're poiting at!
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.
Very clear explanations!!! Thanks a lot 🙏🏻🙏🏻🙏🏻
Best one Wallah❤🙏
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.
Great to know because I have been suffering with this for 20 years😖
Best explanation ever 👏🏻
I love your teaching, this one however is hard to follow
You are wonderful , please keep doing this !
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
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?
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
That fresh vid great quality dude keep up with the great work
Loved the explanation. Thank you.
Thankyou somuch for This masterpiece video thankyou very much
Great, thx!)
I will wait for your next lesson
Thank you so much for these videos.
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.
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
Pointer wasn’t very easy to keep up with. Need to use something different. Great video’s.
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.
Would be nice if you would sometimes speak of the treatment aswell
Woow best explanation
awesome 👏🏼 please make more videos about ecg ❤️
As good as possible
I got a question, why did he say the ratio is 1:1, not like 1:3 or 3:1 in 12:50? Thanks
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 easy to understand video,but its also difficult to understand if you can't see what is being pointed at.
very useful video...please put a bigger pointer
are the t waves hidden in the sawtooth waves for the second example??
Keep it up guys awesome content
yea, you didn't explain how to calculate the atrial rate for atrial flutter
Couldn’t see the pointer some of the times. But great job explaining.
Is it not a rate of around 110? 6 second strip x10 for a 60 second rate?
Thank you so much, sir.
Thank you 😊
@Ninja Nerd, I can't see the pointer! :'( Love your videos..please solve it.
Very useful 👌 make ur marker visible i find very difficult to trace that
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!
so good 😭why do i bother using other resources
Can you please point out where you are by moving the pointer 😮
Sir is it possible that an ECG of atrial fibrillation the rate will be brady?
Thanks
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.
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...?
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....
Can't see anything on ECG. Please do something.
thank you
good video
7:31 where are you pointing at ?
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
Very difficult to see your cursor on P wave , qrs, lead 2 etc . Help if larger or a different color
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
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?
So great .. thank u
Can you compute the QT interval when the rhythm is atrial flutter?
Sir, how to calculate atrial flutter and fibrillation rate ? Any formula
Why is lead 2 6sec rate diff from R wave *6 ( 70 and 150)
I was really struggling to find his pointer.
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,,
You're the best!
Plz when u marking its not seen clear ( on ecg strip )
Atrial fibrillation can be seen even at 100bpm?
AWESOME thank you ❤
Bundle branch system? You mean bundle of his?
THANK YOU
literally just in timee
thanx
Thanks sir😊
Thank you sir
How am I supposed to see when there's no cursor?
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
I love your video's but please change the size of your pointer.
How do I enroll at Ninja Nerd University?
Support his patreon account.
Are you saying “Saul tooth” instead of saw tooth
What is the 1…1ratio¿ can anyone explain ¿
At 9:32 ekg gives 150 beats but rhythmic strips gives. 70 how are they even comparable
love! thank you!