LESSON 8 – General Overview of Cardiac Arrhythmias

At this stage, we will assume that the concept of sinus rhythm has been understood sufficiently to move forward. However, regardless of clinical experience, difficulties in rhythm assessment are quite common due to various factors — but we will not focus on that for now.

So, if you identify sinus rhythm on an ECG, there is no issue. But what if the rhythm is non-sinus? How do you navigate the wide range of possible diagnoses? Simply stating “non-sinus rhythm” in the conclusion is not acceptable.

In fact, the approach is straightforward: if the rhythm is not sinus, then it must belong to one of the following categories 🙂
Here is our “minimum working framework”:

• Sinus bradycardia
• Sinus tachycardia
• Supraventricular rhythm (atrial, AV junctional)
• Wandering atrial pacemaker
• Atrial fibrillation
• Atrial flutter
• Paroxysmal supraventricular tachycardia (AVNRT, AVRT, atrial tachycardia)
• Idioventricular rhythm
• Ventricular tachycardia (this topic will be covered in detail at the end of the course; understanding it requires several fundamental concepts — attempting to study it now may lead to confusion)

It is also reasonable to include ectopy in this group:

• Atrial premature beats
• Ventricular premature beats

Do not panic — stay calm and don’t close the page! Although there are many arrhythmias, understanding one rhythm significantly облегчает understanding the next — you will see this for yourself.

Note: In this course, we do not cover life-threatening arrhythmias such as ventricular fibrillation and ventricular flutter. These should be studied independently, including their management protocols.

Let us start with something simple — what you have already almost mastered: sinus tachycardia and sinus bradycardia.