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The rhythm is the pattern in which the heart is activated. Normally this rhythm starts at the SA node and includes one P wave (atrial activation) and then one QRS complex (ventricular activation).


  • Identify sinus rhythm and explain the normal sequence of heart activation/depolarisation.
  • Identify key arrest rhythms and describe them as shockable (VT and VF) or non-shockable.
  • Identify and describe a broad range of ventricular rhythms including Ventricular Tachycardia (VT), polymorphic VT / Torsades de Pointes, Ventricular Fibrillation and Ventricular Flutter.
  • Identify and describe a broad range of Supraventricular Tachycardia (SVT) rhythms such as Sinus tachycardia, Atrial flutter, Atrial fibrillation (AF), AV Nodal Reentrant Tachycardia (AVNRT), Junctional tachycardia, Atrial Tachycardia and AVRT.
  • Analyse wide complex tachycardias using tools such as the Brugada algorithm to help differentiate VT from SVT with aberrancy.
  • Identify and describe AV blocks including First degree, Second degree (Mobitz 1 / Wenckebach and Mobitz 2) and Third degree.
  • Identify and describe ectopic (premature and escape) rhythms including atrial, junctional and ventricular (VEBs, idioventricular rhythm and AIVR).
  • Identify and describe a broad range of sinus variations, bradycardias and pauses including sinus bradycardia, sinus arrhythmia, sinus arrest, sinoatrial exit block, (sick sinus syndrome) and escape rhythms.
  • Analyse artificially paced rhythms for capture, false capture, artifacts and single / dual chamber pacing.
  • Analyse complex rhythms with ladder diagrams
  • Explain the use of a Lewis Lead to detect atrial activity
  • Define and use the terms: VT, VF, fibrillation, flutter, SVT, AF, AVNRT, AVRT, aberrancy, Mobitz, Wenckebach, VEB, AIVR, capture beat, fusion beats, MAT, Bigeminy, lewis lead...

How to use this page:

  • Explore the sections below by clicking on Process, Review, Apply or Contribute to find a variety of educational exercises. Click again to hide the same content.
  • Read the suggestions for each type of activity.
  • Choose your learning goals using the list of skills on the previous slide.
  • Make this page better by editing it or leaving comments on the talk page.

Medical disclaimer: This page is for educational and informational purposes only and may not be construed as medical advice. The information is not intended to replace medical advice offered by physicians. Please refer to the full text of the Wikiversity medical disclaimer.

Red apple with leaf.svg Materials (click here)

Suggested formats:

  • Poster of arrhythmias (can you improve on this one?)
  • Table comparing different characteristics of all the rhythms that can be termed 'supraventricular' rhythms.

Problem based learning questions:


Nuvola apps kate.png Process
Active learning exercise:
Wizard Hat Icon.png Can you process some new information and transform it into something different?Nuvola multimedia.png

Help: Learning by connectivism involves remixing information to create new connections and links. Start by choosing materials from the collection above that are most relevant to you. Keep a record of which materials you have accessed (suggested ways of doing this can be found here). Transform the information from one format to another. A traditional example of this learning exercise might be taking a lecture and processing it to make dot point notes, but also consider other formats like diagrams, mind maps, short movies and more. Revise your notes by transforming them again rather than just passively reading them. The theory is that this exercise helps you to engage elements of active learning and learning by teaching to increase the quality of your own learning while also creating something useful for others to learn with if you choose to share it.

Nuvola apps korganizer.png Review
Active learning exercise:
Bombilla amarilla - yellow Edison lamp.svg Can you review your knowledge by trying this quiz?True.svg
Stub doctors.svg Apply
Active learning exercise:
Wikiman MD.png Can you apply this information to these clinical examples?

Pp interrogation.gif Can you identify these key arrest rhythms? (What is the rhythm? Is it shockable or non-shockable?)

Ectopic beats:

P wave problems: (Look closely)

Wide complex tachycardias: is it VT or SVT with aberrancy?


Help: For each skill, here is a collection of relevant cases and clinical examples. You can practise these skills and exercises in any order, but the coloured icons (Icon Transparent Blue.pngIcon Transparent Green.pngIcon Transparent Yellow.pngNuvola filesystems services.png) should help you to find examples of a similar difficulty level. Planned future versions of this page should allow you to keep track of which exercises you have completed, for example by exporting the list to Learnist where you can mark each item as 'done'. You can also review the concepts, theory and background knowledge in the 'Review' section above.

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Active learning exercise:
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Wikiversity is a community devoted to collaborative learning. We build learning resources from the ground up and also link to existing internet resources. By getting involved, you can benefit from powerful educational models including active learning to strengthen your own knowledge, while also helping others around the world to access medical education.

Join in the community:

You can also learn more about the projects that this page is designed to support, including FOAM, Global Open Educational Resources Logo.svg and CC-logo.svg