PVCs and heart rate

Nurses General Nursing

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Specializes in Rural Nursing.

When looking at a Rhythm strip, do you count PVC's in the heart rate?

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Specializes in CCRN BSN Student FNP.

Yes....

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Specializes in Rural Nursing.

Just wondering. Had a rhythm strip test at my hospital for education, got it back and the nurse educator wrote on it she didn't count PVC's in determining the rate. Looking online I find some conflicting information.

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Specializes in CCRN BSN Student FNP.

well ask her this if they are in bi/trigemeny is she not counting the pvcs? so your strip diagnosis could say sinus bradycardia HR 40 with bigeminal pvcs?!?! I would think it would be HR 80 bigeminal pvcs ...Seems odd to me not to... now if they are having intermittent pvc's it would be best to find a clean strip with little or no to make an accurate diagnosis. ectopy. If you are in icu and they have an arterial line and those are perfusing pvc's I say they count as well...no they aren't sinus beats but they are a beat nonetheless. If they are in a stable Vtach we count the beats...it all comes down to the situation and use of critical thinking and nursing judgement.

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I always thought if the rhythm is not regular (which it would not be with PVC's) then to calculate the rhythm on a 6 second strip you count the beats (including ectopic beats) and multiply it by 10. At least thats how I learned it.

So I think you could say it is sinus rhythm (just not Normal sinus rhythm) with occational PVC's. But I still think the rate would include the ectopic beats.

Please someone correct me if I'm wrong, it's been a little while since I've taken my ECG class.

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Specializes in Critical Care.

Heart rate is usually defined as ventricular beats per minute, so PVC's still count towards the rate. Pulse however is different and only counts perfusing beats at the point where the pulse is being taken. A HR of 80 with bigeminy might only produce a radial pulse of 40 if the PVC's are not perfusing. Vtach can have a HR of 200 but a pulse of 0, etc. Maybe your educator is confusing HR and pulse?

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Specializes in Rural Nursing.

I think that's exactly what happened MunoRN.

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Specializes in ER/ICU/STICU.

Yes it's an extra "beat", it counts.

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according to the aha for testing purposes ectopy is not counted in the heart rate

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