This rulebook defines the core rhythm and pacemaker labels used for annotating ECG strips, including leadless pacemaker cases (Aveir VR, Micra), nocturnal non-capture, fusion beats, and artifact discrimination.
Rhythm Labels (8)
NSR (Normal Sinus Rhythm):
The heart beats regularly with normal P waves originating from the sinus node and consistent PR intervals.
Sinus Bradycardia:
A slow but regular rhythm in which the sinus node fires normally but at a rate below 60 bpm.
Sinus Tachycardia:
A fast but regular rhythm where the sinus node fires normally at a rate above 100 bpm.
AF (Atrial Fibrillation):
An irregularly irregular rhythm with no consistent P waves and highly variable RR intervals.
AFL (Atrial Flutter):
A rhythm characterized by rapid, saw-tooth atrial flutter waves with a fixed or variable conduction ratio.
PVC / Ventricular Ectopy:
Premature QRS complexes originating from the ventricles that disrupt the regular rhythm.
AV Block (Any degree):
A conduction abnormality where impulses from the atria are delayed or fail to reach the ventricles.
Artifact / Unknown Rhythm:
The tracing is distorted by noise or unclear patterns that prevent confident rhythm identification.
Pacemaker Labels (4)
Spike + Capture:
A pacing spike is followed immediately by an appropriate evoked QRS complex.
Spike + True Non-Capture:
A pacing spike occurs but fails to produce a QRS complex, typically followed by a compensatory pause.
Spike + Pseudo-Non-Capture (Artifact):
A pacing spike appears without a visible QRS, but the absence is due to noise, motion, or baseline artifact rather than true failure.
Fusion / Pseudofusion Beat:
A beat resulting from simultaneous intrinsic conduction and pacing, creating a hybrid QRS morphology.
This rulebook is the foundation for labeling ECG strips efficiently and consistently, especially in datasets involving leadless pacemakers and nocturnal non-capture analysis.