Chapter 3 - Mapping the Rebels (rhythm origins)

A conceptual chapter - no rhythm strips of its own. It establishes where rhythms come from and the supraventricular/ventricular divide that drives the systematic read.

Where rhythms begin - the floor plan

Chapter 3 is conceptual: it maps WHERE each rhythm originates rather than showing strips. The supraventricular-vs-ventricular divide is the first split - anything above the ventricles gives a narrow QRS; the ventricles give a wide QRS. Each origin becomes a later chapter.

Origin (the hideout)Rhythm familyQRSChapter
SA nodeSinus rhythmsNarrow4
Atria (ectopic)Atrial rhythms (PAC, AT, flutter, AF, WAP/MAT)Narrow5
AV junctionJunctional rhythmsNarrow6
VentriclesVentricular rhythms (PVC, VT, VF, etc.)Wide7
Conduction blockAV blocksNarrow or wide8
DevicePacemaker rhythmsPaced9
Reentry circuitAVNRT / AVRT / WPWNarrow (or wide)10

The five-step read connects to origin: QRS width first splits supraventricular (narrow) from ventricular (wide); the P wave and its relationship to the QRS then pinpoint which room above the ventricles the rhythm came from; rate/regularity and clinical context finish the call. Practice strips for each origin live in Chapters 4-12.