Rate: 20–40 bpm

Rhythm: Regular

P Waves: None

PR Interval: None

QRS: Wide (greater than 0.10 sec), bizarre appearance

Clinical Tip: Diminished cardiac output is expected because of the slow heart rate. An idioventricular rhythm may be called an agonal rhythm when the heart rate drops below 20 bpm. An agonal rhythm is generally terminal and is usually the last rhythm before asystole.