AFTERNOON ROUNDS TUCSON

DOS: 

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Bed 1

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 2

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 3

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 4

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 5

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 6

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 7

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 8

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 9

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 10

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 11

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 12

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 13

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 14

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 15

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

Bed 16

Show/Hide Patient

Patient Name:  DOB:    ID#: 

Height:  in   Weight:  lb    0 BMI   

Previous PSG:    PSG Type:    AHI =    Lowest O2 =

Arrhythmias:
 Normal Sinus Rhythm = NSR
 Sinus Rhythm
 1st Degree Heart Block
 2nd Degree Heart Block
 2nd degree Heart Block MOBITZ I
 2nd degree Heart Block MOBITZ II
 3rd Degree Heart Block
 Accelerated Idio-Ventricular rhythm
 Accessory Pathway Tachycardias
 Amiodarone causing Bradyarrhythmia’s
 Arrhythmogenic Right Ventricular Dysplasia
 Artificial Pacemaker rhythm
 Asystole
 Atrial Escape Rhythms
 Atrial Extrasystoles
 Atrial Fibrilation = AF
 Atrial Flutter
 Atrial Premature Beats
 Atrial Premature Complexes
 Atrioventricular block
 AV Nodal Reentrant Tachycardia
 Bigeminy
 Bradycardia
 BRUGADA Syndrome
 Bundle Branch Block = BBB
 Catecholaminergic Polymorphic Ventricular Tachycardia
 Chaotic Depolarization
 Chest Pain
 Clinicaly Dead
 Conduction Delay in AV Node
 Congestive Heart Failure
 DRESSLER’s Syndrome
 Drugs Induce Arrhythmias
 Ectopic Beats
 Extrasystoles
 Heart Block
 Heart Block in AV Node
 Heart Block in HIS-Purkinje System
 Hypercalcemia EKG Electrolyte Abnormality
 Hyperkalemia EKG Electrolyte Abnormality
 Hypertrophic Cardiomyopathy
 Hypocalcemia EKG Electrolyte Abnormality
 Hypokalemia EKG Electrolyte Abnormality
 Inappropriate Sinus Tachycardia = IST
 Intra-Atrial Conduction Delays
 Junctional Escape Rhythms
 Junctional Premature Beats
 Left Atrial Abnormality
 Left Atrial Depolarization
 Left Atrial Enlargement = LAE
 Left Bundle Branch Block = LBBB
 Left Ventricular Hypertrophy = LVH
 Left Ventricular Noncompaction = LVNC
 Long Q-T Syndrome = LQTS
 Multifocal Atrial Tachycardia
 Non-ST-Elevation Myocardial Infarction = NSTEMI
 Pacemaker
 Pacemaker Mediated Tachycardia = PMT
 Paroxysmal Supraventricular Tachycardia = PSVT
 PE EKG reveals either with Classic or Non-Specific signs
 Pericarditis with ST changes
 Postural Orthostatic Tachycardia Syndrome = POTS
 Premature Atrial Beats = PAB
 Premature Atrial Complexes = PAC
 Premature Atrial Contraction
 Premature Junctional Contractions
 Premature Supraventricular Complexes
 Premature Supraventricular Delays
 Premature Ventricular Complexes
 Premature Ventricular Complexes with Aberrant Conduction
 Premature Ventricular Contraction = PVC
 Pro-Arrhythmic drug propensity to Polymorphic Ventricular Tachycardia
 Pulmonary Embolism = PE
 Pulseless Electrical Activity
 Right Atrial Abnormality
 Right Atrial Depolarization
 Right Atrial Enlargement = RAE
 Right Bundle Branch Block = RBBB
 Right Ventricular Hypertrophy = RVH
 Right Ventricular Pacing = RV Pacing
 Sinus Bradycardia
 Sinus Node Dysfunction
 Sinus Pause
 Sinus Sick Syndrome = SSS
 Sotalol causing Bradyarrhythmia’s
 ST Segment Rythm Changes
 Sudden Arrhythmia Death Syndrome
 Sudden Cardiac Arrest = SCA
 Sudden Cardiac Death = SCD
 Supraventricular Bigeminy
 Supraventricular Ectopic Beats
 Supraventricular Extrasystoles
 Supraventricular Premature Beats
 Supraventricular Tachycardia = SVT
 Tachyarrhythmia
 Tachycardia
 Tachycardia ~ Automatic
 Tachycardia ~ Chaotic Atrial
 Tachycardias via Accessory Pathways
 Tako-Tsubo Cardiomyopathy
 Tako-Tsubo Syndrome = Broken Heart Syndrome
 Torsades de Pointes
 Torsades de Pointes Digoxin
 Torsades de Pointes Disopyramide
 Torsades de Pointes due to Procainamide
 Torsades de Pointes due to Quinidine
 Transient Antero Apical Dyskinesia
 Trigeminy
 Ventricular Ectopics
 Ventricular Escape Rhythms
 Ventricular Extrasystole
 Ventricular Filibration = VF
 Ventricular Pace = VP
 Ventricular Premature Beats = VPB
 Ventricular Sense = VS
 Ventricular Tachycardia = VT
 Ventricular Tachycardia ~ Monomorphic
 Ventricular Tachycardia ~ Polymorphic
 Wandering Atrial Pacemaker
 Wenckenbach
 Wolf Parkinson White Syndrome

PAP NAP Time Started: : PAP NAP Time Ended: :

Current settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Final settings

CPAP: cm H20

BiLevel: IPAP EPAP cm H20

BiLevel ST: IPAP EPAP cm H20 Rate

ASV: EPAP Max EPAP min PS Max PS Min

Auto-PAP: - cm H20

AVAPS: VT RR EPAP PS Min PS Max

Additional Instructions:

Comments:

In-House Checklist

Check-in/Check-out     Linked Visit PSG     Linked Visit Notes Report     Task Updated ID#