EKG Rhythm Strips 17: Slow rhythms 1
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Third Degree Heart Block. The atrial rate is about 55 and the ventricular rate is about 30. The P-P interval is regular as is the R-R interval. There is more than one P wave for each QRS complex and the P waves are not associated with a QRS complex. This is characteristic of a complete heart block where the atrium are beating at there own rate and the ventricles at there own rate. What is the recommended treatment for an unstable patient who presents with this rhythm?
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Idioventricular Rhythm. The rhythm is regular. The rate is 35. There are no P waves before each QRS complex. The QRS complex is > .12 sec. A slow rhythm without P wave is characteristic of an idioventricular rhythm. I have a question that I am hoping that someone will probably respond to. Can you have a junctional rhythm with aberrant conduction? If the patient has a preexisting heart block, can you have a junctional rhythm with a wide QRS complex? If you exam the above strip it appears that there are perhaps retrograde P waves on the upstroke of the S wave. Please share your comments on this. Thank you!
Reviewed on 2/28/16
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| Bradycardia with 1st Degree Heart Block |
Bradycardia with 1st Degree Heart Block. The rate is 42. The rhythm is regular. There is one upright P wave before each QRS complex. If you measure the PR interval you will find that it is > .20 seconds. What is the actual measurement? A prolonged PR interval is characteristic of a 1st degree AV block.
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| Atrial Fibrillation with Ventricular Escape Rhythm |
Atrial Fibrillation with Ventricular Escape Rhythm. The ventricular rate is 30. The ventricular rhythm is regular. There are only fibrillatory waves before each QRS complex. There is no measureable PR interval. Because there is a complete AV block present a ventricular escape mechanism has taken over the pacemaker function of the heart. Recall that the inhereant rate of the ventricle is between 20-40.
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| Third Degree Heart Block |
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| Junctional Rhythm with Retrograde Conduction |
Junctional Rhythm with Retrograde Conduction. The rate is 30. The rhythm is regular. There are inverted, retrograde P waves that follow the narrow QRS complex. The retrograde P waves after the QRS complex indicates that the atria are depolarized after the ventricles. Inverted P waves that follow the QRS complex is indicative of a junctional rhythm.
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| Bradycardia with Sinus Arrhythmia |
Bradycardia with Sinus Arrhythmia. The rate is 55. The rhythm is irregular. There is one upright P wave before each QRS complex. The PR interval is < .20 seconds. If you measure each PR interval you will find that they are the same. This is an important when you are trying to differentiate between sinus arrhythmia and sinus rhythm with ectopy. Recall that with PACs the morphology of the P wave will change as well as the PR interval. Whereas with sinus arrhythmia the P wave morphology and the PR intveral will be the same.
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| Idioventricular Rhythm |
Idioventricular Rhythm. The rhythm is regular. The rate is 35. There are no P waves before each QRS complex. The QRS complex is > .12 sec. A slow rhythm without P wave is characteristic of an idioventricular rhythm. I have a question that I am hoping that someone will probably respond to. Can you have a junctional rhythm with aberrant conduction? If the patient has a preexisting heart block, can you have a junctional rhythm with a wide QRS complex? If you exam the above strip it appears that there are perhaps retrograde P waves on the upstroke of the S wave. Please share your comments on this. Thank you!
Reviewed on 2/28/16
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