EKG Rhythm Strips 32
Identify the following rhythms
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2.
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4.
5.
Answers
1.
The rhythm is slightly irregular with a rate of 80/min. There are no P waves before each QRS complex. There is one ectopic beat, the 7th complex which has a small inverted P wave before the QRS complex. Based upon the rate and the absence of P waves this is an accelerated junctional rhythm. PR; ---, QRS: .08 sec, QT: .48 sec.
2.
The rhythm is regular with a ventricular rate of 75/min. Although there is artifact, there are some upright P waves seen between some of the QRS complexes. The PR interval on these beats is prolonged. Biventricular pacer spikes precede each QRS complex. The QRS complex is primarily negative with a positive ST segment. This is characteristic of a ventricular paced rhythm. PR: .32 sec, QRS; .16 sec, QT: .44 sec.
3.
The rhythm begins with complete heart block and changes to a more lethal rhythm of P wave asystole. Pacing is no longer recommended for asystolic rhythms so attention should be given to initiating high quality CPR and administering some vasoconstrictors: epinephrine and vasopressin. Look for reversible cause and treat them accordingly.
4.
The rhythm is irregular due to the PVCs. The rate is 115/min. The P waves are uniform and upright. They are associated with a QRS complex. A unifocal PVC is seen every 8th beat. You might call it octogeminy. PR: .16 sec, QRS: .08 sec, QT; .32 sec.
5.
The rhythm is irregular with a long period of sinus arrest. The P waves are positive and precede the QRS complexes. No ectopic beats are noted. A 2.8 second pause follows the 3rd complex before the sinus rhythm resumes. The T wave is inverted. PR: .12 sec, QRS: .08 sec, QT: .44 sec. Sinus pause or sinus arrest? In general, if the length of the pause is less than two ventricular cycles then it is termed a sinus pause. If the length of the pause is over two cardiac cycles then it is termed a sinus arrest.
Reviewed 3/1/16
1.
Answers
1.
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| Accelerated Junctional rhythm |
The rhythm is slightly irregular with a rate of 80/min. There are no P waves before each QRS complex. There is one ectopic beat, the 7th complex which has a small inverted P wave before the QRS complex. Based upon the rate and the absence of P waves this is an accelerated junctional rhythm. PR; ---, QRS: .08 sec, QT: .48 sec.
2.
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| Biventricular pacing |
The rhythm is regular with a ventricular rate of 75/min. Although there is artifact, there are some upright P waves seen between some of the QRS complexes. The PR interval on these beats is prolonged. Biventricular pacer spikes precede each QRS complex. The QRS complex is primarily negative with a positive ST segment. This is characteristic of a ventricular paced rhythm. PR: .32 sec, QRS; .16 sec, QT: .44 sec.
3.
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| Complete heart block changing to ventricular standstill |
The rhythm begins with complete heart block and changes to a more lethal rhythm of P wave asystole. Pacing is no longer recommended for asystolic rhythms so attention should be given to initiating high quality CPR and administering some vasoconstrictors: epinephrine and vasopressin. Look for reversible cause and treat them accordingly.
4.
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| NSR with unifocal PVCs |
The rhythm is irregular due to the PVCs. The rate is 115/min. The P waves are uniform and upright. They are associated with a QRS complex. A unifocal PVC is seen every 8th beat. You might call it octogeminy. PR: .16 sec, QRS: .08 sec, QT; .32 sec.
5.
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| NSR with sinus arrest |
The rhythm is irregular with a long period of sinus arrest. The P waves are positive and precede the QRS complexes. No ectopic beats are noted. A 2.8 second pause follows the 3rd complex before the sinus rhythm resumes. The T wave is inverted. PR: .12 sec, QRS: .08 sec, QT: .44 sec. Sinus pause or sinus arrest? In general, if the length of the pause is less than two ventricular cycles then it is termed a sinus pause. If the length of the pause is over two cardiac cycles then it is termed a sinus arrest.
Reviewed 3/1/16
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