EKG Rhythm Strips 41

Identify the following rhythms


1.
2.
3.
4.
5.











Answers


1.
2nd degree heart block type II










The rhythm is regular with a ventricular rate of 48/min.   The P waves are positive and uniform.  There are some P waves that are not associated with a QRS complex.  Those P waves that are associated with a QRS complex have a consistent PR interval.   No ectopic beats are noted.   PR:  .16 sec,  QRS:  .16 sec,  QT:  .46 sec.


2.
AV paced










The rhythm is regular with a ventricular rate of 60/min.  Atrial pacer spikes precede the P waves and ventricular pacer spikes precede each QRS complex.  No ectoptic beats are noted.  PR:  .24 sec,  QRS:  ..12 sec,  QT:  .40 sec.


3.
Atrial fibrillation










The rhythm is irregular.   The heart rate is 80/min.   Sinus P waves are not seen.   There is fibrillatory activity between the QRS complexes.  No ectopic beats are seen.  PR:  ---,  QRS:  .08 sec,  QT:  .36 sec.


4.
Atrial flutter










The rhythm is regular with a rate of 71/min.  Flutter waves are seen in a 3:1 configuration.  No ectopic beats are present.   PR:  ---,  QRS:  .08 sec,  QT:  .24 sec.


5.
1st degree with multifocal PVCs and some PACs













The rhythm is regular with multiple PVCs present.   The ventricular rate is 90/min.  The P waves are upright, uniform, and have a corresponding QRS complex. A PAC follows the 5th complex.  It is followed by a PVC then another PAC quickly follows.   The P wave of the PACs has a different morphology than the sinus P waves and the PR interval is more prolonged.   Multifocal PVCs present.  A compensatory pause follows the 1st, 2nd, and 4th PVC.  The 3rd PVC is interpolated between to PACs.   PR:  .22 sec.  QRS:  .10 sec.  QT:  .40 sec.


Reviewed on 3/2/16

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