EKG Rhythm Strips 55

Identify the following rhythms.

1.
2.
3.
4.
5.








Answers


1.
Atrial fibrillation with RVR and frequent PVCs








The rhythm is irregular.   The rate is 132/min.   No P waves are seen.  Some fibrillatory waves can be seen between the QRS  complexes.   Three PVCs can be seen.   Their morphology is very similar.  The T waves are inverted.  PR:  ---,  QRS:  .12 sec,  QT:  .32 sec.


2.
Atrial flutter with  unifocal PVCs








The rhythm is irregular.   The rate is 66/min.   Flutter waves are seen between the QRS complexes.   Unifocal PVCs are present.   Some flutter waves are seen between the PVCs so I am not going to call them a couplet.   PR:  ---,  QRS:  .12 sec,  QT:  .24 sec.


3.
NSR with artifact








The rhythm is regular with a ventricular rate of 78/min.   It is difficult to visualize the P waves because of the artifact from either the patient moving or a loose lead.


4.
NSR with unifocal PVCs








The rhythm is irregular due to the PVCs.   The rate is 84/min.   The P waves are positive and are associated with a QRS complex.   Three unifocal PVCs are seen.  PR:  .16 sec,  QRS:  .08 sec,  QT:  .38 sec.


5.
Sinus tachycardia

The rhythm is regular with a rate of 125/min.   The P waves are upright, uniform, and precede the QRS complex.  The P waves are tall and wide suggesting biatrial enlargement.  No ectopic beats are seen.  PR:  .18 sec,  QRS:  .08 sec,  QT:  .30 sec.   The combination of the tall T waves and the tall P waves gives the rhythm a flutter-like appearance. 


Reviewed 3/2/16

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