EKG Rhythm Strips 83
Identify the following rhythms.
1.
a. Normal sinus rhythm
b. Atrial fibrillation
c. Sinus arrhythmia
d. 1st degree block
2.
a. Ventricular paced with underlying complete heart block
b. Ventricular paced with an underlying 2nd degree type II block
c. Ventricular paced with an underlying atrial flutter
d. Ventricular paced with an underlying sinus arrest
3.
a. Atrial paced with a PVC
b. AV paced with a PVC
c. Biventricular paced with a PVC
d. Ventricular paced with a PVC
4.
a. Normal sinus rhythm with a PVC
b. 1st degree block with a PVC
c. Accelerated idioventricular rhythm with a PVC
d. 2nd degree AV block with a 2:1 conduction
5.
a. Sinus arrhythmia with PVCs
b. Normal sinus rhythm with PACs
c. Normal sinus rhythm with sinus pauses
d. Sinus rhythm with bigeminal junctional escape beats
Answers
1. b. Atrial fibrillation.
The rhythm is irregular with a rate of 60/min. No P waves are present. Fibrillatory waves are seen between the QRS complexes. No ectopic beats are noted. PR: ---, QRS: .10 sec, QT: .40 sec.
2. c. Ventricular paced with an underlying atrial flutter.
The rhythm is irregular with a rate of 70/min. Flutter waves are present in a 4:1 and 3:1 configuration. Except for the 4th complex, a ventricular pacer spike is noted before the QRS complexes. No ectopic beats are seen. PR: ---, QRS: .16 sec, QRS: .44 sec.
3. a. Atrial paced with a PVC.
The rhythm is irregular. The rate is 70/min. Small upright P waves are seen and these are preceded by an atrial pacer spike. There is a single PVC present. The 8th complex is a fusion beat. A fusion beat occurs when a native beat and a paced beat occur simultaneously. PR: .20 sec, QRS: .20 sec, QT: .44 sec.
4. b. 1st degree block with a PVC
The rhythm is irregular because of the PVC. The rate is 80/min. The P waves are upright and precede the QRS complexes. The PR interval is prolonged. There is a single PVC present which is followed by a compensatory pause. PR: .28 sec, QRS: .12, QT: .40 sec.
5. d. Sinus rhythm with bigeminal junctional escape beats
The rhythm is irregular and the rate is 90/min. The P waves are associated with a QRS complex. There are late occurring junctional ectopic beats every other beat. The P waves on these complexes are negative and precede the QRS complexes. PR: .12 sec, QRS: .08 sec, QT: .32 sec.
Reviewed 3/9/16
1.
a. Normal sinus rhythm
b. Atrial fibrillation
c. Sinus arrhythmia
d. 1st degree block
2.
a. Ventricular paced with underlying complete heart block
b. Ventricular paced with an underlying 2nd degree type II block
c. Ventricular paced with an underlying atrial flutter
d. Ventricular paced with an underlying sinus arrest
3.
a. Atrial paced with a PVC
b. AV paced with a PVC
c. Biventricular paced with a PVC
d. Ventricular paced with a PVC
4.
a. Normal sinus rhythm with a PVC
b. 1st degree block with a PVC
c. Accelerated idioventricular rhythm with a PVC
d. 2nd degree AV block with a 2:1 conduction
5.
a. Sinus arrhythmia with PVCs
b. Normal sinus rhythm with PACs
c. Normal sinus rhythm with sinus pauses
d. Sinus rhythm with bigeminal junctional escape beats
Answers
1. b. Atrial fibrillation.
The rhythm is irregular with a rate of 60/min. No P waves are present. Fibrillatory waves are seen between the QRS complexes. No ectopic beats are noted. PR: ---, QRS: .10 sec, QT: .40 sec.
2. c. Ventricular paced with an underlying atrial flutter.
The rhythm is irregular with a rate of 70/min. Flutter waves are present in a 4:1 and 3:1 configuration. Except for the 4th complex, a ventricular pacer spike is noted before the QRS complexes. No ectopic beats are seen. PR: ---, QRS: .16 sec, QRS: .44 sec.
3. a. Atrial paced with a PVC.
The rhythm is irregular. The rate is 70/min. Small upright P waves are seen and these are preceded by an atrial pacer spike. There is a single PVC present. The 8th complex is a fusion beat. A fusion beat occurs when a native beat and a paced beat occur simultaneously. PR: .20 sec, QRS: .20 sec, QT: .44 sec.
4. b. 1st degree block with a PVC
The rhythm is irregular because of the PVC. The rate is 80/min. The P waves are upright and precede the QRS complexes. The PR interval is prolonged. There is a single PVC present which is followed by a compensatory pause. PR: .28 sec, QRS: .12, QT: .40 sec.
5. d. Sinus rhythm with bigeminal junctional escape beats
The rhythm is irregular and the rate is 90/min. The P waves are associated with a QRS complex. There are late occurring junctional ectopic beats every other beat. The P waves on these complexes are negative and precede the QRS complexes. PR: .12 sec, QRS: .08 sec, QT: .32 sec.
Reviewed 3/9/16
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