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Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Atrial fibrillation with bigeminy The rhythm is is irregular with a rate of 100/min.   The P waves are absent and there are fibrillatory/flutter waves between the QRS complexes.  A unifocal PVC is seen every other beat.   A compensatory pause follows the PVC.  PR:  ---,  QRS:  .08 sec,  QT:  .32 sec. 2. Normal Sinus Rhythm with Unifocal PVCs The ectopic beats give this strip an irregular rhythm.   The rate is 70/min (Count the R waves in a 6 second strip and multiply by 10.)  The P waves are uniform, upright, and are associated with a QRS complex.  The ST segment is down slopping. Two unifocal PVCs are seen and they are followed by a compensatory pause.  PR: .16 sec,  QRS:  .12 sec,  QT:  .28 sec. 3. Ventricular paced with unifocal PVCs The rhythm is irregular with a rate of 80/min.  The P waves are absent and so

Identify the following rhythms 1. 2. 3. 4. 5. Answers 1. 2nd Degree Heart Block Type I The rhythm is irregular with a rate of 40/min.   The P waves are upright and uniform but there are some dropped P waves following the 2nd, 4th, and 6th complexes.   There is progressive prolongation of the PR interval.  No ectopic beats are noted.  PR:  .28 sec and .34 sec,  QRS:  .12 sec,  QRS:  .52 sec 2. Accelerated Junctional Rhythm with Unifocal PVCs The rhythm is irregular due to the ectopic beats.   The rate is 100/min.   There are negative P waves seen before their associated QRS complexes.  Two unifocal PVCs are present and are followed by a compensatory pause.  The QRS complex in the V1 lead has an rSR configuration suggesting a right bundle branch block (RBBB).  PR:  .16 sec,  QRS:  .12 sec,  QT:  .36 sec. 3. Normal sinus rhythm with bigeminy The rhythm is irregular bec

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. 1st Degree Block The rhythm is regular with a rate of 86/min.   The are positive P waves before each QRS complex. The PR interval is prolonged.  No ectopic beats are noted.   PR:  .32 sec,  QRS:  .08 sec,  QT:  .40 sec. 2. Accelerated Idioventricular Rhythm The rhythm is regular with a rate of 63/min.   No P waves or ectopic beats are noted.   The QRS is wide suggesting a ventricular ectopic rhythm.   PR:  ---,  QRS:  .16 sec,  QT:  .44 sec 3. Accelerated Junctional Rhythm The rhythm is regular with a rate of 75/min.   There are negative P waves before each QRS complex.  No ectopic beats are noted.   PR:  .20 sec,  QRS:  .08 sec,  QT:  .32 sec. 4. A trial Fibrillation with Demand Ventricular Pacing The rhythm is irregular.   The rate is 72/min.   The P waves are absent.   Some fibrillatory activity is present between the QRS complexes.   N

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. 2nd Degree AV Block Type I The rhythm is irregular with some dropped beats.   The rate is 60/min.   The P waves are upright and uniform but there are dropped P waves after the 4th and 7th complexes.  There is progressive lengthening of the PR interval.   No ectopic beats are noted.  PR: .20/.26/.32/.36 sec,  QRS:  .12 sec,  QT:  .48 sec.  This patient would sometime alternate between 3 beat cycles and 4 beat cycles of this rhythm. 2. 2nd Degree AV Block Type II The rhythm is is irregular with some dropped complexes.  The rate is 50/min.   The P waves are upright but there are some that are not associated with a QRS complex.   The PR interval is the same on the conducted beats.  No ectopic beats are present.  There is ST elevation in the V1 lead with some reciprocal ST depression in lead II.  PR:  .16 sec,  QRS:  .16 sec,  QT

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. 2nd Degree Heart Block Type I The rhythm is irregular with a rate of 50/min.   The P waves are upright and uniform but there are some dropped P waves after the 2nd and 4th complexes.   The PR interval gets progressively longer.   No ectopic beats are noted.   PR:  .22/.24 sec (3rd & 4th complexes),  QRS:  .08 sec,  QT:  .40 sec.   This patient had an underlying 1st degree block but often she would transition in to a Mobitz I block of varying cycles of 3-5 grouped beats. 2. Sinus bradycardia with biventricular pacing The rhythm is regular with a rate of 55/min.   The P waves are upright and have a corresponding QRS complex.   The wide P waves suggest a left atrial enlargement.   There are both single and double pacer spikes seen before the QRS complexes.  I am not sure if the monitor is sensing each pacer spike correctly.  The pace