Practice EKG Rhythm Strips 123
Identify the following rhythms.
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Answers
1.
The underlying rhythm is regular. The rate is 70. There are upright P waves before each QRS complex. There are two PACs present, the 5th and 7th complex, that have P waves that differ in morphology than the sinus beats. PR: .12 sec. QRS: .08, QT: .42 sec.
2.
The rhythm is regular. The rate is 166. There are not P waves present. No ecotopy is noted. PR: --, QRS: .08, QT: .28.
3.
The rhythm is regular. The rate is 55. There are upright P waves before each QRS complex. There are not any ectopic beats. PR: .20 sec, QRS: .06 sec, QT: .42 sec. At first glance one might think that this was a 2nd degree type II because of the late T waves. Recall that with a Mobitz II block the P-P interval is usually very regular and the P waves "march out." If you measure the distance between the P-T waves and the T-P waves you will see that the intervals are different.
4.
The underlying rhythm is regular. The underlying rate is 63. There are upright P waves present. There are unifocal PVC present every 3rd beat. PR: .20 sec , QRS. 12 sec, QT: .36 sec. Some sources do not include ectopic beats in the heart rate so that is why I stated that the underlying rate was 63. If you count the complexes in the 6 second strip and multiply by 10 you would get a rate of 80.
5.
The underlying rhythm is irregular. The calculated rate is 68/min. There are upright P waves present. The PR interval increases over time with a non-conducted P wave being noted after the 4th complex. The are unifocal PVCs present. The QRS complexes are preceded by a single pacer spike. The underlying rhythm is a type I AV block.
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2.
3.
4.
5.
Answers
1.
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| Normal sinus rhythm with PACs |
The underlying rhythm is regular. The rate is 70. There are upright P waves before each QRS complex. There are two PACs present, the 5th and 7th complex, that have P waves that differ in morphology than the sinus beats. PR: .12 sec. QRS: .08, QT: .42 sec.
2.
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| Supraventricular tachycardia |
The rhythm is regular. The rate is 166. There are not P waves present. No ecotopy is noted. PR: --, QRS: .08, QT: .28.
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| Sinus bradycardia |
The rhythm is regular. The rate is 55. There are upright P waves before each QRS complex. There are not any ectopic beats. PR: .20 sec, QRS: .06 sec, QT: .42 sec. At first glance one might think that this was a 2nd degree type II because of the late T waves. Recall that with a Mobitz II block the P-P interval is usually very regular and the P waves "march out." If you measure the distance between the P-T waves and the T-P waves you will see that the intervals are different.
4.
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| Sinus rhythm with 1st degree block with ventricular trigeminy |
The underlying rhythm is regular. The underlying rate is 63. There are upright P waves present. There are unifocal PVC present every 3rd beat. PR: .20 sec , QRS. 12 sec, QT: .36 sec. Some sources do not include ectopic beats in the heart rate so that is why I stated that the underlying rate was 63. If you count the complexes in the 6 second strip and multiply by 10 you would get a rate of 80.
5.
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| Ventricular paced with unifocal PVCs |
The underlying rhythm is irregular. The calculated rate is 68/min. There are upright P waves present. The PR interval increases over time with a non-conducted P wave being noted after the 4th complex. The are unifocal PVCs present. The QRS complexes are preceded by a single pacer spike. The underlying rhythm is a type I AV block.
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