Saturday, June 8, 2013

Practice EKG Rhythm Strips 148

Identify the following rhythms.

1.














2.













3.













4.














5.














Answers


1.
Atrial fibrillation














The rhythm is irregular and the rate is 60/min.  There fibrillatory/flutter waves between the QRS complexes.  No P waves are noted.  There are three unifocal PVCs present in quick succession, a triplet.  PR:  ---,  QRS:  08 sec,  QT:  .40 sec


2.
Normal sinus rhythm with bigeminal PVCs














The rhythm is irregular and the rate is 90/min.   There are upright P waves and they have a 1:1 relationship with the QRS complexes.  There are unifocal PVCs every other beat, bigeminal pattern.  PR:  .12 sec,  QRS:  .12 sec,  QRS:  .40 sec.


3.
Demand ventricular paced














The rhythm is irregular and there is a transition from the patient's own rhythm to a ventricular paced rhythm.   The patient's underlying rhythm looks like an atrial flutter with a variable block.  The pacemaker does not sense a QRS complex within it's programmed parameters and initiates a ventricular paced beat, the 4th complex.  The programmed PR:  .16 sec,  QRS:  .16 sec,  QT:  .44 sec.


4.
Junctional rhythm














The rhythm is regular with a rate of 50/min.   No P waves are present.  No ectopy is noted.  PR:  ---,  QRS:  .08 sec,  QT:  .42 sec.


5.
Normal sinus rhythm with sinus pause
















The rhythm is irregular due to the pause.   The rate is 50/min.  The P waves are small, upright, and precede the QRS complexes.  No ectopy is noted.  The ST segment is depressed but don't treat it with paroxetine.  LOL.   The sinus pause that follows the 4th complex is approximately 1.28 sec.  PR:  .12 sec,  QRS:  .06 sec,  QT:  .38 sec.


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