Practice EKG Rhythm Strips 156
Identify the following rhythms.
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Answers
1.
The rhythm is irregular because of the frequent unifocal PVCs as well as the AV dissociation. The atrial rate is 110/min. The ventricular rate is 33/min. The P waves are upright and uniform. They are not associated with the QRS complexes. Some P waves can be seen within the QRS complexes and T waves. There are unifocal PVCs occurring every 3rd beat. PR: ---, QRS: .12 sec, QT: .56 sec.
2.
The rhythm is regular until the run of polymorphic ventricular tachycardia occurs. The underlying sinus rate is 53/min. You have an R-on-T problem here. The T waves are actually inverted and the run of the ventricular tachycardia starts on the upstroke of the T wave. The run of VT ends with a blocked P wave. A 1.04 sec pause follows. . PR: .20 sec, QRS: .08 sec, QT: 68 sec. The QT interval is very prolonged.
3.
The rhythm is regular with a rate of 93/min. There are flutter waves present, seen best on the V1 lead. No ectopic beats are noted. Ventricular pacer spikes precede each QRS complex. PR: ---, QRS. 16 sec, QT: .44 sec.
4.
The rhythm is irregular because of the unifocal PVCs. The calculated rate is 75/min. Upright P waves are present. There are two large unifocal PVCs. PR: .20 sec, QRS: .08 sec. QT: .40 sec.
5.
The rhythm is irregular because of the run of supraventricular tachycardia. The rhythm changes to a sinus rhythm in which there are upright P waves before each QRS complex. The SVT rate is 166/min. The tachycardic complexes are narrow and the P waves are absent. This is characteristic of SVT. The sinus rate is 83. The sinus rhythm intervals are as follows: PR: .16 sec, QRS: .08 sec, QT: .40 sec.
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2.
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4.
5.
Answers
1.
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| 3rd degree heart block with trigeminal PVCs |
The rhythm is irregular because of the frequent unifocal PVCs as well as the AV dissociation. The atrial rate is 110/min. The ventricular rate is 33/min. The P waves are upright and uniform. They are not associated with the QRS complexes. Some P waves can be seen within the QRS complexes and T waves. There are unifocal PVCs occurring every 3rd beat. PR: ---, QRS: .12 sec, QT: .56 sec.
2.
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| Sinus bradycardia with run of polymorphic ventricular tachycardia |
The rhythm is regular until the run of polymorphic ventricular tachycardia occurs. The underlying sinus rate is 53/min. You have an R-on-T problem here. The T waves are actually inverted and the run of the ventricular tachycardia starts on the upstroke of the T wave. The run of VT ends with a blocked P wave. A 1.04 sec pause follows. . PR: .20 sec, QRS: .08 sec, QT: 68 sec. The QT interval is very prolonged.
3.
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| Ventricular paced |
The rhythm is regular with a rate of 93/min. There are flutter waves present, seen best on the V1 lead. No ectopic beats are noted. Ventricular pacer spikes precede each QRS complex. PR: ---, QRS. 16 sec, QT: .44 sec.
4.
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| Normal sinus rhythm with unifocal PVCs |
The rhythm is irregular because of the unifocal PVCs. The calculated rate is 75/min. Upright P waves are present. There are two large unifocal PVCs. PR: .20 sec, QRS: .08 sec. QT: .40 sec.
5.
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| Supraventricular tachycardia changing to NSR |
The rhythm is irregular because of the run of supraventricular tachycardia. The rhythm changes to a sinus rhythm in which there are upright P waves before each QRS complex. The SVT rate is 166/min. The tachycardic complexes are narrow and the P waves are absent. This is characteristic of SVT. The sinus rate is 83. The sinus rhythm intervals are as follows: PR: .16 sec, QRS: .08 sec, QT: .40 sec.
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