Practice EKG Rhythm Strips 168
Identify the following rhythms.
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Answers
1.
The rhythm is irregular due to the PVCs. The rate is 90/min. P waves precede QRS complexes and are uniform and upright. Two unifocal ectopic beats are present. There is a P wave before each of them and the QRS complex is wide. These complexes may represent some kind of fusion beats. PR: .12 sec, QRS: .08 sec, QT: .36 sec.
2.
The rhythm is irregular due to the PVCs. The rate is 40/min. (this strip is longer than 6 seconds so be careful about how you count the R waves). The P waves are upright and precede a QRS complex. The PR interval is shortened. There are unifocal PVCs every other beat, bigeminy pattern. The PVC look like they fall on what would be the T wave. R-on-T? PR: .10, QRS: .08 sec, QT: .36 sec.
3.
The rhythm is irregular and there is complete AV dissociation present. The atrial rhythm is slightly irregular with a rate of 50/min and the ventricular rate is irregular with a rate of 30/min. There is no correspondence between the P waves and the QRS complexes. A narrow complex junctional escape beat is present. PR: ---, QRS: .12 sec, QT: .54 sec.
4.
The rhythm is regular with a rate of 46/min. There are small voltage P waves present and they are associated with a QRS complex. No ectopy is present. PR: .12 sec, QRS: .08 sec. QT: .42 sec.
5.
The rhythm is regular with rate of 187/min. Notice the small P waves in the bottom V lead. The PR interval is shortened. No ectopic beats are noted. PR: .06, QRS: .08, QT: .30 sec.
1.
2.
3.
4.
5.
Answers
1.
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| Normal sinus rhythm with unifocal PVCs |
The rhythm is irregular due to the PVCs. The rate is 90/min. P waves precede QRS complexes and are uniform and upright. Two unifocal ectopic beats are present. There is a P wave before each of them and the QRS complex is wide. These complexes may represent some kind of fusion beats. PR: .12 sec, QRS: .08 sec, QT: .36 sec.
2.
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| Bigeminal PVCs |
The rhythm is irregular due to the PVCs. The rate is 40/min. (this strip is longer than 6 seconds so be careful about how you count the R waves). The P waves are upright and precede a QRS complex. The PR interval is shortened. There are unifocal PVCs every other beat, bigeminy pattern. The PVC look like they fall on what would be the T wave. R-on-T? PR: .10, QRS: .08 sec, QT: .36 sec.
3.
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| Complete heart block |
The rhythm is irregular and there is complete AV dissociation present. The atrial rhythm is slightly irregular with a rate of 50/min and the ventricular rate is irregular with a rate of 30/min. There is no correspondence between the P waves and the QRS complexes. A narrow complex junctional escape beat is present. PR: ---, QRS: .12 sec, QT: .54 sec.
4.
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| Sinus bradycardia sinus arrhythmia |
The rhythm is regular with a rate of 46/min. There are small voltage P waves present and they are associated with a QRS complex. No ectopy is present. PR: .12 sec, QRS: .08 sec. QT: .42 sec.
5.
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| Sinus tachycardia |
The rhythm is regular with rate of 187/min. Notice the small P waves in the bottom V lead. The PR interval is shortened. No ectopic beats are noted. PR: .06, QRS: .08, QT: .30 sec.
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