Practice EKG Rhythm Strips 176
Identify the following rhythms.
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The rhythm is irregular due to the PVCs. There is complete AV dissociation. The atrial rhythm is slightly irregular with a rate of 100/min. The ventricular rhythm is irregular with a rate of 33/min. The P waves are upright and show no relationship to the QRS complexes. There are unifocal PVCs every 3rd beat. PR: ---, QRS: .14 sec, QT: .44 sec.
2.
This rhythm is irregular with a rate of 70/min. No P waves are present. There are flutter/fibrillatory waves between the QRS complexes. Two unifocal PVCs are present, the 3rd and 7th complexes. PR: ---, QRS: .10 sec, QT: .36 sec.
3.
The rhythm is irregular due to the transition between demand and paced beats. The rate is 80/min. No P waves are present but there appears to be flutter waves between the complexes. No ectopic beats are noted. Biventricular pacer spikes are seen before the paced QRS complexes. PR: ---, QRS: .12 sec, QT: .40 sec.
4.
The rhythm is irregular due to the PVC and the rate is 70/min. Upright P waves precede the QRS complexes. The 3rd beat is a PVC that is followed by a compensatory pause. PR: .20 sec, QRS: .06 sec, QT: .40 sec.
5.
The rhythm is regular with a rate of 166/min. No P waves are clearly seen. No ectopic beats can be identified. The narrow QRS complexes suggest that this rhythm is supraventricular in origin. PR: ---, QRS: .08, QT: .28 sec.
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Answers
1.
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| Complete heart block with trigeminal PVCs |
The rhythm is irregular due to the PVCs. There is complete AV dissociation. The atrial rhythm is slightly irregular with a rate of 100/min. The ventricular rhythm is irregular with a rate of 33/min. The P waves are upright and show no relationship to the QRS complexes. There are unifocal PVCs every 3rd beat. PR: ---, QRS: .14 sec, QT: .44 sec.
2.
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| Atrial fibrillation |
This rhythm is irregular with a rate of 70/min. No P waves are present. There are flutter/fibrillatory waves between the QRS complexes. Two unifocal PVCs are present, the 3rd and 7th complexes. PR: ---, QRS: .10 sec, QT: .36 sec.
3.
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| Demand biventricular pacing |
The rhythm is irregular due to the transition between demand and paced beats. The rate is 80/min. No P waves are present but there appears to be flutter waves between the complexes. No ectopic beats are noted. Biventricular pacer spikes are seen before the paced QRS complexes. PR: ---, QRS: .12 sec, QT: .40 sec.
4.
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| Normal sinus rhythm with a PVC |
The rhythm is irregular due to the PVC and the rate is 70/min. Upright P waves precede the QRS complexes. The 3rd beat is a PVC that is followed by a compensatory pause. PR: .20 sec, QRS: .06 sec, QT: .40 sec.
5.
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| Supraventricular tachycardia |
The rhythm is regular with a rate of 166/min. No P waves are clearly seen. No ectopic beats can be identified. The narrow QRS complexes suggest that this rhythm is supraventricular in origin. PR: ---, QRS: .08, QT: .28 sec.
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