Practice EKG Rhythm Strips 195
Identify the following rhythms.
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Answers
1.
The rhythm is regular with a ventricular rate of 35/min and an atrial rate of 100/min. The P waves and the QRS complexes are not associated. The wide QRS complexes with a slow rate is indicative of a ventricular escape rhythm. PR: ---, QRS: .16 sec, QT: .40 sec.
2.
The rhythm is is irregular due to the PVCs. The heart rate is 90/min. The P waves are upright and appear before the QRS complexes. A multifocal couplet is present. The rSR pattern in the V1 lead suggests a RBBB. There is 1mm ST depression in lead II. PR: .16 sec, QRS: .12 sec, QT: .36 sec.
3.
The rhythm is irregular with frequent PACs. The rate is 100/min. The P waves are not uniform but there is one P wave for each QRS complex and the P waves are upright. A PAC occurs every third beat. The P wave of the PAC is small with a short PR interval. PR: .12 sec, QRS: .08 sec, QT: .40 sec.
4.
The rhythm is irregular with a ventricular rate of 70/min. The P waves are absent. A single PVC is noted, the 5th complex. A ventricular pacer spike appears before each QRS complex. Two pacer spikes are seen that do not capture. PR: ---, QRS: .16 sec, QT: .40 sec.
5.
The rhythm is irregular with a rate of 50/min. The P waves are upright and uniform. A nonconducted P wave follows the 3rd complex. The PR interval increases over successive beats and this is followed by the nonconducted P wave. No ectopic beats are noted. PR: .16/.24/.32 sec, QRS: .08 sec, QT: .42 sec.
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2.
3.
4.
5.
Answers
1.
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| Complete heart block |
The rhythm is regular with a ventricular rate of 35/min and an atrial rate of 100/min. The P waves and the QRS complexes are not associated. The wide QRS complexes with a slow rate is indicative of a ventricular escape rhythm. PR: ---, QRS: .16 sec, QT: .40 sec.
2.
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| NSR with a multifocal couplet |
The rhythm is is irregular due to the PVCs. The heart rate is 90/min. The P waves are upright and appear before the QRS complexes. A multifocal couplet is present. The rSR pattern in the V1 lead suggests a RBBB. There is 1mm ST depression in lead II. PR: .16 sec, QRS: .12 sec, QT: .36 sec.
3.
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| NSR with trigeminal PACs |
The rhythm is irregular with frequent PACs. The rate is 100/min. The P waves are not uniform but there is one P wave for each QRS complex and the P waves are upright. A PAC occurs every third beat. The P wave of the PAC is small with a short PR interval. PR: .12 sec, QRS: .08 sec, QT: .40 sec.
4.
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| Ventricular paced with failure to capture |
The rhythm is irregular with a ventricular rate of 70/min. The P waves are absent. A single PVC is noted, the 5th complex. A ventricular pacer spike appears before each QRS complex. Two pacer spikes are seen that do not capture. PR: ---, QRS: .16 sec, QT: .40 sec.
5.
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| 2nd degree AV block type I |
The rhythm is irregular with a rate of 50/min. The P waves are upright and uniform. A nonconducted P wave follows the 3rd complex. The PR interval increases over successive beats and this is followed by the nonconducted P wave. No ectopic beats are noted. PR: .16/.24/.32 sec, QRS: .08 sec, QT: .42 sec.
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