Practice EKG Rhythm Strips 196
Identify the following rhythms.
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Answers
1.
The rhythm is regular with a rate of 65/min. The P waves are uniform, positive, and precede the QRS complex. However, the PR interval is prolonged. No ectopic beats are present. PR: .38 sec, QRS: .10 sec, QT: .40 sec.
2.
The rhythm is regular with a heart rate of 136/min. The P waves are small but they are upright and positive. No ectopic beats are noted. PR: .12 sec, QRS: .08 sec, QT: .28 sec.
3.
The rhythm is regular. The heart rate is 100/min. The P waves are buried in the T wave of the preceding complex. You can see a P wave on the later half of the T wave of the 1st and 3rd complexes but less clearly on the other complexes. No ectopic beats are present. PR: .24 sec, QRS: .10 sec, QT: .34 sec. So I'll call this rhythm sinus tachycardia with 1st degree block. If you are not convinced that there are P waves then call the rhythm an accelerated junctional rhythm.
4.
The rhythm is irregular with a ventricular rate of 180/min. No P waves are seen. No ectopic beats are noted. I don't see any fibrillatory activity, especially as the rate slows down, between the 3rd and 4th complexes and the 10th and 11th complex. PR: ---, QRS: .08 sec, QT: .30 sec. I will play it safe and call it an SVT.
5.
The rhythm is irregular. The ventricular rate is 30/min and the atrial rate is 94/min. The P waves are not associated with the QRS complexes. A PVC follows the 2nd P wave but the P-P interval remains unchanged. The R-R interval is irregular with some morphology changes to the QRS complexes. PR: ---, QRS: .12 sec. QT: ---. Because of the irregularity in the R-R interval this rhythm is more correctly defined as an AV dissociation instead of a complete heart block.
1.
2.
3.
4.
.jpg)
5.
Answers
1.
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| Sinus bradycardia with 1st degree block |
The rhythm is regular with a rate of 65/min. The P waves are uniform, positive, and precede the QRS complex. However, the PR interval is prolonged. No ectopic beats are present. PR: .38 sec, QRS: .10 sec, QT: .40 sec.
2.
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| Sinus tachycardia |
The rhythm is regular with a heart rate of 136/min. The P waves are small but they are upright and positive. No ectopic beats are noted. PR: .12 sec, QRS: .08 sec, QT: .28 sec.
3.
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| Sinus tachycardia with 1st degree block |
The rhythm is regular. The heart rate is 100/min. The P waves are buried in the T wave of the preceding complex. You can see a P wave on the later half of the T wave of the 1st and 3rd complexes but less clearly on the other complexes. No ectopic beats are present. PR: .24 sec, QRS: .10 sec, QT: .34 sec. So I'll call this rhythm sinus tachycardia with 1st degree block. If you are not convinced that there are P waves then call the rhythm an accelerated junctional rhythm.
4.
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| Supraventricular tachycardia |
The rhythm is irregular with a ventricular rate of 180/min. No P waves are seen. No ectopic beats are noted. I don't see any fibrillatory activity, especially as the rate slows down, between the 3rd and 4th complexes and the 10th and 11th complex. PR: ---, QRS: .08 sec, QT: .30 sec. I will play it safe and call it an SVT.
5.
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| AV dissociation |
The rhythm is irregular. The ventricular rate is 30/min and the atrial rate is 94/min. The P waves are not associated with the QRS complexes. A PVC follows the 2nd P wave but the P-P interval remains unchanged. The R-R interval is irregular with some morphology changes to the QRS complexes. PR: ---, QRS: .12 sec. QT: ---. Because of the irregularity in the R-R interval this rhythm is more correctly defined as an AV dissociation instead of a complete heart block.
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