Practice EKG Rhythm Strips 198
Identify the following rhythms.
1.
2.
3.
4.
5.
Answers
1.
The rhythm is irregular. The rate is 20/min. No atrial activity is present. The QRS complex is wide, bizzare looking, and slow.
2.
The rhythm is regular with a heart rate of 94/min. The P waves are uniform, upright, and precede the QRS complexes. There are biventricular pacer spikes seen before each QRS complex. No ectopic beats are noted. PR: .12 sec, QRS: .12 sec, QT: .40 sec.
3.
The rhythm is irregular with a ventricular rate of 30/min. The R-R interval between the 1st and 2nd complexes is 1.68 sec and the R-R interval between the 2nd and 3rd complex is 1.52 sec. No P waves are present but there looks like some small flutter waves present in the V1 lead, though this could be some artifact. No PVCs, PACs or PJCs are seen. PR: ---, QRS: .08 sec, QT: .48 sec. Because of the irregular rhythm and absent of P waves this rhythm looks more like an atrial fibrillation with slow ventricular response. If the rhythm were more regular I would call it a junctional rhythm. For this slow rhythm, of course, check the patient for hemodynamic instability.
4.
The rhythm is irregular with a run of ventricular tachycardia. The underlying rhythm is sinus in origin. The P waves are upright and precede the QRS complexes. The PR interval is fixed. A 5 beat run of ventricular tachycardia follows the 3rd are wave. It appears that the run begins on the later half of the T wave of the 3rd complex so we have VT with R-on-T. A fusion beat follows the run of VT then sinus rhythm resumes. PR: .20 sec, QRS: .10 sec, QT: .32 sec.
5.
The rhythm is irregular with a rate of 50/min. The P waves are upright not are not all uniform. A PAC follows the 3rd complex. The P wave (seen better in the V1 lead) has a different morphology and PR interval than the P waves of sinus origin. PR: .22 sec, QRS: .08 sec, QT: .44 sec.
1.
2.
3.
4.
5.
Answers
1.
 |
| Agonal rhythm |
The rhythm is irregular. The rate is 20/min. No atrial activity is present. The QRS complex is wide, bizzare looking, and slow.
2.
 |
| Biventricular paced |
The rhythm is regular with a heart rate of 94/min. The P waves are uniform, upright, and precede the QRS complexes. There are biventricular pacer spikes seen before each QRS complex. No ectopic beats are noted. PR: .12 sec, QRS: .12 sec, QT: .40 sec.
3.
 |
| Atrial fibrillation with slow ventricular response |
The rhythm is irregular with a ventricular rate of 30/min. The R-R interval between the 1st and 2nd complexes is 1.68 sec and the R-R interval between the 2nd and 3rd complex is 1.52 sec. No P waves are present but there looks like some small flutter waves present in the V1 lead, though this could be some artifact. No PVCs, PACs or PJCs are seen. PR: ---, QRS: .08 sec, QT: .48 sec. Because of the irregular rhythm and absent of P waves this rhythm looks more like an atrial fibrillation with slow ventricular response. If the rhythm were more regular I would call it a junctional rhythm. For this slow rhythm, of course, check the patient for hemodynamic instability.
4.
|
| NSR with 5 beat run of VT |
The rhythm is irregular with a run of ventricular tachycardia. The underlying rhythm is sinus in origin. The P waves are upright and precede the QRS complexes. The PR interval is fixed. A 5 beat run of ventricular tachycardia follows the 3rd are wave. It appears that the run begins on the later half of the T wave of the 3rd complex so we have VT with R-on-T. A fusion beat follows the run of VT then sinus rhythm resumes. PR: .20 sec, QRS: .10 sec, QT: .32 sec.
5.
 |
| Sinus bradycardia with a PAC |
The rhythm is irregular with a rate of 50/min. The P waves are upright not are not all uniform. A PAC follows the 3rd complex. The P wave (seen better in the V1 lead) has a different morphology and PR interval than the P waves of sinus origin. PR: .22 sec, QRS: .08 sec, QT: .44 sec.
Comments
Post a Comment