Practice EKG Rhythm Strips 206
Identify the following rhythms.
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Answers
1.
The underlying rhythm is asystole. There are atrioventricular pacer spikes present but they are not capturing. The heart is dead but the pacemaker is still functioning and generating impulses as it was programmed to do. Usually an internal pacemaker is disabled by placing a magnet over it.
2.
The rhythm is slightly irregular with a rate of 80/min. There are flutter waves present between the QRS complexes. No ectopic beats are seen. PR: ---, QRS: .12 sec, QT: .48 sec.
3.
The rhythm is regular with a rate of 75/min. P waves are present, upright, and have a corresponding QRS complex. There are biventricular pacer spikes before each QRS complex. No ectopic beats are seen. PR: .12 sec, QRS: .10 sec, QT: .40 sec.
4.
The rhythm is irregular with unifocal PVCs present. The heart rate is 70/min. The P waves are small but are associated with a QRS complex. There are unifocal PVCs present in a bigeminal pattern. PR: .12 sec, QRS: .08 sec, QT: .44 sec.
5.
The rhythm is irregular with a rate of 100/min. The P waves are upright and are associated with a QRS complex. There are at least 3 P waves of differing morphology present. Multiple PACs are present. PR: .16 sec, QRS: .08 sec, QT: .32 sec.
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2.
3.
4.
5.
Answers
1.
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| Asystole with AV pacer spikes |
The underlying rhythm is asystole. There are atrioventricular pacer spikes present but they are not capturing. The heart is dead but the pacemaker is still functioning and generating impulses as it was programmed to do. Usually an internal pacemaker is disabled by placing a magnet over it.
2.
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| Atrial flutter |
The rhythm is slightly irregular with a rate of 80/min. There are flutter waves present between the QRS complexes. No ectopic beats are seen. PR: ---, QRS: .12 sec, QT: .48 sec.
3.
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| Biventricular paced |
The rhythm is regular with a rate of 75/min. P waves are present, upright, and have a corresponding QRS complex. There are biventricular pacer spikes before each QRS complex. No ectopic beats are seen. PR: .12 sec, QRS: .10 sec, QT: .40 sec.
4.
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| Normal sinus rhythm with bigemal PVCs |
The rhythm is irregular with unifocal PVCs present. The heart rate is 70/min. The P waves are small but are associated with a QRS complex. There are unifocal PVCs present in a bigeminal pattern. PR: .12 sec, QRS: .08 sec, QT: .44 sec.
5.
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| Wandering atrial pacemaker |
The rhythm is irregular with a rate of 100/min. The P waves are upright and are associated with a QRS complex. There are at least 3 P waves of differing morphology present. Multiple PACs are present. PR: .16 sec, QRS: .08 sec, QT: .32 sec.
"The underlying rhythm is asystole. There are atrioventricular pacer spikes present but they are not capturing. The heart is dead but the pacemaker is still functioning and generating impulses as it was programmed to do. Usually an internal pacemaker is disabled by placing a magnet over it." This is an incorrect statement. The PPM will switch to an asynchronous pacing mode at a fixed rate. A magnet will inhibit shocks from an ICD.
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