Practice EKG Rhythm Strips 221
Identify the following rhythms.
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Answers
1.
The rhythm is irregular with a rate of 60/min. The P waves are uniform and upright. There is some splitting of the P wave which is often seen with biatrial enlargement. There is progressive elongation of the PR interval over successive beats. There is a dropped P wave after the 2nd QRS complex. The QRS complexes are narrow. PR: .20/.24/..26/.30 sec. QRS: .08 sec, QT: .44 sec. Interpretation: 2nd degree heart block type I
2.
The rhythm is slightly irregular. The heart rate is 83/min. The P waves are negative or possibly biphasic in complexes 1 through 5 and then are positive in the remaining complexes. The QRS complexes are narrow. PR: .10 sec, QRS: .08 sec, QT: . 36 sec. Interpretation: Accelerated junctional changing to sinus rhythm or NSR with a competing atrial ectopic focus.
3.
The rhythm is irregular with a rate of 50/min. There are flutter waves seen between the QRS complexes. There is variable conduction to the ventricle with a ratio of 4:1 and 7:1 No ectopic beats are seen. PR: ---, QRS: .10 sec, QT: .28 sec. Interpretation: Atrial flutter with variable ventricular response.
4.
The rhythm is regular with a rate of 71/min. The P waves are upright and associated with a QRS complex. The wide P waves are often indicative of left atrial enlargement. No ectopic beats are seen. PR: .20 sec, QRS: .10 sec, QT: .44 sec. Interpretation: Normal sinus rhythm
5.
The rhythm is irregular. No P waves are seen. The QRS complexes are not well organized. Interpretation: Ventricular fibrillation
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2.
3.
4.
5.
Answers
1.
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| 2nd degree heart block type I |
The rhythm is irregular with a rate of 60/min. The P waves are uniform and upright. There is some splitting of the P wave which is often seen with biatrial enlargement. There is progressive elongation of the PR interval over successive beats. There is a dropped P wave after the 2nd QRS complex. The QRS complexes are narrow. PR: .20/.24/..26/.30 sec. QRS: .08 sec, QT: .44 sec. Interpretation: 2nd degree heart block type I
2.
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| Accelerated junctional changing to sinus rhythm |
The rhythm is slightly irregular. The heart rate is 83/min. The P waves are negative or possibly biphasic in complexes 1 through 5 and then are positive in the remaining complexes. The QRS complexes are narrow. PR: .10 sec, QRS: .08 sec, QT: . 36 sec. Interpretation: Accelerated junctional changing to sinus rhythm or NSR with a competing atrial ectopic focus.
3.
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| Atrial flutter with variable ventricular conduction |
The rhythm is irregular with a rate of 50/min. There are flutter waves seen between the QRS complexes. There is variable conduction to the ventricle with a ratio of 4:1 and 7:1 No ectopic beats are seen. PR: ---, QRS: .10 sec, QT: .28 sec. Interpretation: Atrial flutter with variable ventricular response.
4.
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| Normal sinus rhythm |
The rhythm is regular with a rate of 71/min. The P waves are upright and associated with a QRS complex. The wide P waves are often indicative of left atrial enlargement. No ectopic beats are seen. PR: .20 sec, QRS: .10 sec, QT: .44 sec. Interpretation: Normal sinus rhythm
5.
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| Ventricular fibrillation |
The rhythm is irregular. No P waves are seen. The QRS complexes are not well organized. Interpretation: Ventricular fibrillation
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