Practice Rhythm Strips 306

Identify the following rhythms.

1.







a. Asystole
b. Ventricular paced
c. Atrial paced
d. Biventricular paced

2.






a. NSR with couplets
b. NSR with ventricular bigeminy
c. NSR with uniform PVCs
d. NSR with unifocal PACs

3.







a. Accelerated idioventricular rhythm
b. Accelerated junctional rhythm
c. Complete heart block
d. Agonal rhythm


4.













a. 1st degree block with a triplet of PVCs
b. Sinus rhythm with triplet of PVCs
c. Sinus bradycardia with triplet of PVCs
d. Sinus rhythm with trigeminal PVCs


5.







a. Sinus bradycardia with a pause
b. Sinus arrhythmia
c. Complete heart block
d. 2nd degree AV block type II


Answers

1. a. Asystole.   Asystole with a functioning single chamber pacemaker.
2. b. NSR with ventricular bigeminy.  The rhythm is irregular because of the PVCs. The heart rate is 90/min. The P waves look the same and are paired with a QRS complex. The QRS complexes are narrow. Unifocal PVCs are seen in a bigeminal pattern. PR: .12 QRS: .08 sec, QT: .36 sec. Interpretation: NSR with ventricular bigeminy or bigeminal PVCs
3. a. Accelerated idioventricular rhythm.  This rhythm is regular. The heart rate is 50/min. No P waves are seen. The QRS complex is wide so this screams that it is a ventricular rhythm. No ectopic beats are seen. PR: ---, QRS: .16 sec, QT: .44 sec. Interpretation: Accelerated Idioventricular rhythm.
4. d. Sinus rhythm with trigeminal PVCs.  The rhythm is irregular due to the PVCs. The rate is 68/min. The P waves are uniform, upright, and are paired with a QRS complex. Three consecutive PVCs follow the 2nd complex. This is followed by a short compensatory pause then sinus rhythm resumes. PR: .16 sec, QRS: .08 sec, QT: .40 sec. Interpretation: Sinus rhythm with triplet of PVCs
5. a. Sinus bradycardia with a pause.  Yikers! This looks serious. The rhythm is irregular due to the pause. The heart rate is 30/min. The P waves are associated with a QRS complex. There is a 2.2 sec pause following the 1st beat. No ectopic beats are seen. PR: .16 sec, QRS: .10 sec, QT: .44 sec.


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