Practice EKG Strips 358

Identify the following rhythms.

1.

a. Normal sinus rhythm with wide QRS and run of VT with frequent PVCs
b. Junctional rhythm with run of VT and frequent PVCs
c. Accelerated Idioventricular rhythm with run of VT and frequent PVCs
d. Atrial fibrillation with wide QRS and run of VT with frequent PVCs

2.

a. Atrial fibrillation
b. Normal sinus rhythm
c. Accelerated junctional rhythm
d. Atrial flutter

3.

a. Junctional rhythm
b. Atrial flutter
c. Idioventricular rhythm
d. Sinus bradycardia

4.

a. Normal sinus rhythm with a three beat run of VT
b. First degree block with a three beat run of VT
c. Sinus bradycardia with a three beat run of VT
d. Sinus tachycardia with a three beat run of VT


5.

a. Normal sinus rhythm with T wave inversion
b. Sinus bradycardia with T wave inversion
c. First degree block with T wave inversion
d. Atrial fibrillation with T wave inversion



Answers
1. d. Atrial fibrillation with wide QRS and run of VT with frequent PVCs. I am basing this on the irregularity of the rhythm: comparing the R - R intervals between complexes 1 and 2 with the last two complexes. Truthfully, there is so much ectopy that it is really hard sure. Let's call the teletech and get another strip.
2. d. Atrial flutter. I see a couple of flutter waves between some of the complexes. The conduction through the AV node is variable which gives this atrial flutter its irregular rhythm
3. a. Junctional rhythm.  No P waves, narrow QRS complex, rate between 40 - 60 bpm
4. a. Normal sinus rhythm with a three beat run of VT vs. Borderline First degree block with PR interval at .20 sec.
5.  a. Normal sinus rhythm with T wave inversion. The rhythm is regular with a rate of 60 bpm. No ectopic beats are seen. The PR interval is about .16 sec. There is T wave inversion in lead II which suggest some inferior ischemia.