Monday, December 1, 2014

Practice EKG Strips 362

Identify the following rhythms.

1.

a. Accelerated junctional rhythm
b. Atrial fibrillation
c. Sinus rhythm
d. Accelerated idioventricular rhythm

2.

a. Multifocal atrial tachycardia
b. Sinus tachycardia with frequent PACs
c. Atrial fibrillation with RVR
d. Supraventricular tachycardia


3.












a. Sinus bradycardia
b. 2nd degree block type II
c. Idioventricular rhythm
d. Complete heart block

4.

a. Second degree heart block type II
b. 2nd degree heart block type I
c. 1st degree heart block
d. Sinus rhythm with pauses

5.






a. Junctional rhythm
b. Sinus bradycardia
c. Idioventricular rhythm
d. 3rd degree heart block


Answers
1. a. Accelerated junctional rhythm. The hear rate is around 94 bpm. There are negative P waves preceding each QRS complex. These retrograde P waves are junctional in origin which means that the impulse arises from the AV junction and travels northward to depolarize the atrium. When a negative P wave is seen it means that the impulse depolarized the atria first. When no P wave is seen it means that the atria and the ventricles were depolarized simultaneously. When the P wave follows the QRS complexes it means that the ventricles were depolarized before the atria.
2. c. Atrial fibrillation with RVR.  An irregular, irregular rhythm with no clearly defined P waves. The heart rate is about 150 bpm. The fibrillatory activity is seen very clearly between the 4th and 5th complexes and this defines the rhythm as atrial fibrillation rather than SVT.
3. d. Complete heart block. The usual 1:1 relationship between the P waves and the QRS complexes is no evident. The atrial rate is about 94 bpm and the ventricular rate is 38 bpm. There is no consistency to the PR interval so it cannot be either answer A or B. Since P waves are present, it cannot be answer C.
4. a. Second degree heart block type II. The PR interval is consistent on the conducted beats. There are two nonconducted P waves that follow the 1st beat.
5. b. Sinus bradycardia


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