Friday, December 19, 2014

Practice EKG Strips 371

Identify the following rhythms.

1.











a. Sinus tachycardia
b. Supraventricular tachycardia
c. Atrial fibrillation with RVR
d. Ventricular tachycardia

2.













a. Complete heart block
b. Junctional rhythm
c. Sinus bradycardia
d. Sinus arrhythmia

3.











a. Sinus tachycardia
b. Sinus rhythm
c. Accelerated junctional rhythm
d. Accelerated idioventricular rhythm

4.











a. Atrial paced with a couplet
b. AV paced with a couplet
c. Biventricular paced with a couplet
d. Ventricular paced with a couplet

5.






a. NSR with multifocal PVCs
b. NSR with bigeminal PVCs
c. NSR with trigeminal PVCs
d. NSR with quadrigeminal PVCs


Answers
1. c. Atrial fibrillation with RVR. Overall I think it is afib with RVR. At times it looks like there might be some P waves present but they are not consistent. If it were MAT then we would see more consistent P wave of varying morphology. If it were SVT then we would see a very regular rhythm. If it were ST then there would be one P wave for every QRS complex and the rhythm would be regular. If it were VT then then the QRS complexes would be > .12 sec.
2. a. Complete heart block. The QRS complex is narrow so the block is at the level of the AV node
3. b. Sinus rhythm. Biphasic P waves (P mitrale) due to left atrial enlargement. The terminal portion of the P wave is prolonged due to increased muscle mass of the left atrium
4. d. Ventricular paced with a couplet. The underlying rhythm looks like atrial fibrillation. Pacemaker spikes are seen before the QRS complexes. A multifocal couplet is seen towards the end of the strip.
5. d. NSR with quadrigeminal PVCs.  Unfocal PVCs are seen every 4th beat.

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