Wednesday, December 24, 2014

Practice EKG Strips 374

Identify the following rhythms.

1.













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

2.












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

3.









a. Demand atrial pacing with frequent PVCs
b. Demand AV pacing with frequent PVCs
c. Demand biventricular pacing with frequent PVCs
d. Demand ventricular pacing with frequent PVCs

4.














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

5.











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

Answers

1. a. Atrial paced. The rhythm is regular with a rate of 60 bpm. Very small P waves can be seen in lead V1 after the atrial pacer spike. The QRS complex is wide, .16 sec. It looks like an RSR complex lead V1 which is consistent with a RBBB. There is T wave inversion in the inferior lead II. A very long QT interval is seen of .56 sec too.

2. c. Biventricular paced with a PAC. The PAC is the third beat. The P wave of the PAC is merged somewhat with the T wave of the preceding beat. Two pacer spikes can be seen before each QRS complex.

3. d. Demand ventricular pacing with frequent PVCs. The first beat is native beat. It is followed by a PVC. A compensatory pause follows so two ventricular paced beats kick in. A triplet of PVCs is next then another native beat. Two more demand ventricular paced beats follow.

4. b. AV paced with biventricular pacing.  An atrial pacer spike is seen before the P wave and two pacer spikes are seen before each QRS complex

5.  d. Ventricular paced. The rhythm is regular with a rate of 60 bpm. No P waves are noted. A pacer spike is seen before each QRS complex. No native or ectopic beats are seen.

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