Practice EKG Strips 377

Identify the following rhythms.

1.

a. Sinus arrhythmia
b. Sinus rhythm with PACs
c. Sinus rhythm with PVCs
d. Sinus rhythm with pauses

2.

a. Idioventricular rhythm
b. Ventricular tachycardia
c. Junctional rhythm
d. Complete heart block

3.

a. Atrial fibrillation
b. Ventricular fibrillation
c. Torsades de pointes
d. Ventricular tachycardia

4.

a. Demand atrial pacing
b. Demand AV pacing
c. Demand biventricular pacing
d. Demand ventricular pacing

5.

a. 2nd degree heart block type I
b. 2nd degree heart block type II
c. 1st degree heart block
d. Sinus bradycardia with dropped PACs


Answers
1. b. Sinus rhythm with PACs. The rhythm is irregular due to the frequent PACs. The heart rate is around 70 bpm. The PACs are the 3rd, 6th, and 8th complexes. The P waves of complexes 3 and 6 are fused with the T waves of the preceding complexes. A small P wave is seen with the 8th complex.

2.  a. Idioventricular rhythm. The rhythm is irregular. The rate is around 30 bpm. No P waves are seen before the QRS complexes. The QRS complexes are wide, > .12 sec. The rate of an idioventricular rhythm is between 20 and 40 bpm

3. b. Ventricular fibrillation. We are going to shock this rhythm beginning at 200 J biphasic or 360 monophasic.

4. a. Demand atrial pacing. The underlying rhythm is sinus. There is one P wave for each QRS complex. A PJC follows the 4th complex. This is followed by a compensatory pause. This is followed by two atrial paced beats.

5. b. 2nd degree heart block type II with 2:1 conduction. The PR interval on the conducted beats is prolonged, .24 sec. A nonconducted P wave can be seen following each T wave.