Practice EKG Strips 386

Identify the following rhythms.

1.












a. Sinus arrhythmia, sinus bradycardia
b. 2nd degree heart block type I
c. 2nd degree heart block type II
d.Sinus rhythm with sinus arrest

2.












a. Sinus rhythm with multifocal PVCs
b. Atrial fibrillation with multifocal PVCs
c. Atrial paced with multifocal PVCs
d. AV paced with multifocal PVCs

3.








a. Idioventricular rhythm
b. Complete heart block
c. Junctional rhythm with unifocal PVCs
d. Atrial fibrillation with slow ventricular response

4.













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

5.













a. 2nd degree heart block type I
b. Sinus arrhythmia
c. Sinus rhythm with an exit block
d. NSR with a blocked PAC

Answers

1. b. 2nd degree heart block type I. The PR interval is getting progressively longer. The drop beat is noted after the 2nd complex

2. c. Atrial paced with multifocal PVCs. The PVCs are seen after the 2nd and 5th paced beats. The morphology of the QRS complexes is different and this indicates that there are two different ectopic site firing off within the ventricles. Sometimes you will see the terms multiform or multifocal used but they mean the same thing.

3. d. Atrial fibrillation with slow ventricular response. The rhythm is very irregular. No P waves are seen between the QRS complexes. The QRS complexes are narrow. No ectopic beats are seen.

4. a. Junctional rhythm. The rate is around 46 bpm. The rhythm is regular. Inverted P waves are seen before each QRS complex. No ectopic beats are noted.

5.  c. Sinus rhythm with an exit block. The sinus exit block is a term that refers to when the SA node fails to fire. The impulse is blocked and this is what accounts for the pause or the period of arrest.

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