Thursday, January 15, 2015

Practice EKG Strips 388

Identify the following rhythms.

1.







a. First degree block
b. 2nd degree block type II
c. 2nd degree block type I
d. Complete heart block

2.











a. Atrial fibrillation
b. Atrial flutter
c. Normal sinus rhythm
d. Sinus arrhythmia

3.










a. Sinus tachycardia
b. Multifocal atrial tachycardia
c. Atrial fibrillation
d. Wandering atrial pacemaker

4.











a. Sinus tachycardia with quadrigeminal PVCs
b. Sinus tachycardia with bigeminal PVCs
c. Sinus tachycardia with multiple PACs
d. Sinus tachycardia with uniform PVCs

5.






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

Answers

1. b. 2nd degree block type II. The rhythm is is irregular due to the dropped beats. There are two nonconducted P waves seen between the 1st and 2nd complexes as well as after the 4th complexes. The conducted beats have a P wave before each complex. The PR interval is about 0.16 sec. The QRS complex is 0.08 sec. No ectopic beats are seen. We have an intermittent block that is about the level of the AV junction so that is what gives us the narrow QRS complexes. 2nd degree type II

2. a. Atrial fibrillation. The rhythm is irregular. The rate is around 80 bpm. No P waves are seen but you can see some fibrillation between the QRS complexes, especially in the V1 lead. The QRS complexes are narrow, 0.08 sec. The QT interval is slightly prolonged, about 44 sec

3. b. Multifocal atrial tachycardia. The rhythm is irregular. There are some multfocal PVCs that are seen. The second complex may be a fusion complex since it has the characteristics or shape of PVC and has a small P wave. The other PVCs are the 6th, 8th, and 11th complexes. There are P waves before the QRS complexes but the are some morphological differences present. This may be related to some kind of compensatory mechanism since most of them seem to follow the PVCs. The PR interval looks to be at 0.20 sec. The QRS compleses look to be .10 sec. The QT interval is about . 32 sec.

4. d. Sinus tachycardia with uniform PVCs. The rhythm is regular except for the PVCs. The rate is around 107 bpm. The PR interval looks like 0.16 sec. While the QRS complexes are wide at .12 sec. There is some down slopping of the ST segment in the top lead. Uniform PVCs are seen every 5th beat, penatageminy.

5. b. Ventricular paced.   The rhythm is regular.  The rate is 71 bpm.  No P waves are seen.  There are ventricular pacer spikes before each QRS complex.  No ectopic beats are seen.

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