Tuesday, January 20, 2015

Practice EKG Strips 391

Identify the following rhythms.

1.










a. Sinus rhythm with unifocal PVCs
b. Sinus rhythm with multifocal PVCs
c. Sinus rhythm with bigeminal PVCs
d. Sinus rhythm with polymorphic VT

2.









a. Sinus rhythm changing to SVT
b. Sinus rhythm changing to VT
c. Sinus rhythm changing to AIVR
d. Sinus rhythm changing to MAT

3.














a. AV pacing with demand ventricular pacing
b. AV pacing with atrial failure to capture
c. AV pacing with demand biventricular pacing
d. AV pacing with demand atrial pacing

4.











a. Sinus bradycardia with unifocal PVCs
b. Sinus rhythm with PACs
c. Sinus arrhythmia
d. Wenckebach

5.











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


Answers
1. b. Sinus rhythm with multifocal PVCs. Lots of PVCs of varying morphology.
2. a. Sinus rhythm changing to SVT. The rate of the SVT is around 150 bpm. No P waves are observed. The QRS complexes are narrow so this rules out answer B and C. No P waves of varying morpholoy are seen so this rules out answer D.
3. d. AV pacing with demand atrial pacing. Ventricular paced with some demand atrial pacing. All the QRS complexes have a ventricular pacer spike. Some are AV or dual paced. There is a native P wave on the 1st, 4th, and 6th complexes.
4. b. Sinus rhythm with PACs. P waves are seen every other beat. The morphology of the ectopic P waves are different from the those of the sinus beats.
5. The P waves and the QRS complexes should have not relationship in CHB. Here there is a relationship but the P waves and the QRS complexes are no longer close and appear to be drifting away from one another. Sounds like a soap opera.

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