Practice EKG Strips 402

Identify the following rhythms.

1.

a. Asystole
b. Agonal
c. Atrial fibrillation
d. Complete heart block

2.

a. Atrial fibrillation with RVR
b. Supraventricular tachycardia
c. Atrial flutter with RVR
d. Multifocal atrial tachycardia

3.

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

4.

a. Sinus bradycardia
b. Complete heart block
c. Junctional rhythm
d. Idioventricular rhythm

5.

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


Answers
1.  b. Agonal. This rhythm was from a DNR patient. You typically see loss of the P wave and widening of the QRS complexes as the heart beat terminates. There is no atrial activity so the ventricles take over the pacemaker function and continue to beat for a little while. Since no blood is being pumped forward by the atrial the cardiac ouput declines rapidly and global hypoxia sets in.

2. c. Atrial flutter with RVR. The rhythm is irregular. There is variable conduction through the AV node so that is what causes the rhythm to be irregular. No P waves are seen but there are some flutter waves present. No ectopic beats are seen. PR:---, QRS: .08 sec, QT: .40 sec.

3. b. Atrial paced.   The rhythm is regular.  The heart rate is 71 bpm. There are pacer spikes seen before each P wave.  The A-V interval is .16 sec.  The QRS complexes are narrow.  No ectopic beats are seen.  PR: .16 sec, QRS: .08 sec, QT: .44 sec.

4. a. Sinus bradycardia. The rhythm is regular. The heart rate is 50 bpm. The P waves point upwards and they are paired with a QRS complex. No ectopic beats are seen. ST-T wave depression is present. PR" .12 sec, QRS: .10 sec, QT: .48 sec

5. a. Sinus rhythm with trigeminal PVCs. Unifocal PVCs are seen ever 3rd beat. Notice the small P wave associated with the last PVC. This is a fusion beat in which a sinus beat and a PVC occur at the same time.