Practice EKG Strips 408

Identify the following rhythms.

1.

a. Sinus rhythm with 1st degree block
b. Sinus bradycardia with 1st degree block
c. Sinus arrest with 1st degree block
d. Sinus arrhythmia with 1st degree block

2.

a. Atrial flutter
b. Atrial fibrillation
c. Atrial tachycardia
d. Atrial paced

3.

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

4.

a. Sinus arrhythmia
b. Wandering atrial pacemaker
c. Sinus rhythm with PACs
d. Sinus exit block

5.

a. Second degree heart block type II
b. Second degree heart block type I
c. Third degree heart block
d. First degree heart block

Answers
1. A. Sinus rhythm with 1st degree block. The rate is 63 bpm. The rhythm is regular. The P waves are paired with a QRS complex. The PR interval is prolonged. The QRS complex is wide. No ectopic beats are seen. PR: .24 sec, QRS: .12 sec, QT: .46 sec

2. a. Atrial flutter. Let's go with atrial flutter with some variable ventricular response. The issue here is that the AV node is hit with a barrage of wavelets from the atrium. It cannot respond fast enough to each of the stimuli. Some get through but many do not.

3. d. Sinus bradycardia. The rhythm is irregular. The rate is around 20 bpm. There are upright P waves that are associated with a QRS complex. The QRS complex is wide with a deep Q wave in the V1 lead. The T wave is inverted in the V1 lead. PR: .20 sec, QRS: .12 sec. QT: .60 sec.

4. B. Wandering atrial pacemaker. Check out the variety of different looking P waves. With WAP you need at least three different P waves. This means that you have at least 3 different sites within the atrium competing for the pacemaker role.

5. a. Second degree heart block type II.   The PR intervals on the conducted beats is consistent.  There are extra P waves without a QRS complex