Thursday, March 26, 2015

Practice EKG Strips 438

Identify the following rhythms.

1.







a. Sinus bradycardia
b. Idioventricular rhythm
c. Junctional rhythm
d. 2nd degree heart block type I

2.







a. Demand ventricular pacing
b. Demand atrial pacing
c. Failure to sense
d. Failure to capture

3.







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


4.







a. Ventricular paced with bigeminal PVCs
b. Atrial paced with bigeminal PVCs
c. Biventricular paced with bigeminal PVCs
d. Atrial paced with bigeminal PVCs

5.







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



Answers
1. b. Idioventricular rhythm.  Idioventricular is slow and fat qrs's. Junctional slow with small qrs's

2. c. Failure to sense. The pacemaker is firing without sensing the inherent or native heart rhythm. As you can see there are pacespikes that fall on or around the QRS complexes. With failure to capture, the pace spkes will not be immediately followed by a QRS complex.

3.  c. Sinus bradycardia. The rhythm is regular. The heart rate is 50/min. The P waves are uniform and upright. The QRS complexes are narrow. There is some ST depression and T wave inversion present. No ectopic beats are seen. PR: .12 sec, QRS: .08 sec, QT: .40 sec.

4. c. Biventricular paced with bigeminal PVCs. The rhythm is irregular. The rate is about 100/min. Upright P waves are present and they are associated with a QRS complex. Biventricular pacer spikes are seen before the QRS complexes. PVCs are seen every other beat, bigeminy.

5. b. Second degree block type I. The PR interval is getting longer over successive beats. This is followed by a dropped beat. Then the cycle repeats itself.

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