EKG Rhythm Strip

Identify the following rhythm. (Click on the image to enlarge)



























Atrial fibrillation with ventricular escape beats.  The underlying rhythm is atrial fibrillation.  Beats  4, 5, and 6 occur late in the cardiac cycle. The morphology of the QRS complex is much wider than the QRS complexes of beats 1, 2, 3, and 7. The R - R interval between beats 3 and 4 is about 37 small boxes, this corresponds to a rate of about 40 beats/min.  Since the inherent rate of the ventricles is 20 - 40 bpm, complex 4 falls within the upper limits of an escape beat of ventricular origin. Complexes 5 and 6 occur at the same rate.  

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