Tuesday, July 14, 2015
Practice EKG Strips
Identify the following rhythm (click on the image to enlarge it).
The rhythm begins with what looks like a pause followed by a junctional escape beat, complex 1. We know that it is junctional escape beat because the QRS complex is narrow and the P wave is absent. Complex 2 may be an atrial escape beat. The PR interval looks shorter than any of the other complexes. Complexes 3 – 6 are sinus tachycardia. There is a P wave associated with each QRS complex. The P waves of complexes 3 – 6 are fused with the T wave of the preceding complexes. There is a dropped PAC seen following complex 6. The dropped P wave occurs on the T wave. At this point the ventricle is in a state of relative repolarization and an ectopic complex may or may not be conducted. There is a compensatory pause following complex 6. Complex 7 is a junctional escape beat. A nonconducted P wave follows the junctional escape beat. It has a similar morphology to the complex 13, so I believe it is a nonconducted P wave as opposed to a PAC. Complex 8 is another junctional escape complex or PAC. Sinus tachycardia resumes in complexes 9 – 12. A dropped PAC is seen fused with the T wave of complex 12. This is followed by a compensatory pause. Complex 13 is a junctional escape beat. It is followed by a nonconducted PAC. Complex 14 is another junctional escape beat. Complexes 15 – 17 look like sinus tachycardia. The P waves of these complexes are fused with the T waves of the preceding complexes.