EKG Rhythm Strips 03

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Answers:
1.

1st degree AV block

1st degree AV block. The rhythm is regular.  There is one P wave before each QRS but the PR interval is prolonged, >.20 seconds (you do the measurement). 

2.

Multifocal Atrial Tachycardia

Multifocal Atrial Tachycardia.   The rhythm is irregular.  Notice the morphology (shape) of the P wave varies as well as the PR interval.  For this to be MAT there should be at least 3 different sites of ectopy and a rate over 100/min.  If less than 100/min, then consider wandering atrial pacemaker.

3.

NSR with sinus arrest (pause)

NSR with sinus arrest (pause).   The rhythm is regular except for the brief pause.  There is one P wave before each QRS and the PR interval is normal.  Remember that during the pause there is no cardiac output. 

4.

Accelerated junctional rhythm

Accelerated junctional rhythm.  The rhythm is regular.  There are no P waves.  Where are the P waves?  Recall that with a junctional rhythm you get retrograde conduction northward towards the atrium.  If the atrium and ventricles depolarize at the same time,  then the P wave will not be seen.  Where would the P waves be if the atrium depolarized after the ventricles? 

5. 

Ventricular Tachycardia

Ventricular Tachycardia.   Uniform or monomorphic ventricular tachycardia.  The rhythm is regular.  There are no P waves.   The patient may or may not have a pulse.  What would be the difference in the treatment approach if the patient had a pulse verses a pulseless and apneic patient?


Reviewed 2/28/16