EKG Rhythm Strips 23: Paced Rhythms
Identify the following rhythms:
1.
2.
Answers
1.
Ventricular Demand Pacing. The patient has an underlying atrial flutter.
2.
Ventricular Demand Pacing. The underlying rhythm looks like atrial flutter. The pacer spikes are small and difficult to see on complexes 3, 4, 5, and 7. My first thought about this rhythm was that the patient was having some ventricular escape beats. But I learned that the patient had a pacemaker and that the 12 lead also showed a functioning pacemaker. If the patient was having some escape beats then I would suspect a primary pacemaker failure.
3.
Ventricular Paced Rhythm. The rhythm is regular. The rate is 60. The PR interval is 20. A pacer spike occurs before each QRS complex.
4.
100% ventricular paced with some demand atrial pacing.
5.
Biventricular Pacing with PVCs. The rhythm is irregular. There are P waves before each paced beat. There are biventricular pacer spikes before each QRS complex. There are unifocal PVCs present occurring alone and as a couplet.
Reviewed 3/1/16
1.
2.
3.
4.
5.
Answers
1.
Ventricular Demand Pacing. The patient has an underlying atrial flutter.
2.
|
| Ventricular Demand Pacing |
Ventricular Demand Pacing. The underlying rhythm looks like atrial flutter. The pacer spikes are small and difficult to see on complexes 3, 4, 5, and 7. My first thought about this rhythm was that the patient was having some ventricular escape beats. But I learned that the patient had a pacemaker and that the 12 lead also showed a functioning pacemaker. If the patient was having some escape beats then I would suspect a primary pacemaker failure.
3.
|
| Ventricular Paced Rhythm |
Ventricular Paced Rhythm. The rhythm is regular. The rate is 60. The PR interval is 20. A pacer spike occurs before each QRS complex.
4.
100% ventricular paced with some demand atrial pacing.
5.
|
| Biventricular Pacing |
Biventricular Pacing with PVCs. The rhythm is irregular. There are P waves before each paced beat. There are biventricular pacer spikes before each QRS complex. There are unifocal PVCs present occurring alone and as a couplet.
Reviewed 3/1/16
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