EKG Rhythm Strip Quiz 33

Identify the following rhythms.
1.

a. Junctional tachycardia

b. Ventricular tachycardia

c. Multifocal atrial tachycardia

d. Supraventricular tachycardia

2.

a. Sinus tachycardia

b. Ventricular tachycardia

c. Accelerated junctional rhythm

d. Supraventricular tachycardia

3.

a. Sinus tachycardia

b. Atrial flutter with rapid ventricular response

c. Multifocal atrial tachycardia

d. Supraventricular tachycardia

4.

a.  Atrial paced

b.  Ventricular paced

c.  AV pacing

d.  Biventricular pacing 

5.

a. Accelerated junctional with prominent U waves
b. 1st degree AV block
c. 2nd degree heart block type II
d. Complete heart block

6.

a.  Normal sinus rhythm

b.  Sinus bradycardia

c.  Sinus tachycardia

d.  1st degree AV block

7.

a.  Normal sinus rhythm

b.  Sinus bradycardia

c.  Sinus arrhythmia

d. Accelerated junctional rhythm
8.

a.  Complete heart block

b.  Atrial flutter with slow ventricular response

c.  Sinus rhythm with sinus arrest

d.  2nd degree heart block type II

9.

a.  Normal sinus rhythm with trigeminal PACs

b.  Sinus bradycardia with sinus pauses

c.  Sinus arrhythmia

d. Junctional rhythm with PVCs every 3rd beat
10.

a.  Atrial paced

b.  Ventricular paced

c.  AV pacing

d.  Biventricular pacing 

Answers
1.

d. Supraventricular tachycardia.  The rate is 187.   There are no P waves present.   They may be absent due to a junctional focus or buried within the preceding T waves.   In general, this is more correctly described as SVT.

2.

c. Accelerated junctional rhythm. No P waves are present. This occurs when the the retrograde ativated atria and the ventricles depolarize at the same time.

3.

b. Atrial flutter with rapid ventricular response. The rate is around 137. There are numerous small "F" waves present between the QRS complexes.

4.

a. Atrial paced. The small pacer spike is seen before each P wave. There is a long delay of 0.32 secs between the P wave and the activation of the ventricles. This long delay allows activation of the ventricles by more the native pathways and preserves ventricle function in patients with long-term pacemakers.

5.

a. Accelerated junctional with prominent U waves. The EKG machine identified this rhythm as a junctional rhythm with retrograde P waves. I agree with the junctional focus but do not agree with the retrograde P waves. The deflection after the T wave is more characteristic of a U wave. If this is a 1st degree block then it is one of the longest 1st degree blocks that I have every seen. Any thoughts?

6.

a. Normal sinus rhythm

7.

c. Sinus arrhythmia. There is some variation in the R-R interval.

8.

a. Complete heart block. The P waves do not correlate with the QRS complexes.

9.

a. Normal sinus rhythm with trigeminal PACs. A PAC occurs every 3rd beat.

10.

b. Ventricular paced. A small pacer spike is found before each QRS complex.



Reviewed 6/4/13, 3/2/16