ECG Rhythm Strips 74
Identify the following rhythm strips.
1.
a. Atrial fibrillation with a PVC
b. Sinus arrhythmia with a PVC
c. Normal sinus rhythm with a PVC
d. Wandering atrial pacemaker with a PVC
2.
a. Atrial paced
b. Ventricular paced
c. Biventricular paced
d. AV paced
3.
a. Normal sinus rhythm with unifocal PVCs
b. Normal sinus rhythm with multifocal PVCs
c. Normal sinus rhythm with unifocal PACs
d. Normal sinus rhythm with PVCs and PACs
4.
a. Normal sinus rhythm
b. Supraventricular tachycardia
c. Sinus arrhythmia with a PJC
d. Sinus tachycardia with a PAC
5.
a. Atrial paced with a PVC
b. Ventricular paced with a PVC
c. Biventricular paced with a PVC
d. AV paced with a PVC
Answers
1. a. Atrial fibrillation with a PVC
The rhythm is irregular with a rate of 60/min. No P waves are seen but fibrillatory waves are seen between each complex. There is a single PVC present. PR: ---, QRS: .12 sec, QRS: .32 sec.
2. a. Atrial paced
The rhythm is regular and has a ventricular rate of 60/min. There are small upright P waves that are preceded by an atrial pacer spike. No ectopic beats are present. PR: .24 sec, QRS: .08 sec, QT: .40 sec.
3. b. Normal sinus rhythm with multifocal PVCs
The rhythm is irregular due to the PVCs. The rate is 90/min. The P waves are positive and are associated with a QRS complex. There multifocal PVCs present. The 2nd, 3rd, and 4th PVCs have a trigeminal pattern and appear to have a P wave fused in the upstroke of the R wave. They could represent either fusion complexes or some kind of aberrantly conducted PACs. PR: .12 sec, QRS: .08 sec, QT: .36 sec.
4. d. Sinus tachycardia with a PAC
Except for the PAC the rhythm is regular. The rate is 110/min. The P waves are upright and precede a QRS complex. The wide P waves could represent left atrial enlargement. There is a single PAC present, the 12th complex. The ST segment is up slopping. PR: .20 sec, QRS: .08 sec, QT: .36 sec. The QT interval is not very distinct in this strip. I am measuring the QT interval from the beginning of the QRS complex until where the ST segment meets the P wave.
5. c. Biventricular paced with a PVC
The rate is irregular because of the PVC. The rate is 100/min. The P waves are tall, uniform, and are associated with a QRS complex. There is a single PVC present. Biventricular pacer spikes are seen before each QRS complex. PR: .12 sec, QRS: .12 sec, QT: .38 sec.
Reveiwed 3/8/16
1.
b. Sinus arrhythmia with a PVC
c. Normal sinus rhythm with a PVC
d. Wandering atrial pacemaker with a PVC
2.
a. Atrial paced
b. Ventricular paced
c. Biventricular paced
d. AV paced
3.
b. Normal sinus rhythm with multifocal PVCs
c. Normal sinus rhythm with unifocal PACs
d. Normal sinus rhythm with PVCs and PACs
4.
b. Supraventricular tachycardia
c. Sinus arrhythmia with a PJC
d. Sinus tachycardia with a PAC
5.
a. Atrial paced with a PVC
b. Ventricular paced with a PVC
c. Biventricular paced with a PVC
d. AV paced with a PVC
Answers
1. a. Atrial fibrillation with a PVC
The rhythm is irregular with a rate of 60/min. No P waves are seen but fibrillatory waves are seen between each complex. There is a single PVC present. PR: ---, QRS: .12 sec, QRS: .32 sec.
2. a. Atrial paced
The rhythm is regular and has a ventricular rate of 60/min. There are small upright P waves that are preceded by an atrial pacer spike. No ectopic beats are present. PR: .24 sec, QRS: .08 sec, QT: .40 sec.
3. b. Normal sinus rhythm with multifocal PVCs
The rhythm is irregular due to the PVCs. The rate is 90/min. The P waves are positive and are associated with a QRS complex. There multifocal PVCs present. The 2nd, 3rd, and 4th PVCs have a trigeminal pattern and appear to have a P wave fused in the upstroke of the R wave. They could represent either fusion complexes or some kind of aberrantly conducted PACs. PR: .12 sec, QRS: .08 sec, QT: .36 sec.
4. d. Sinus tachycardia with a PAC
Except for the PAC the rhythm is regular. The rate is 110/min. The P waves are upright and precede a QRS complex. The wide P waves could represent left atrial enlargement. There is a single PAC present, the 12th complex. The ST segment is up slopping. PR: .20 sec, QRS: .08 sec, QT: .36 sec. The QT interval is not very distinct in this strip. I am measuring the QT interval from the beginning of the QRS complex until where the ST segment meets the P wave.
5. c. Biventricular paced with a PVC
The rate is irregular because of the PVC. The rate is 100/min. The P waves are tall, uniform, and are associated with a QRS complex. There is a single PVC present. Biventricular pacer spikes are seen before each QRS complex. PR: .12 sec, QRS: .12 sec, QT: .38 sec.
Reveiwed 3/8/16
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