ECG Rhythm Strip Quiz 75

Identify the following rhythms.

1.

a.  Ventricular fibrillation changing to aystole

b.  Torasdes de pointe changing to asystole

c.  Agonal rhythm changing to aystole

d.  Idioventricular rhythm changing to aystole

2.

a.  Atrial flutter with a PVC
b.  2nd degree AV block type II with a PVC
c.  1st degree AV block with a PVC
d.  Sinus arrhythmia

3.

a.  Atrial paced
b.  AV paced
c.  Biventricular paced
d.  Ventricular paced

4.

a.  Sinus bradycardia
b.  1st degree AV block
c.  Junctional rhythm
d.  Bradycardia with sinus arrhythmia

5.

a.   Sinus arrhythmia
b.   Normal sinus rhythm
c.   Normal sinus rhythm with PACs
d.   Normal sinus rhythm with sinus pauses

6.

a.   Sinus arrhythmia
b.   Normal sinus rhythm with PVCs
c.   Sinus tachycardia with PVCs
d.   Normal sinus rhythm with sinus pauses

7.

a.   Junctional rhythm with PVCs
b.   Accelerated junctional with PVCs
c.   Idioventricular rhythm with PVCs
d.   Normal sinus rhythm with PVCs



8.

a.  Ventricular fibrillation
b.  Multifocal atrial tachycardia
c.  Atrial tachycardia
d.  Atrial flutter


9.

a.   Sinus arrhythmia
b.   Normal sinus rhythm with a PVC
c.   Sinus bradycardia with a PVC
d.   Normal sinus rhythm with sinus pauses


10.

a.   Normal sinus rhythm with a blocked PAC and a PJC

b.   Sinus arrhythmia with a PAC and a PJC

c.   2nd degree AV block type II with a PAC and a PJC

d.   Sinus bradycardia with a PVC and a PJC

Answers

1.    a.  Ventricular fibrillation changing to aystole

2.    b.  2nd degree AV block type II with a PVC

3.    a.  Atrial paced

4.    d.  Bradycardia with sinus arrhythmia

5.    c.   Normal sinus rhythm with PACs

6.    c.   Sinus tachycardia with PVCs

7.    b.   Accelerated junctional with PVCs.

This is a very unusual junctional rhythm because of the widened QRS complex.   Usually junctional rhythms are defined as having a narrow QRS complex.  However, this patient already has a preexisting right bundle branch block seen as the rSR complex in lead V1 so the QRS appears wider than normal.  

8.    d.  Atrial flutter

9.    c.   Sinus bradycardia with a PVC

10.  a.   Normal sinus rhythm with a blocked PAC and a PJC

The nonconducted P wave occurs early in the cardiac cycle so it is a blocked premature beat rather than a type II AV block.   Usually with a type II block the P-P interval is regular and the nonconducted beat occurs at the expected time in the cardiac cycle.  

Normal sinus rhythm with a blocked premature beat and a PJC

 Reviewed 6/4/13, 3/9/16