Practice ECG Rhythm Strips 133
Identify the following rhythms.
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Answers
1.
The rhythm is regular. The rate is 93/min. There are no P waves before each QRS complex. This suggests that the rhythm is junctional in origin. Recall that when the P waves is absent it indicates that the atria and the ventricles are depolarized at the same time. No ectopic beats are identified. PR: ---, QRS: .08 sec, QT: .42 sec.
2.
The rhythm is irregular. A long pause is present. The rate is 60/min. There are upright P waves before each QRS complex with an extra non-conducted P wave noted after the 4th complex. This is followed by a 1.4 sec pause. No ectopic beats are seen. PR: .24 sec, QRS: .08 sec, QT: .08 sec.
3.
The rhythm is irregular. There is a definite problem with the AV association here. The atrial rate is 70/min and the ventricular rate is 30. There are upright P waves but they are not associated with the QRS complexes. There are also non-conducted P waves present. On the 1st complex an extra P wave is buried in the terminal portion of the T wave, on the 2nd complex the extra P wave follows the T wave, and on the 3rd complex the extra P waves is between the QRS complex and the T wave. The 1st and 2nd QRS complexes are wide suggestion a ventricular escape mechanism. The 3rd complex is more narrow and arrives much later in the cardiac cycle. PR: ---, QRS: .14 sec, QT: .56 sec.
4.
The rhythm is regular except for the ectopic beats. The rate calculated rate is 83/min. Fibrillatory waves are present between each QRS complex. No definite P waves are identified. A multifocal couplet follows the 3rd complex. There are biventricular pacer spikes that precede the QRS complexes. PR: ---, QRS: .12 sec, QT: .32 sec.
5.
The rhythm is irregular because of the frequent PVCs. The rate is 80/min. There are upright P waves that precede the sinus beats. There are unifocal PVCs that occur every 3rd beat. These are followed by brief compensatory pauses. PR: .16 sec, QRS: .08 sec, QT: .42 sec.
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Answers
1.
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| Accelerated junctional rhythm |
The rhythm is regular. The rate is 93/min. There are no P waves before each QRS complex. This suggests that the rhythm is junctional in origin. Recall that when the P waves is absent it indicates that the atria and the ventricles are depolarized at the same time. No ectopic beats are identified. PR: ---, QRS: .08 sec, QT: .42 sec.
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| 1st degree block with non-conducted P wave |
The rhythm is irregular. A long pause is present. The rate is 60/min. There are upright P waves before each QRS complex with an extra non-conducted P wave noted after the 4th complex. This is followed by a 1.4 sec pause. No ectopic beats are seen. PR: .24 sec, QRS: .08 sec, QT: .08 sec.
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| Complete heart block |
The rhythm is irregular. There is a definite problem with the AV association here. The atrial rate is 70/min and the ventricular rate is 30. There are upright P waves but they are not associated with the QRS complexes. There are also non-conducted P waves present. On the 1st complex an extra P wave is buried in the terminal portion of the T wave, on the 2nd complex the extra P wave follows the T wave, and on the 3rd complex the extra P waves is between the QRS complex and the T wave. The 1st and 2nd QRS complexes are wide suggestion a ventricular escape mechanism. The 3rd complex is more narrow and arrives much later in the cardiac cycle. PR: ---, QRS: .14 sec, QT: .56 sec.
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| Biventricular paced with a multifocal couplet |
The rhythm is regular except for the ectopic beats. The rate calculated rate is 83/min. Fibrillatory waves are present between each QRS complex. No definite P waves are identified. A multifocal couplet follows the 3rd complex. There are biventricular pacer spikes that precede the QRS complexes. PR: ---, QRS: .12 sec, QT: .32 sec.
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| Normal sinus rhythm with trigeminal PVCs |
The rhythm is irregular because of the frequent PVCs. The rate is 80/min. There are upright P waves that precede the sinus beats. There are unifocal PVCs that occur every 3rd beat. These are followed by brief compensatory pauses. PR: .16 sec, QRS: .08 sec, QT: .42 sec.
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