Practice EKG Rhythm Strips 158
Identify the following rhythms
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Answers
1.
The rhythm is regular and the rate is 53/min. There are upright P waves before each QRS complex. No ectopic beats are present. PR: .16 sec, QRS: .08 sec, QT: .44 sec.
2.
The rhythm is irregular because of the unifocal PVCs. The rate is 110. With the exception of the PVCs, the P waves are upright, uniform, and precede the QRS complexes. There are unifocal trigeminal PVCs present. The PVCs may be fusion complexes as there appears to be a P wave present right before the initial upstroke of the R wave. The P-P distance tends to substantiate this. PR: .20 sec, QRS: 08 sec, QT: .36 sec.
3.
The rhythm is regular with a rate of 62. No P waves are readily identified. No ectopy is noted. PR: ---, QRS: .06 sec, QT: .36 sec. Based upon the rate, the rhythm is identified as an accelerated junctional rhythm which has a rate between 60 and 100.
4.
The rhythm is very irregular. The rate is 170/min. No readily identifiable P waves are present. No ectopy is noted. The rhythm could be classified as a supraventricular tachycardia but because of the very irregular rhythm it is more than likely and atrial fibrillation with rapid ventricular response. Another possibility could be a multifocal atrial tachycardia. PR: ---, QRS: .10 sec. QT: .28 sec. If the patient is unstable then cardioversion would be an option. One could attempt to control the rate with a beta blocker, calcium channel blocker, or antiarrhythmic. Attention would be given to ruling out an atrial thrombus prior to cardioversion.
5.
This is an example of 60 cycle electrical interference.
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Answers
1.
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| Sinus bradycardia |
The rhythm is regular and the rate is 53/min. There are upright P waves before each QRS complex. No ectopic beats are present. PR: .16 sec, QRS: .08 sec, QT: .44 sec.
2.
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| Sinus tachycardia with trigeminal PVCs |
The rhythm is irregular because of the unifocal PVCs. The rate is 110. With the exception of the PVCs, the P waves are upright, uniform, and precede the QRS complexes. There are unifocal trigeminal PVCs present. The PVCs may be fusion complexes as there appears to be a P wave present right before the initial upstroke of the R wave. The P-P distance tends to substantiate this. PR: .20 sec, QRS: 08 sec, QT: .36 sec.
3.
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| Accelerated junctional rhythm |
The rhythm is regular with a rate of 62. No P waves are readily identified. No ectopy is noted. PR: ---, QRS: .06 sec, QT: .36 sec. Based upon the rate, the rhythm is identified as an accelerated junctional rhythm which has a rate between 60 and 100.
4.
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| Atrial fibrillation with rapid ventricular response |
The rhythm is very irregular. The rate is 170/min. No readily identifiable P waves are present. No ectopy is noted. The rhythm could be classified as a supraventricular tachycardia but because of the very irregular rhythm it is more than likely and atrial fibrillation with rapid ventricular response. Another possibility could be a multifocal atrial tachycardia. PR: ---, QRS: .10 sec. QT: .28 sec. If the patient is unstable then cardioversion would be an option. One could attempt to control the rate with a beta blocker, calcium channel blocker, or antiarrhythmic. Attention would be given to ruling out an atrial thrombus prior to cardioversion.
5.
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| Artifact 60 cycle interference |
This is an example of 60 cycle electrical interference.
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