Practice EKG Rhythm Strips 217

Identify the following rhythms.

1.











2.














3.














4.















5.













Answers


1.
2nd degree heart block type II







The rhythm is irregular.   The rate is 30/min.  There are upright, uniform P waves present but not all of them are associated with a QRS complex.  A non-conducted P wave follows each QRS complex.  The PR interval is constant on the conducted P waves.  There are two PVCs present, the 1st complex and the 4th complex.   PR:  .36 sec,  QRS:  .12 sec,  QT:  .48 sec.   Interpretation: 2nd degree heart block type II


2.
Atrial flutter









The rhythm is irregular with a rate of 90.   Flutter waves are present.  No ectopic beats are seen.  PR:---,  QRS:  .12 sec,  QT:.44 sec.   Interpretation:  Atrial flutter.


3.
Atrial paced








The rhythm is regular with a rate of 75/min.   A small P wave follows the atrial pacer spike.   No ectopic beats are seen.  PR:  .28 sec,  QRS:  .12 sec,  QT:  .36 sec.  The underlying rhythm looks like atrial fibrillation.  Interpretation:   Atrial paced.


4.
Supraventricular tachycardia









The rhythm is irregular.   The heart rate is 170/min.   The rhythm starts off as normal sinus rhythm but changes to a supraventricular tachycardia after the 2nd complex.   The QRS complexes of the SVT are narrow so this suggest a supraventricular origin as opposed to a wide QRS complex which would be seen with a ventricular rhythm.  PR:  ---,  QRS:  .08,  QT:  .20 sec.   Interpretation Supraventricular tachycardia


5.
Normal sinus rhythm with trigeminal PJCs








The rhythm is irregular.    The P waves are associated with a QRS complex but not all of them are upright.   The P waves of the 3rd,  6th, and 9th complexes are negative.   The these PJCs come early in the cardiac cycle which gives the strip it's irregular rhythm.  Notice that the PJCs occur in a trigeminal pattern.  The QRS complexes are narrow.   PR:  .16 sec,  QRS:  .10 sec,  QT:  .36 sec.  Interpretation:  Normal sinus rhythm with trigeminal PJCs

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