Practice EKG Rhythm Strips 233
Identify the following rhythms.
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Answers
1.
The rhythm is irregular. The heart rate is 90/min. There are flutter waves present. The QRS complexes are narrow. No ectopic beats are seen. PR: ---, QRS: .08 sec, QT: .32 sec. Interpretation: Atrial flutter with variable ventricular response
2.
The rhythm is regular with a rate of 75/min. The P waves are preceded by a atrial pacer spike and the QRS complex is preceded by a biventricular pacer spike. Ideally, one should only see one ventricular pacer spike. Where there is only ventricular pacer spike seen then it is probably a sensitivity problem with the monitor as there are no demand settings for either chamber. Interpretation: Dual paced
3.
The rhythm is regular. The heart rate is 65/min. The P waves are upright and precede the QRS complex. The wide and tall P waves suggest biatrial enlargement. The QRS complex is also wide. The Q wave in lead II may represent an old MI. No ectopic beats are seen. PR: .20 sec, QRS: .12 sec. QT: .44 sec. Interpretation: Normal sinus rhythm
4.
The rhythm is irregular. It begins with a run of polymorphic ventricular tachycardia and transitions into sinus bradycardia. The complex after the VT has a negative P wave so it may represent a junctional ectopic beat. It is followed by a sinus beat. PR: .16 sec. QRS: .08 sec. QT: .52 sec. The prolonged QT interval may be a factor in the polymorphic VT. Interpretation: Polymorphic VT changing to sinus bradycardia
5.
The rhythm is irregular. The heart rate is 40/min. The P waves have a corresponding QRS complex and are positive. There is a 2 sec pause that follows the 1st complex. No ectopic beats are seen. PR: .20 sec, QRS: .08 sec. QT: .40 sec. Interpretation: Sinus bradycardia with a sinus pause
1.
2.
3.
4.
5.
Answers
1.
 |
| Atrial flutter with variable ventricular response |
The rhythm is irregular. The heart rate is 90/min. There are flutter waves present. The QRS complexes are narrow. No ectopic beats are seen. PR: ---, QRS: .08 sec, QT: .32 sec. Interpretation: Atrial flutter with variable ventricular response
2.
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| Dual paced |
The rhythm is regular with a rate of 75/min. The P waves are preceded by a atrial pacer spike and the QRS complex is preceded by a biventricular pacer spike. Ideally, one should only see one ventricular pacer spike. Where there is only ventricular pacer spike seen then it is probably a sensitivity problem with the monitor as there are no demand settings for either chamber. Interpretation: Dual paced
3.
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| Normal sinus rhythm |
The rhythm is regular. The heart rate is 65/min. The P waves are upright and precede the QRS complex. The wide and tall P waves suggest biatrial enlargement. The QRS complex is also wide. The Q wave in lead II may represent an old MI. No ectopic beats are seen. PR: .20 sec, QRS: .12 sec. QT: .44 sec. Interpretation: Normal sinus rhythm
4.
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| Polymorphic VT changing to sinus bradycardia |
The rhythm is irregular. It begins with a run of polymorphic ventricular tachycardia and transitions into sinus bradycardia. The complex after the VT has a negative P wave so it may represent a junctional ectopic beat. It is followed by a sinus beat. PR: .16 sec. QRS: .08 sec. QT: .52 sec. The prolonged QT interval may be a factor in the polymorphic VT. Interpretation: Polymorphic VT changing to sinus bradycardia
5.
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| Sinus bradycardia with a sinus pause |
The rhythm is irregular. The heart rate is 40/min. The P waves have a corresponding QRS complex and are positive. There is a 2 sec pause that follows the 1st complex. No ectopic beats are seen. PR: .20 sec, QRS: .08 sec. QT: .40 sec. Interpretation: Sinus bradycardia with a sinus pause
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