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Identify the following rhythms. 1. a. Supraventricular tachycardia b. Atrial fibrillation with RVR c. Ventricular tachycardia d. Multifocal atrial tachycardia 2. a. Atrial flutter b. 2nd degree heart block type II c. Atrial fibrillation d. 2nd degree heart block type I 3. a. NSR with unifocal PACs b. NSR with multifocal PVCs c. NSR with bigeminal PVCs d. NSR with multiform PVCs 4. a. Sinus bradycardia with PACs b. Sinus arrhythmia with PVCs c. Complete heart block d. Atrial fibrillation with slow ventricular 5. a. Sinus bradycardia with a U wave b. 2nd degree heart block type II c. 2nd degree heart block type I d. Sinus bradycardia with dropped PACs Answers 1. Atrial fibrillation with RVR. The rhythm is very irregular so this cannot be SVT which has a regular rhythm. The QRS complexes appear to be a little wide but there appears to be some fibrillation between some of the QRS complexes. Thi

Identify the following rhythms. 1. a. Atrial fibrillation b. 2nd degree heart block type I c. First degree block d. Sinus arrhythmia 2. a. Atrial flutter b. Atrial fibrillation c. Atrial tachycardia c. Atrial paced 3. a. AV paced changing to VT b. AV paced changing to SVT c. AV paced changing to AIVR d. AV paced changing to MAT 4. a. Idioventricular rhythm b. Junctional rhythm c. Sinus bradycardia d. Complete heart block 5. a. Sinus bradycardia changing to AIVR b. Sinus bradycardia changing to VT c. Sinus bradycardia with multiple PVCs d. Sinus bradycardia with SVT Answers 1. b. 2nd degree heart block type I. The PR interval just gets long (.24 sec), longer (.28 sec), and longer (.32 sec) until there is a nonconducted P wave, seen after the 2nd 4th, and 7th complexes 2. a. Atrial flutter. It looks like 3:1 flutter waves for every QRS complex. 3. C. AV paced changing to AIVR. There is a wide variet

Identify the following rhythms. 1. a. Atrial paced b. AV paced c. Biventricular paced d. Ventricular paced 2. a. Demand Dual pacing b. Demand ventricular pacing c. Demand biventricular pacing d. Demand atrial pacing 3. a. Atrial paced b. AV with biventricular pacing c. Demand ventricular pacing d. Ventricular paced 4. a. Atrial paced with multifocal PVCs b. Biventricular paced with demand atrial pacing and trigeminal PVCs c. Atrial paced with demand biventricular pacing and PVCs d. Demand AV pacing with PVCs 5. a. Atrial paced b. AV paced c. Biventricular paced d. Ventricular paced Answers 1. a. Demand atrial pacing.  The rate is about 70 bpm. The QRS complexes are wide with an rSR complex in the V1 lead, RBBB.  No ectopic beats ares seen. The A-V interval is .24 sec.  QRS: .12 sec, QT: .44 sec 2. b. Demand ventricular pacing.  The rhythm is irregular with a rate of 70.  In lead V1 there are

Identify the following rhythms. 1. a. 2nd degree heart block type II b. Idioventricular rhythm c. Sinus bradycardia d. Complete heart block 2. a. Sinus bradycardia b. Sinus arrest c. Atrial fibrillation with slow ventricular response d. 3rd degree heart block 3. a. Agonal rhythm b. Idioventricular rhythm c. Junctional rhythm d. Complete heart block 4. 5. a. Sinus arrhythmia b. Sinus arrest c. 3rd degree heart block d. Junctional rhythm Answers 1. d. Complete heart block. The ventricular rate is 30 bpm and the atrial rate is 71 bpm. There is no conduction between the atria and the ventricles- each are beating independently of one another. So there is a significant drop in the cardiac output associated with this rhythm. As long as the patient remains at rest sometimes this rhythm is tolerated. However, when increased demand is on the body then the heart is unable to compensate by increasing the c

Identify the following rhythms. 1. a. Wandering atrial pacemaker with a PVC b. Ventricular tachycardia with a PVC c. Sinus tachycardia d. Junctional tachycardia 2. a. Sinus tachycardia b. Ventricular tachycardia c. Atrial fibrillation with RVR d. Supraventricular tachycardia 3. a. Accelerated idioventricular rhythm b. Ventricular tachycardia c. Ventricular fibrillation d. Sinus tachycardia with aberrancy 4. a. Atrial fibrillation b. Ventricular fibrillation c. Multifocal atrial tachycardia d. Torsades de pointes 5. a. Atrial fibrillation with RVR b. Supraventricular tachycardia c. Ventricular tachycardia d. Sinus tachycardia Answers 1. c. Sinus tachycardia. Very distinct and uniform P waves are seen. The presence of upright P waves rules out answers B and D. The uniformity of the P waves rules out answer A. In MAT there are at least three P waves of varying morphology or shape. The rhyt

Identify the following rhythms. 1. a. Atrial flutter with rapid ventricular response b. Ventricular fibrillation c. Atrial fibrillation with rapid ventricular response d. Multifocal atrial tachycardia 2. a. Atrial paced with a PVC b. Biventricular paced with a PVC c. Dual paced with a PVC d. Ventricular paced with a PVC 3. a. Complete heart block with a PVC b. Junctional rhythm with a PVC c. Sinus bradycardia with a PVC d. Idioventricular rhythm with a PVC 4. a. NSR with unifocal PVCs b. NSR with trigeminal PVCs c. NSR with bigeminal PVCs d. NSR with multifocal PVCs 5. a. Sinus rhythm with 1st degree block b. Sinus bradycardia with 1st degree block c. Sinus arrhythmia with 1st degree block d. Sinus arrest with 1st degree block Answers 1. a. Atrial flutter with rapid ventricular response 2. b. Biventricular paced with a PVC 3. b. Junctional rhythm with a PVC 4. d. NSR with multifocal PVCs

Identify the following rhythms. 1. a. Atria flutter b. Atrial paced c. Atrial fibrillation d. Wandering atrial pacemaker 2. a. 2nd degree heart block type I b. 3rd degree block c. Idioventricular rhythm d. Junctional rhythm 3. a. Sinus arrhythmia b. Sinus arrest c. 1st degree block with a pause d. Atrial fibrillation 4. a. Atrial fibrillation b. Sinus arrhythmia c. NSR with PACs d. Mobitz I 5.  What is the post shock rhythm? a. Ventricular fibrillation b. Ventricular tachycardia c. Polymorphic ventricular tachycardia d. Torsades de pointes Answers 1. a. Atria flutter. An irregular atrial flutter. Sometimes you will hear it referred to as atrial flutter with variable ventricular response. The strip has a bigeminal pattern to it. Every other beat there is one flutter wave for every QRS complex. 2. b. 3rd degree block. The P waves and the QRS complexes are NOT paired up. The atrial rate is around 68 bpm

Identify the following rhythms. 1. a. Ventricular tachycardia changing to SVT b. Ventricular tachycardia changing to AIVR c. Ventricular tachycardia changing to wide complex tachycardia d. Ventricular tachycardia changing to sinus tachycardia 2. a. Sinus bradycardia with trigeminal PVCs b. Sinus rhythm with a 3 beat run of SVT c. Sinus bradycardia with a run of VT d. Sinus rhythm with a triplet of PVCs 3. a. Atrial fibrillation b. Junctional rhythm c. Sinus bradycardia d. Accelerated idioventricular rhythm 4. a. Atrial paced b. AV paced c. Biventricular pacing d. Ventricular pacing 5. a. Sinus bradycardia with PACs b. Sinus bradycardia with sinus arrhythmia c. Sinus bradycardia with a first degree block d. Sinus bradycardia with pauses Answers 1. c. Ventricular tachycardia changing to wide complex tachycardia. Clearly there is VT at the beginning of the strip. This changes to a fast rhythm

Identify the following rhythms. 1. a. Sinus rhythm with unifocal PVCs b. Sinus rhythm with multifocal PVCs c. Sinus rhythm with bigeminal PVCs d. Sinus rhythm with polymorphic VT 2. a. Sinus rhythm changing to SVT b. Sinus rhythm changing to VT c. Sinus rhythm changing to AIVR d. Sinus rhythm changing to MAT 3. a. AV pacing with demand ventricular pacing b. AV pacing with atrial failure to capture c. AV pacing with demand biventricular pacing d. AV pacing with demand atrial pacing 4. a. Sinus bradycardia with unifocal PVCs b. Sinus rhythm with PACs c. Sinus arrhythmia d. Wenckebach 5. a. Complete heart block b. 2nd degree heart block type I c. Mobitz II d. First degree block with pauses Answers 1. b. Sinus rhythm with multifocal PVCs. Lots of PVCs of varying morphology. 2. a. Sinus rhythm changing to SVT. The rate of the SVT is around 150 bpm. No P waves are observed. The QRS complexes

Identify the following rhythms. 1. a. First degree heart block b. Second degree heart block type I c. Second degree heart block type II d. Third degree heart block 2. a. 1st degree heart block b. 2nd degree heart block type I c. 2nd degree heart block type II d. 3rd degree heart block 3. a. 1st degree heart block b. Wenckebach c. Mobitz II d. Complete heart block 4. a. First degree heart block b. Mobitz I c. 2nd degree AV block type II d. Complete heart block 5. a. 1st degree heart block with a run of VT b. 2nd degree heart block type I with a run of VT c. 2nd degree heart block type II with a run of VT d. 3rd degree heart block with a run of VT Answers 1. A. First degree block. The rhythm is regular with a rate around 83 bpm. The P waves are upright and paired with a QRS complex. The PR interval is prolonged at .22 sec. The QRS complexes are wide, .12 sec. The QT interval is about .