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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:

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. 2nd degree AV block type I The rhythm is irregular with a rate of 50/min.   The P waves are upright and uniform.   There is gradual elongation of the PR interval.    There is a nonconducted P wave after the 4th complex.  No ectopic beats are seen.   The QRS complex is narrow.   PR:  .28/.32/.36 sec.  QRS:  .08 sec, QT:  .48 sec.  Interpretation:  2nd degree AV block type I 2. Atrial fibrillation  The rhythm is irregular with a rate of 80/min.   No P waves are seen.  There is an aberrantly conducted complex that arrives later in the cycle after the 4th complex.  There is 3 mm ST elevation in the V1 lead.  PR:  ---,  QRS:  .12 sec,  QT:  .44 sec.   Interpretation:  Atrial fibrillation 3. Atrial paced The rhythm is regular with a rate of 65/min.  The are upright P waves that are preceded by atrial pacer spikes.   The PR interval is prolonged.  T

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Accelerated junctional rhythm The rhythm is regular with a heart rate of 71/min.   The P waves are absent.   No ectopic beats are noted.   The QRS complex is narrow.   PR:  ---,  QRS:  .08 sec,  QT:  .40 sec. 2. Multifocal atrial tachycardia The rhythm is irregular with ventricular rate of 150/min.    P waves are upright but are not uniform in appearance.   There is also some variability in the PR interval.   No ectopic beats are noted.  PR:  .16 sec,  QRS:  .08 sec,  QT:  .32 sec. 3. Atrial flutter The rhythm is regular with a rate of 71/min.   There flutter waves seen between the QRS complexes.  No ectopic beats are noted.  PR:  ---,  QRS:  .08 sec,  QT:  undetermined. 4. Atrial paced The rhythm is regular with a heart rate of 68/min.   The P waves are preceded by an atrial pacing stimulus.   No ectopic beats are seen.   PR:  .20

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Atrial fibrillation with rapid ventricular response The rhythm is very irregular with a rate of 160/min.  No P waves are seen.  No ectopic beats are noted. PR:  ---,  QRS:  .10 sec,  QT:  .28 sec. 2. Atrial paced The rhythm is regular with a heart rate of 68/min.   The P waves are preceded by an atrial pacing stimulus.   No ectopic beats are noted.   PR:  .16 sec,  QRS:  .08 sec,  QT:  .36 sec. 3. Dual paced The rhythm is regular.   The heart rate is 68/min.   The P waves and the QRS complexes are preceded by a pacer spike.   PR:  .12 sec,  QRS:  .16 sec,  QT:  .44 sec. 4. Normal sinus rhythm with bigeminal PVCs The rhythm is irregular due to the multiple PVCs.   The ventricular rate is 100/min.   The P waves are uniform, positive, and are associated with a QRS complex.   There are unifocal PVCs every other

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Atrial paced This paced rhythm is regular with a rate of 60/min.  There are upright P waves before each QRS complexes.   Each P wave is preceded by a pacer spike.   No ectopic beats are noted.  PR:  .20 sec,  QRS:  .08 sec, QT .48 seconds. 2. Normal sinus rhythm with ST elevation in lead II The rhythm is regular and the rate is 88/min.  The P waves are associated with the QRS complexes and are uniform and upright.   No ectopic beats are seen. In lead II there is 2mm ST elevation with some inversion of the T wave.  PR:  .16 sec,  QRS:  .08 sec,  QT:  .40 sec. 3. Normal sinus rhythm with a PAC This rhythm is irregular due to the PAC.   The rate is 80/min.   The P waves are upright and precede the QRS complex.  The 3rd complex is a PAC.  Notice the change in the height of the preceding T wave.   The change in height is the