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Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Complete heart block The rhythm is regular with a rate of 38/min.   The P waves are upright and uniform.   There is no association between the P waves and the QRS complexes.   A P wave is buried in the ST segment of the 2nd complex.  No ectopic beats are seen.   The QRS complex is wide suggesting an ventricular escape rhythm.   PR:  ---,  QRS:  .16 sec,  QT:  .52 sec. 2. Junctional rhythm changing to a sinus rhythm The rhythm is irregular with a rate of 70/min.   The initial 3 complexes have negative P waves and the remaining 4 complexes have upright P waves.  There is slight pause after the 3rd complex in which the rhythm transitions from a junctional rhythm to a sinus rhythm.   All the P waves have a corresponding QRS complex.  No ectopic bea...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. 1st degree AV block The rhythm is regular.   The rate is 78/min.   There are upright P waves before each QRS complex.   No ectopic beats are noted.   The PR interval is prolonged at .32 sec,  QRS:  .08 sec,  QT:  .40 sec. 2. Artifact There is electrical interference present.   The patient had his lap top sitting on his chest. 3. Atrial fibrillation with rapid ventricular response The rhythm is irregular.   The rate is 110/min.   The are no readily identifiable P waves present. Fibrillatory waves are noted, especially towards the end of the strip as the rate slows down.  No ectopic beats are seen.   PR: --,  QRS:   .08 sec,  QT:  .34 sec 4. NSR with quadrigeminal PVCs The rhythm is irregular due to the ectopic beats.   The unde...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. 1st degree AV block The rhythm is regular with a rate of 83/min.   The P waves are upright, uniform and precede the QRS complexes.   The PR interval is prolonged.  No ectopic beats are noted.  PR:  .30 sec,  QRS:  .10 sec,  QT:  .36 sec. 2. Normal sinus rhythm with unifocal PVCs (quadrigeminy) The rhythm is irregular due to the PVCs.   The rate is 100/min.   The P waves are wide, uniform, and precede a QRS complex.   Unifocal PVCs occur every fourth beat.   PR:  .12 sec,  QRS:  .12 sec,  QT:  .34 sec. 3. Normal sinus rhythm with sinus arrest The rhythm is irregular due to the pause.   The rate is 80/min.   Upright P waves come before each QRS complex.  The P waves are wide suggesting left...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Sinus arrhythmia with a PAC The rhythm is irregular and the rate is 60/min.   The P waves are upright and are associated with a QRS complex.  The 3rd complex arrives early in the cardiac cycle.   It's P waves is partially hidden in the T wave of the 2nd complex.  The R-R interval between the 1st and 2nd complex is 1.0 sec and the R-R interval between the 5th and 6th complex is .88 sec.   PR:  .16 sec,  QRS:  .08 sec,  QT:  .40 sec. 2. Normal sinus rhythm with PJCs The rhythm is irregular with some junctional ectopic beats.   The rate is 90/min.   The P are present and have a corresponding QRS complex.  There is some down slopping of the ST segment. The P wave of the 3rd and 10th beat is inverted. PR:  .12 sec,  QRS:  .10 sec,  QT: ...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. NSR with unifocal PVCs (bigeminy) The rhythm is irregular with multiple ectopic beats.   The rate is 96/min.  The P waves are positive and are associated with a QRS complex.  Unifocal PVCs occur every other beat.  There are P waves before the 3rd and 4th PVC.   The remaining PVC have a slurred upstroke on the R wave suggesting that they are fused with a P wave, this is especially evident on the 6th PVC.  There is down slopping of the ST segment with a negative T wave.  PR:  .12 sec,  QRS:  .08 sec,  QT:  . 36 sec. 2. NSR with unifocal PVCs (trigeminy) The rhythm is irregular due to the ectopic beats.  The rate is 72/min.  There are positive P waves that are associated with a QRS complex.  Unifocal PVCs are seen every 3rd beat in a trigeminal pattern.  A compensatory pause fo...