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Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. 1st degree block with a PVC The rhythm is irregular due to the PVC.   The rate is 60/min.    The P waves are upright and precede the QRS complexes.   The PR interval is prolonged.   There is a single PVC present.  PR:  .36 sec,  QRS:  .08 sec,  QT:  .40 sec. 2. Agonal rhythm The rhythm may be regular or irregular.   The rate is 20/min.    No P waves are present.   The QRS complexes are wide suggesting a ventricular origin to the rhythm.   PR:  ---,  QRS:  .20 sec,  QT:  .52 sec. 3. Atrial fibrillation  The rhythm is irregular with a heart rate of 100/min.   The P waves are absent.   There are flutter waves seen between the QRS complex,  seen more clearly in the V1 lead.  No ectopic beats are noted.  PR:  ---,  QRS:  ...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Sinus bradycardia with a PJC The rhythm is irregular with a heart rate of 50/min.   The P waves are upright, except for the 2nd complex.   The P wave of the PJC is negative.   PR:  .16 sec,  QRS:  .08 sec, QT:  .40 sec. 2. Ventricular paced with unifocal PVCs The rhythm is irregular due to the PVCs.   The ventricular rate is 60/min.   No P waves are seen. There are two unifocal PVCs present, the 1st and 4th complexes.   There are ventricular pacer spikes before the remaining QRS complexes.  PR:  ---,  QRS:  .16 sec,  QT:  .44 sec. 3. Junctional tachycardia The rhythm is regular with a rate of 125/min.   The P waves are absent.  No ectopic beats are noted.  The QRS complex is narrow.   PR:  ---,  QRS:  .08 sec,  QT...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. 3rd degree heart block The rhythm is irregular with a ventricular rate of 30 and an atrial rate of 88/min.   The P waves and the QRS complexes are not associated.  The wide QRS complex suggests an underlying ventricular escape rhythm.  No ectopic beats are present.  PR:  ---,  QRS;  .12 sec,  QT:  ..60 sec. 2. Accelerated idioventricular rhythm The rhythm is regular with a rate of 68.   No P waves are noted.  The QRS complex is very wide and the T waves are tall.  No PVCs, PJCs, or PACs are present.   PR:  ---,  QRS:  .22 sec.  QT:  .56 sec.  This patient was actually profoundly hyperkalemic.   With severe hyperkalemia there is loss or flattening of the P wave,  a nodal rhythm,  bizarre and widened QRS complex that may have a sine wave appearan...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Agonal rhythm The rhythm is irregular.  The rate is 20/min.  No atrial activity is present.   The QRS complex is wide, bizzare looking, and slow. 2. Biventricular paced The rhythm is regular with a heart rate of 94/min.   The P waves are uniform, upright, and precede the QRS complexes.   There are biventricular pacer spikes seen before each QRS complex.  No ectopic beats are noted.  PR:  .12 sec,  QRS: .12 sec,  QT:  .40 sec. 3. Atrial fibrillation with slow ventricular response The rhythm is irregular with a ventricular rate of 30/min.   The R-R interval between the 1st and 2nd complexes is 1.68 sec and the R-R interval between the 2nd and 3rd complex is 1.52 sec.  No P waves are present but there looks like some small flutter waves present in the V1 lead, t...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Atrial flutter The rhythm is irregular with a rate of 100/min.   Flutter waves are seen with a varying ration of 2:1 3;1 and 4:1.  No ectopic beats are present.   PR:  ---,  QRS:  .08 sec,  QT:  ---.   Sometimes you cannot clearly pick out the T wave with atrial flutter. 2. NSR with bigeminal PVCs The rhythm  irregular with frequent PVCs.   The rate is 90/min.   The P waves are uniform, upright, and paired with a QRS complex.  There are bigeminal PVCs present.   A compensatory pause follows each PVC.   PR:  .16 sec,  QRS:  .08 sec,  QT:  .28 sec. 3. Junctional rhythm  The rhythm is regular and the heart rate is 50/min.   The P waves are negative and follow the QRS complex.   The QRS complex is wide so this sugge...