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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 68 bpm/regular
Atrial rate/rhythm PR interval 0.24 sec QRS duration 0.06 to 0.08 sec Identification Sinus rhythm with first-degree AV block, ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 83/min (sinus beats)/
Regular except for the event Atrial rate/rhythm PR interval 0.20 sec QRS duration 0.08 to 0.10 sec Identification Sinus rhythm with two PJCs, ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 83-year-old woman with syncope. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 38 to 75 bpm/irregular
Atrial rate/rhythm 75 bpm/regular PR interval Lengthening QRS duration 0.06 to 0.08 sec Identification Second-degree AV block, type I Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 82-year-old man complaining of back pain. Top = lead II, bottom = MCL1 Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 41 to 73 bpm/irregular
Atrial rate/rhythm 56 to 125 bpm/irregular PR interval 0.20 sec QRS duration 0.12 sec Identification Sinus rhythm with a nonconducted PAC Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 86-year-old woman who experienced a cardiopulmonary arrest. The initial rhythm was asystole. The following rhythm resulted after IV administration of epinephrine and atropine. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 40 bpm/regular
Atrial rate/rhythm None PR interval QRS duration 0.18 sec Identification Idioventricular rhythm (IVR) (ventricular escape rhythm) Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 69-year-old man complaining of shortness of breath. Lung sounds reveal bilateral rales. Blood pressure: 160/58. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 107 bpm (sinus beats)/
Regular except for the events Atrial rate/rhythm PR interval 0.20 sec (sinus beats) QRS duration 0.08 sec (sinus beats) Identification Sinus tachycardia with uniform PVCs Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 68 bpm/regular
Atrial rate/rhythm PR interval 0.28 sec QRS duration 0.06 sec Identification Sinus rhythm with first-degree AV block, ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 214 bpm/regular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.14 sec Identification Monomorphic ventricular tachycardia Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 214 bpm (VT) to 71 bpm (atrial fib)/ Irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.12 to 0.16 sec (VT) to sec (atrial fib) Identification Monomorphic VT to atrial fibrillation Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 88 bpm/regular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.06 sec Identification Atrial flutter with ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 32 bpm/regular
Atrial rate/rhythm 32 bpm (sinus beats)/ None (junctional beats) to regular (sinus beats) PR interval 0.14 sec (sinus beats) QRS duration 0.04 to 0.06 sec Identification Junctional bradycardia with ST-segment depression to sinus bradycardia, inverted T waves Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 35 bpm/regular
Atrial rate/rhythm 71 bpm/regular PR interval Varies QRS duration 0.12 sec Identification Complete (third-degree) AV block with inverted T waves Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 52-year-old man found unresponsive, apneic, and pulseless. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 88 bpm/regular
Atrial rate/rhythm None PR interval QRS duration 0.12 to 0.14 sec Identification Accelerated idioventricular rhythm (AIVR) Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 79 bpm (sinus beats)/
Regular except for the event(s) Atrial rate/rhythm PR interval 0.24 sec (sinus beats) QRS duration 0.08 sec (sinus beats) Identification Sinus rhythm with first-degree AV block and PACs Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 48 to 83 bpm/irregular
Atrial rate/rhythm 167 bpm/regular PR interval 0.24 sec QRS duration 0.12 sec Identification Second-degree AV block type II with ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular paced activity?
Atrial paced activity? Yes Ventricular paced activity? Paced interval rate 71 Identification 100% paced rhythm – AV sequential pacemaker Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
These rhythm strips are from a 78-year-old man complaining of shortness of breath. He has a history of COPD, coronary artery disease, and hypertension. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 55 to 94 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.10 sec Identification Atrial fibrillation (controlled) Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 97-year-old woman after a fall. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 88 bpm/regular
Atrial rate/rhythm PR interval 0.24 sec QRS duration 0.06 sec Identification Sinus rhythm with first-degree AV block, ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 70-year-old man complaining of a sharp pain across his shoulders. Blood pressure: 218/86. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 115/min (sinus beats)/
Regular except for the events Atrial rate/rhythm PR interval 0.18 sec (sinus beats) QRS duration 0.06 sec (sinus beats) Identification Sinus tachycardia with uniform PVCs Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 76-year-old man complaining of indigestion. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 32 bpm/regular
Atrial rate/rhythm None PR interval QRS duration 0.06 sec Identification Junctional bradycardia with ST-segment depression and inverted T waves Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 80-year-old woman complaining of weakness. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular paced activity? Yes
Atrial paced activity? No Ventricular paced activity? Yes Paced interval rate 83 Identification 100% ventricular paced rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 55/min (sinus beats)/
Regular except for the event (every other beat is an ectopic beat) Atrial rate/rhythm PR interval 0.12 sec (sinus beats) QRS duration 0.08 to 0.10 sec (sinus beats) Identification Sinus bradycardia with ventricular bigeminy Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 90-year-old woman complaining of hip pain after a fall. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 75 bpm/regular
Atrial rate/rhythm PR interval 0.18 sec QRS duration 0.08 to 0.10 sec Identification Sinus rhythm with ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 86-year-old woman complaining of chest pain that she rates a 4 on a scale of 0 to 10. Blood pressure: 142/72. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 60 bpm/regular
Atrial rate/rhythm PR interval 0.20 sec QRS duration 0.06 sec Identification Sinus rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 78-year-old man complaining of palpitations. Note the point at which the patient was defibrillated. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm
63 to 79 bpm (sinus beats)/ Irregular (sinus beats) Atrial rate/rhythm PR interval 0.12 sec (sinus beats) QRS duration 0.04 to 0.06 sec (sinus beats) Identification Monomorphic ventricular tachycardia – shock – ventricular beats – sinus arrhythmia Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 68 bpm (sinus beats)/
Regular except for the event Atrial rate/rhythm PR interval 0.18 sec (sinus beats) QRS duration 0.06 sec (sinus beats) Identification Sinus rhythm with uniform PVCs Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 115 bpm (sinus beats)/
Regular except for the event Atrial rate/rhythm PR interval 0.16 sec QRS duration 0.08 to 0.10 sec Identification Sinus tachycardia with PACs Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 3-month-old infant who had an altered level of responsiveness. She was limp with a respiratory rate of 4 breaths/min. Blood sugar was 174. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 125 bpm/regular
Atrial rate/rhythm PR interval 0.12 to 0.16 sec QRS duration 0.06 sec (sinus beats) Identification Sinus tachycardia with an interpolated PVC Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 83-year-old man complaining of chest pain. He had a new pacemaker implanted 5 days ago. His blood pressure is 148/60. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 79 bpm/regular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.08 sec Identification Atrial fibrillation (controlled) Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 52-year-old man with substernal chest pain. He has a history of COPD and mitral valve regurgitation. Blood pressure: 140/78. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 75 bpm/regular
Atrial rate/rhythm PR interval 0.14 sec QRS duration 0.06 to 0.08 sec Identification Sinus rhythm with ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 34 bpm/regular
Atrial rate/rhythm 68 bpm/regular PR interval 0.14 to 0.16 sec QRS duration 0.10 sec Identification 2:1 AV block, probably type I Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 60 to 98 bpm/irregular
Atrial rate/rhythm 111 bpm/regular PR interval Lengthens QRS duration 0.08 sec Identification Second-degree AV block, type I Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 75 bpm/regular
Atrial rate/rhythm None PR interval QRS duration 0.08 sec Identification Accelerated junctional rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 54 bpm/regular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.08 sec Identification Atrial fibrillation (controlled) Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm None
Atrial rate/rhythm PR interval QRS duration Identification Asystole Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular paced activity? Yes
Atrial paced activity? No Ventricular paced activity? Yes Paced interval rate 65 Identification 100% ventricular paced rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
These rhythm strips are from a 46-year-old woman complaining of abdominal pain. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 107 bpm (sinus beats)/
Regular except for the events Atrial rate/rhythm PR interval 0.14 sec (sinus beats) QRS duration 0.06 sec (sinus beats) Identification Sinus tachycardia with uniform PVCs Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 61-year-old man with a history of heart failure. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 65 to 75 bpm (sinus beats)/Irregular
Atrial rate/rhythm PR interval 0.32 sec (sinus beats) QRS duration 0.18 sec (sinus beats) Identification Sinus rhythm with first-degree AV block, wide QRS (bundle branch block), multiform PVCs, and ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 1-month-old infant after a 3-minute seizure. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 130 bpm/regular
Atrial rate/rhythm PR interval 0.14 to 0.16 sec QRS duration 0.06 to 0.08 sec Identification Sinus tachycardia Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 45 bpm/regular
Atrial rate/rhythm 115 bpm/regular PR interval Varies QRS duration 0.16 sec Identification Complete (third-degree) AV block Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 72-year-old man complaining of chest pain. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular paced activity? Yes
Atrial paced activity? No Ventricular paced activity? Yes Paced interval rate 60 Identification 100% ventricular paced rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 77-year-old woman with a congested cough. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 107 to 200 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.06 to 0.08 sec Identification Atrial fibrillation (uncontrolled) Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm
30 bpm (junctional beats) to 56 bpm (sinus beats)/ Irregular (junctional beats) to regular (sinus beats) Atrial rate/rhythm None (junctional beats) to 56 bpm (sinus beats)/ None (junctional beats) to regular (sinus beats) PR interval None (junctional beats) to 0.18 (sinus beats) QRS duration 0.04 sec (junctional beats) to 0.08 (sinus beats) Identification Junctional bradycardia to sinus bradycardia Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 83 bpm (sinus beats)/regular
Atrial rate/rhythm PR interval 0.20 sec (sinus beats) QRS duration 0.06 to 0.08 sec (sinus beats) Identification Atrial flutter to sinus rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 96 bpm (sinus beats)/
Regular except for the event Atrial rate/rhythm PR interval 0.12 sec (sinus beats) QRS duration 0.08 to 0.10 sec (sinus beats) Identification Sinus rhythm with uniform PVCs Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 54-year-old man who had a syncopal episode. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 58 bpm/regular
Atrial rate/rhythm PR interval 0.20 sec QRS duration 0.08 sec Identification Sinus bradycardia Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 66-year-old man complaining of chest pain. Blood pressure: 170/96. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 107 bpm/regular
Atrial rate/rhythm PR interval 0.24 sec QRS duration 0.08 sec Identification Sinus tachycardia with first-degree AV block Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 43-year-old woman complaining of palpitations. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 214 bpm/regular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.08 sec Identification Narrow-QRS tachycardia Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
A 43-year-old woman is complaining of palpitations. The patient has a history of SVT and states she cannot tolerate adenosine. The following rhythm is observed on the cardiac monitor after diltiazem administration. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 187 bpm (atrial beats)/ Regular (atrial beats)
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.08 sec (atrial beats) Identification Junctional to sinus to narrow-QRS tachycardia Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm Unable to determine
Atrial rate/rhythm PR interval QRS duration Identification Ventricular fibrillation (coarse) Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 37 bpm/regular
Atrial rate/rhythm 75 bpm/regular PR interval 0.28 sec QRS duration 0.06 sec Identification 2:1 AV block, probably type I Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 27 bpm/regular
Atrial rate/rhythm PR interval 0.22 sec QRS duration 0.12 sec Identification Sinus bradycardia with first-degree AV block, wide-QRS (probable bundle branch block), ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 76-year-old woman complaining of back pain. Her medical history includes a myocardial infarction 2 years ago. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular paced activity? Yes
Atrial paced activity? No Ventricular paced activity? Yes Paced interval rate 65 Identification 100% ventricular paced rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 80-year-old man found sitting in a chair. He is unresponsive, apneic, and pulseless. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm None
Atrial rate/rhythm PR interval QRS duration Identification Asystole – the electrical activity shown is caused by pacemaker spikes from the patient’s permanent pacemaker (no capture) Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 88-year-old woman complaining of hip pain after a fall injury. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 68 to 125 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.08 sec Identification Atrial fibrillation Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 42 to 68 bpm/irregular
Atrial rate/rhythm 68 bpm/regular PR interval Lengthens QRS duration 0.10 sec Identification Second-degree AV block type I with a ventricular complex Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 48 bpm (junctional beats)/ regular
Atrial rate/rhythm Unable to determine (junctional beats) PR interval QRS duration 0.06 to 0.08 sec Identification Sinus bradycardia with a first-degree AV block to junctional escape rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 67-year-old woman found unresponsive on the side of the road. Outdoor temperature is 112°F. Blood pressure: 238/110, respiratory rate: 60/min. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 136 bpm/regular
Atrial rate/rhythm PR interval 0.16 sec QRS duration 0.08 sec Identification Sinus tachycardia with ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 84-year-old man complaining of dizziness. He had a triple bypass 4 days ago. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 60 bpm (sinus beats)/
Regular except for the event (every other beat is an ectopic beat) Atrial rate/rhythm Regular except for the event PR interval 0.16 sec (sinus beats) QRS duration 0.08 sec (sinus beats) Identification Sinus rhythm with ventricular bigeminy, ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 81-year-old woman with an altered level of responsiveness. blood pressure: 160/70, blood sugar: 114. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 56 bpm/regular
Atrial rate/rhythm PR interval 0.24 sec QRS duration 0.06 sec Identification Sinus bradycardia with first-degree AV block Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 80-year-old woman who was playing Bingo when she felt dizzy and slumped over in her chair. Bystanders state she was unresponsive for approximately 5 minutes. A pulse is present. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 75 to 94 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.08 sec Identification Atrial fibrillation (controlled) Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 91-year-old woman complaining of chest pain and difficulty breathing. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 94 to 108 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.10 sec Identification Atrial fibrillation with ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 85-year-old woman complaining of numbness in her legs. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 48 bpm/regular
Atrial rate/rhythm PR interval 0.16 sec QRS duration 0.08 sec Identification Sinus bradycardia Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 59-year-old woman who complained of sudden weakness in her legs and fell to the floor in her kitchen. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 50 to 79 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.12 sec Identification Atrial fibrillation (controlled) with ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 82-year-old woman with vomiting x 2 days. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 115 bpm/regular
Atrial rate/rhythm PR interval 0.18 sec QRS duration 0.06 sec Identification Sinus tachycardia Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 62-year-old woman complaining of chest pain. Her blood pressure is 146/104, respirations are 20. Breath sounds are clear. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 167 bpm/regular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.06 sec Identification Narrow-QRS tachycardia (SVT) with ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 6-year-old boy immediately after a seizure. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 68 to 88 bpm/irregular
Atrial rate/rhythm PR interval 0.12 sec QRS duration 0.08 sec Identification Sinus arrhythmia Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 76-year-old man who was playing golf and experienced a syncopal episode. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 65 bpm/regular
Atrial rate/rhythm PR interval 0.16 sec QRS duration 0.08 sec Identification Sinus rhythm with ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
These rhythm strips are from a 44-year-old woman complaining of chest pain. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular rate/rhythm 176 bpm/regular
Atrial rate/rhythm None PR interval QRS duration 0.12 to 0.14 sec Identification Monomorphic ventricular tachycardia Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
140
Ventricular rate/rhythm 29 bpm/regular
Atrial rate/rhythm 71 bpm/regular PR interval Varies QRS duration 0.16 sec Identification Complete (third-degree) AV block with ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from an 81-year-old woman complaining of chest pain. Copyright © 2006 by Mosby Inc. All rights reserved.
142
Ventricular rate/rhythm 76 bpm/regular
Atrial rate/rhythm None PR interval QRS duration 0.12 to 0.14 sec Identification Accelerated idioventricular rhythm (AIVR) Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
This rhythm strip is from a 74-year-old woman complaining of weakness. Copyright © 2006 by Mosby Inc. All rights reserved.
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Ventricular paced activity? Yes
Atrial paced activity? No Ventricular paced activity? Yes Paced interval rate 68 Identification Ventricular demand pacemaker Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
146
Ventricular rate/rhythm 75 to 150 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.08 sec Identification Atrial flutter Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
148
Ventricular rate/rhythm 42 bpm (sinus beats)/
Regular except for the event (every other beat is an ectopic beat) Atrial rate/rhythm Regular except for the event PR interval 0.12 sec (sinus beats) QRS duration 0.08 to 0.10 sec (sinus beats) Identification Sinus bradycardia with ventricular bigeminy Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
150
Ventricular rate/rhythm 42 bpm/regular
Atrial rate/rhythm None PR interval QRS duration 0.24 sec Identification Accelerated idioventricular rhythm (AIVR) Copyright © 2006 by Mosby Inc. All rights reserved.
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Rhythm Identification
These rhythm strips are from a 63-year-old woman who experienced a syncopal episode. Blood pressure is 200/90, blood sugar is 98. Copyright © 2006 by Mosby Inc. All rights reserved.
152
Ventricular rate/rhythm 44 bpm/regular
Atrial rate/rhythm 88 bpm/regular PR interval 0.20 sec QRS duration 0.10 sec Identification 2:1 AV block, probably type I Copyright © 2006 by Mosby Inc. All rights reserved.
153
Rhythm Identification
This rhythm strip is from an 84-year-old woman with a nosebleed. Blood pressure: 250/74. Copyright © 2006 by Mosby Inc. All rights reserved.
154
Ventricular rate/rhythm 68 bpm/regular
Atrial rate/rhythm PR interval 0.16 sec QRS duration 0.08 sec Identification Sinus rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
155
Rhythm Identification
This rhythm strip is from a 79-year-old man complaining of palpitations. His initial blood pressure was 112/84. His second blood pressure, 8 minutes after the first, was 78/P. Copyright © 2006 by Mosby Inc. All rights reserved.
156
Ventricular rate/rhythm 147 bpm/regular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.06 to 0.08 sec Identification Narrow-QRS tachycardia (SVT) with ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
157
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
158
Ventricular paced activity? Yes
Atrial paced activity? No Ventricular paced activity? Yes Paced interval rate 60 Identification 100% ventricular paced rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
159
Rhythm Identification
This rhythm strip is from an 80-year-old man complaining of weakness and dizziness. Blood pressure is 160/98, blood sugar is 88. Copyright © 2006 by Mosby Inc. All rights reserved.
160
Ventricular rate/rhythm 63 to 100 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.08 to 0.10 sec Identification Atrial fibrillation (controlled) Copyright © 2006 by Mosby Inc. All rights reserved.
161
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
162
Ventricular rate/rhythm 42 to 71 bpm/irregular
Atrial rate/rhythm 125 bpm/regular PR interval 0.24 sec QRS duration 0.10 to 0.12 sec Identification Second-degree AV block type II Copyright © 2006 by Mosby Inc. All rights reserved.
163
Rhythm Identification
This rhythm strip is from a 58-year-old man with chest pain that he rates as a 2 on a scale of 0 to 10. He states he recently began taking pills for weight control. Copyright © 2006 by Mosby Inc. All rights reserved.
164
Ventricular rate/rhythm 91 bpm (sinus beats)/
Regular except for the event(s) Atrial rate/rhythm PR interval 0.20 sec (sinus beats) QRS duration 0.06 sec (sinus beats) Identification Sinus rhythm with uniform PVCs, ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
165
Rhythm Identification
This rhythm strip is from a 60-year-old woman complaining of palpitations and shortness of breath. Copyright © 2006 by Mosby Inc. All rights reserved.
166
Ventricular rate/rhythm 130 to 214 bpm/ irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.08 sec Identification Atrial fibrillation with a rapid ventricular response (RVR) Copyright © 2006 by Mosby Inc. All rights reserved.
167
Rhythm Identification
This rhythm strip is from a 60-year-old woman complaining of palpitations and shortness of breath after administration of adenosine 6 mg IV. Copyright © 2006 by Mosby Inc. All rights reserved.
168
Ventricular rate/rhythm 28 to 63 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.08 sec Identification Atrial fibrillation Copyright © 2006 by Mosby Inc. All rights reserved.
169
Rhythm Identification
This rhythm strip is from a 60-year-old woman complaining of palpitations and shortness of breath 1 minute after administration of adenosine 12 mg IV. Copyright © 2006 by Mosby Inc. All rights reserved.
170
Ventricular rate/rhythm 18 to 21 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.08 sec Identification Atrial fibrillation Copyright © 2006 by Mosby Inc. All rights reserved.
171
Rhythm Identification
This rhythm strip is from a 60-year-old woman complaining of palpitations and shortness of breath two minutes after administration of adenosine 6 mg IV. Copyright © 2006 by Mosby Inc. All rights reserved.
172
Ventricular rate/rhythm 115 to 250 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.08 sec Identification Atrial fibrillation with a rapid ventricular response (RVR) Copyright © 2006 by Mosby Inc. All rights reserved.
173
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
174
Ventricular rate/rhythm 30 bpm (junctional beats)/irregular
Atrial rate/rhythm None (junctional beats)/irregular PR interval 0.16 sec (sinus beats) QRS duration 0.06 sec Identification Sinus beat, two junctional beats, sinus beat; ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
175
Rhythm Identification
This rhythm strip is from a 90-year-old woman with shortness of breath. Copyright © 2006 by Mosby Inc. All rights reserved.
176
Ventricular paced activity? Yes
Atrial paced activity? No Ventricular paced activity? Yes Paced interval rate 60 Identification 100% ventricular paced rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
177
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
178
Ventricular rate/rhythm 75 bpm (sinus beats)/
Regular except for the event(s) Atrial rate/rhythm PR interval 0.16 to 0.18 sec (sinus beats) QRS duration 0.04 to 0.06 sec (sinus beats) Identification Sinus rhythm with uniform PVCs Copyright © 2006 by Mosby Inc. All rights reserved.
179
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
180
Ventricular rate/rhythm 100 bpm (sinus beats) to 150 bpm (VT)/Regular
Atrial rate/rhythm 100 bpm (sinus beats)/ Regular to unable to determine PR interval 0.24 sec (sinus beats) QRS duration 0.08 sec (sinus beats) Identification Sinus rhythm with first-degree AV block to monomorphic ventricular tachycardia (VT) Copyright © 2006 by Mosby Inc. All rights reserved.
181
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
182
Ventricular rate/rhythm 47 bpm/regular
Atrial rate/rhythm 115 bpm/regular PR interval Varies QRS duration 0.08 sec Identification Complete (third-degree) AV block with ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
183
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
184
Ventricular rate/rhythm 88 to 167 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.06 to 0.08 sec Identification Atrial fibrillation Copyright © 2006 by Mosby Inc. All rights reserved.
185
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
186
Ventricular rate/rhythm None
Atrial rate/rhythm 94 bpm/regular PR interval QRS duration Identification P-wave asystole Copyright © 2006 by Mosby Inc. All rights reserved.
187
Rhythm Identification
This rhythm strip is from a 74-year-old woman with chest pain. Blood pressure: 192/90. She rates her pain as a 9 on a scale of 0 to 10. Copyright © 2006 by Mosby Inc. All rights reserved.
188
Ventricular rate/rhythm 136 bpm/regular
Atrial rate/rhythm PR interval 0.14 sec QRS duration 0.08 sec Identification Sinus tachycardia Copyright © 2006 by Mosby Inc. All rights reserved.
189
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
190
Ventricular rate/rhythm 91 bpm/ Regular except for the event
Atrial rate/rhythm PR interval 0.16 sec QRS duration 0.06 sec Identification Sinus rhythm with a nonconducted PAC Copyright © 2006 by Mosby Inc. All rights reserved.
191
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
192
Ventricular rate/rhythm 35 bpm/regular
Atrial rate/rhythm PR interval 0.16 sec QRS duration 0.06 sec Note U waves are present (they follow the T waves) Identification Sinus bradycardia with ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
193
Rhythm Identification
This rhythm strip is from a 97-year-old man with chest pain. Copyright © 2006 by Mosby Inc. All rights reserved.
194
Ventricular paced activity?
Atrial paced activity? Yes Ventricular paced activity? Paced interval rate 60 Identification AV sequential pacemaker with failure to capture Copyright © 2006 by Mosby Inc. All rights reserved.
195
Rhythm Identification
This rhythm strip is from an 85-year-old woman with an altered level of responsiveness. Blood pressure: 136/78, blood sugar is 96. Copyright © 2006 by Mosby Inc. All rights reserved.
196
Ventricular rate/rhythm 115 bpm (sinus beats)/
Regular except for the event Atrial rate/rhythm PR interval 0.20 sec (sinus beats) QRS duration 0.08 to 0.10 sec (sinus beats) Identification Sinus tachycardia with a PVC and a ventricular couplet Copyright © 2006 by Mosby Inc. All rights reserved.
197
Rhythm Identification
This rhythm strip is from an 88-year-old man complaining of chest pain that he rates as a 6 on a scale of 0 to 10. Blood pressure: 170/80. Copyright © 2006 by Mosby Inc. All rights reserved.
198
Ventricular rate/rhythm 115 bpm (sinus beats)/
Regular except for the event Atrial rate/rhythm PR interval 0.16 sec QRS duration 0.08 sec Identification Sinus tachycardia with PACs Copyright © 2006 by Mosby Inc. All rights reserved.
199
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
200
Ventricular rate/rhythm 29 bpm/essentially regular
Atrial rate/rhythm None PR interval QRS duration 0.04 to 0.06 sec Identification Junctional bradycardia with ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
201
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
202
Ventricular rate/rhythm 88 bpm/regular
Atrial rate/rhythm PR interval 0.28 sec QRS duration 0.08 sec Identification Sinus rhythm with first-degree AV block; ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
203
Rhythm Identification
This rhythm strip is from a 44-year-old construction worker with a sudden onset of chest pressure. Copyright © 2006 by Mosby Inc. All rights reserved.
204
Ventricular rate/rhythm 52 to 94 bpm/irregular
Atrial rate/rhythm PR interval 0.12 sec QRS duration 0.08 sec Identification Sinus arrhythmia at 52 to 94 bpm Copyright © 2006 by Mosby Inc. All rights reserved.
205
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
206
Ventricular-paced rhythm with pacemaker malfunction
Atrial pacing? No Ventricular pacing? Yes Paced interval 80 Identification Ventricular-paced rhythm with pacemaker malfunction (failure to capture) Copyright © 2006 by Mosby Inc. All rights reserved.
207
Rhythm Identification
This rhythm strip is from an 82-year-old man complaining of back pain. Top = lead II, bottom = MCL1. Copyright © 2006 by Mosby Inc. All rights reserved.
208
Ventricular rate/rhythm 41 to 73 bpm/irregular
Atrial rate/rhythm 56 to 125 bpm/irregular PR interval 0.20 sec QRS duration 0.12 Identification Sinus rhythm at 41 to 73 bpm with a nonconducted PAC Copyright © 2006 by Mosby Inc. All rights reserved.
209
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
210
Ventricular rate/rhythm 78/min/regular except for the event
Atrial rate/rhythm PR interval 0.16 sec QRS duration 0.06 sec Identification Sinus rhythm at 78 bpm with a PAC Copyright © 2006 by Mosby Inc. All rights reserved.
211
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
212
Ventricular rate/rhythm 44 bpm/regular
Atrial rate/rhythm PR interval 0.14 sec QRS duration 0.08 sec Identification Junctional rhythm; ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
213
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
214
Ventricular rate/rhythm
115 bpm (sinus beats)/regular except for the event Atrial rate/rhythm PR interval 0.16 sec (sinus beats) QRS duration 0.06 sec (sinus beats) Identification Sinus tachycardia with a PJC Copyright © 2006 by Mosby Inc. All rights reserved.
215
Rhythm Identification
This rhythm strip is from an 82-year-old man complaining of chest pain. Copyright © 2006 by Mosby Inc. All rights reserved.
216
Ventricular rate/rhythm 245 bpm/regular
Atrial rate/rhythm PR interval None QRS duration 0.28 sec Identification Monomorphic ventricular tachycardia Copyright © 2006 by Mosby Inc. All rights reserved.
217
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
218
Ventricular rate/rhythm 21 bpm/irregular
Atrial rate/rhythm PR interval 0.36 sec QRS duration 0.08 to 0.10 sec Identification Sinus bradycardia with junctional escape beats Copyright © 2006 by Mosby Inc. All rights reserved.
219
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
220
Ventricular rate/rhythm 48 to 83 bpm/irregular
Atrial rate/rhythm 167 bpm/regular PR interval 0.24 sec QRS duration 0.12 sec Identification Second-degree AV block type II; ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
221
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
222
Ventricular rate/rhythm 115 to 215 bpm/irregular
Atrial rate/rhythm Unable to determine/irregular PR interval Varies QRS duration 0.04 to 0.06 sec Identification Multifocal atrial tachycardia with ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
223
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
224
Ventricular rate/rhythm 71/min, regular
Atrial rate/rhythm PR interval 0.16 to 0.20 sec QRS duration 0.12 to 0.14 sec Identification Sinus rhythm at 71 bpm with a wide QRS, ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
225
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
226
Ventricular rate/rhythm 94 (sinus beats)/irregular
Atrial rate/rhythm PR interval 0.16 sec (sinus beats) QRS duration 0.08 sec (sinus beats) Identification Sinus rhythm with an episode of couplets and a run of VT Copyright © 2006 by Mosby Inc. All rights reserved.
227
Rhythm Identification
This rhythm strip is from a 73-year-old man complaining of chest pain. History of hypertension and lung disease. Medications include aspirin, albuterol, and Lotensin. Copyright © 2006 by Mosby Inc. All rights reserved.
228
Ventricular rate/rhythm 44 bpm/regular
U wave Ventricular rate/rhythm 44 bpm/regular Atrial rate/rhythm PR interval 0.16 sec QRS duration 0.06 sec Identification Sinus bradycardia at 44 bpm, ST-segment depression. Note the upright U waves following each T wave. Copyright © 2006 by Mosby Inc. All rights reserved.
229
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
230
Ventricular rate/rhythm 60 to 98 bpm/irregular
Atrial rate/rhythm 111 bpm/regular PR interval Lengthens QRS duration 0.08 sec Identification Second-degree AV block type I; ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
231
Rhythm Identification
This rhythm strip is from a 69-year-old man who is disoriented. He knows his name but has no idea where he is or how he got there. BP: 172/98, R: 20. Blood sugar: 127 mg/dL. Copyright © 2006 by Mosby Inc. All rights reserved.
232
Ventricular rate/rhythm 79 bpm/regular
Atrial rate/rhythm PR interval 0.18 sec QRS duration 0.06 to 0.08 sec Identification Sinus rhythm at 79 bpm Copyright © 2006 by Mosby Inc. All rights reserved.
233
Rhythm Identification
This rhythm strip is from a 35-year-old woman complaining of chest pain and palpitations. Copyright © 2006 by Mosby Inc. All rights reserved.
234
Ventricular rate/rhythm 188/min/regular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.06 sec Identification Narrow-QRS tachycardia (AVNRT) with ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
235
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
236
Ventricular rate/rhythm
64 bpm (sinus beats)/regular except for the event Atrial rate/rhythm PR interval 0.16 to 0.18 sec QRS duration 0.08 sec Identification Sinus rhythm with an episode of sinus arrest and a junctional escape beat Copyright © 2006 by Mosby Inc. All rights reserved.
237
Rhythm Identification
This rhythm strip is from an 82-year-old man complaining of back pain. Lead II Lead MCL1 Copyright © 2006 by Mosby Inc. All rights reserved.
238
Ventricular rate/rhythm 75/min/regular except for event
Lead II Lead MCL1 Ventricular rate/rhythm 75/min/regular except for event Atrial rate/rhythm PR interval 0.20 sec QRS duration 0.12 sec Identification Sinus rhythm at 75 bpm with a wide QRS and a nonconducted PAC Copyright © 2006 by Mosby Inc. All rights reserved.
239
Rhythm Identification
This rhythm strip is from a 51-year-old man complaining of dull chest pain that began about 2 hours ago. He rates his discomfort as a 6 on a scale of 1 to 10. BP: 70/48, R: 24. His skin is cool, pale, and diaphoretic. Copyright © 2006 by Mosby Inc. All rights reserved.
240
Ventricular rate/rhythm 48 bpm/regular
Atrial rate/rhythm 71 bpm/slightly irregular PR interval Varies QRS duration 0.08 to 0.10 sec Identification Complete AV block with ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
241
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
242
Ventricular rate/rhythm 250 to 333 bpm/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.16 sec Identification Polymorphic VT Copyright © 2006 by Mosby Inc. All rights reserved.
243
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
244
100% ventricular paced rhythm
Atrial pacing? No Ventricular pacing? Yes Paced interval 74 Identification 100% ventricular paced rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
245
Rhythm Identification
These rhythm strips are from a 78-year-old man complaining of shortness of breath. He has a history of COPD, coronary artery disease, and hypertension. Copyright © 2006 by Mosby Inc. All rights reserved.
246
Ventricular rate/rhythm 55-94/min/irregular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.10 sec Identification Controlled atrial fibrillation at bpm Copyright © 2006 by Mosby Inc. All rights reserved.
247
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
248
Ventricular rate/rhythm 50 bpm/regular
Atrial rate/rhythm 167 bpm/regular PR interval Varies QRS duration 0.06 sec Identification Third-degree AV block; ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
249
Rhythm Identification
This rhythm strip is from a 1-year-old girl. Mom says the infant suddenly went limp and her limbs began shaking. The episode lasted about 45 sec. Her temperature is normal. Copyright © 2006 by Mosby Inc. All rights reserved.
250
Ventricular rate/rhythm 215 bpm/regular
Atrial rate/rhythm PR interval 0.10 sec QRS duration 0.08 sec Identification Sinus tachycardia at 215 bpm Copyright © 2006 by Mosby Inc. All rights reserved.
251
Rhythm Identification
This rhythm strip is from an 81-year-old woman complaining of weakness. BP: 122/59, R: 12. Blood sugar is 109 mg/dL. Copyright © 2006 by Mosby Inc. All rights reserved.
252
Ventricular rate/rhythm 52 bpm/regular
Atrial rate/rhythm PR interval 0.16 to 0.20 sec QRS duration 0.06 sec Identification Sinus bradycardia Copyright © 2006 by Mosby Inc. All rights reserved.
253
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
254
Ventricular rate/rhythm 71 bpm/regular
Atrial rate/rhythm PR interval 0.14 sec QRS duration 0.08 sec Identification Accelerated junctional rhythm; ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
255
Rhythm Identification
This rhythm strip is from a 26-year-old man after a seizure. Copyright © 2006 by Mosby Inc. All rights reserved.
256
Ventricular rate/rhythm 64 to 94 bpm/irregular
Atrial rate/rhythm PR interval 0.16 sec QRS duration 0.06 to 0.08 sec Identification Sinus arrhythmia at 64 to 94 bpm Copyright © 2006 by Mosby Inc. All rights reserved.
257
Rhythm Identification
This rhythm strip is from an 18-year-old man with a gunshot wound to his chest. Copyright © 2006 by Mosby Inc. All rights reserved.
258
Ventricular rate/rhythm Unable to determine
Atrial rate/rhythm None PR interval QRS duration Identification Coarse ventricular fibrillation Copyright © 2006 by Mosby Inc. All rights reserved.
259
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
260
– AV sequential pacemaker
Atrial pacing? Yes Ventricular pacing? Paced interval 71 Identification 100% paced rhythm – AV sequential pacemaker Copyright © 2006 by Mosby Inc. All rights reserved.
261
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
262
Ventricular rate/rhythm 88/min/regular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.06 sec Identification Atrial flutter at 88 bpm with ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
263
Rhythm Identification
This rhythm strip is from a 77-year-old woman who states that she feels fine. She stopped at a blood pressure machine in Wal-Mart and the machine would not read her pulse rate. She later went to her physician’s office and then to the emergency department. Copyright © 2006 by Mosby Inc. All rights reserved.
264
Ventricular rate/rhythm 30 bpm/regular
Atrial rate/rhythm 68 bpm/regular PR interval 0.28 sec QRS duration 0.16 sec Identification 2:1 AV block, probably type II; ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
265
Rhythm Identification
This rhythm strip is from a 57-year-old man with no cardiac history. Copyright © 2006 by Mosby Inc. All rights reserved.
266
Ventricular rate/rhythm 111 bpm/regular except for event
Atrial rate/rhythm PR interval 0.18 sec QRS duration 0.08 sec Identification Sinus tachycardia at 111 bpm with a nonconducted PAC Copyright © 2006 by Mosby Inc. All rights reserved.
267
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
268
Ventricular rate/rhythm Two ventricular complexes to none
Atrial rate/rhythm None PR interval QRS duration 0.14 sec to none Identification Agonal rhythm/asystole Copyright © 2006 by Mosby Inc. All rights reserved.
269
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
270
Ventricular rate/rhythm 30 bpm (sinus beats)/regular except for events
Atrial rate/rhythm PR interval 0.12 to 0.16 sec (sinus beats) QRS duration 0.06 sec (sinus beats) Identification Sinus bradycardia with ventricular bigeminy, inverted T waves, horizontal ST-segments Copyright © 2006 by Mosby Inc. All rights reserved.
271
Rhythm Identification
These rhythm strips are from a 52-year-old man with syncope. Copyright © 2006 by Mosby Inc. All rights reserved.
272
Atrial pacing? Yes Ventricular pacing? No Paced interval 79
Identification Atrial pacemaker Copyright © 2006 by Mosby Inc. All rights reserved.
273
Rhythm Identification
This rhythm strip is from a 79-year-old woman with a nosebleed. Blood pressure is 222/118. Copyright © 2006 by Mosby Inc. All rights reserved.
274
Ventricular rate/rhythm 130 bpm/regular
Atrial rate/rhythm PR interval 0.16 sec QRS duration 0.12 sec Identification Sinus tachycardia at 130 bpm with a wide-QRS and ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
275
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
276
Ventricular rate/rhythm 52 bpm/regular
Atrial rate/rhythm None PR interval QRS duration 0.06 sec Identification Sinus beat to junctional escape rhythm with inverted T waves Copyright © 2006 by Mosby Inc. All rights reserved.
277
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
278
Ventricular rate/rhythm 54 bpm/regular (sinus beats)
Atrial rate/rhythm PR interval 0.12 sec (sinus beats) QRS duration sec (sinus beats) Identification Sinus bradycardia with ventricular bigeminy Copyright © 2006 by Mosby Inc. All rights reserved.
279
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
280
Ventricular rate/rhythm 40 bpm/regular
Atrial rate/rhythm 83 bpm/regular PR interval 0.24 sec QRS duration 0.10 sec Identification 2:1 AV block, probably type I; ST-segment depression Copyright © 2006 by Mosby Inc. All rights reserved.
281
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
282
Ventricular rate/rhythm 36 bpm/regular
Atrial rate/rhythm 72 bpm/regular PR interval 0.32 sec QRS duration 0.10 sec Identification 2:1 AV block, probably type 1 Copyright © 2006 by Mosby Inc. All rights reserved.
283
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
284
Ventricular rate/rhythm 167 bpm/regular
Atrial rate/rhythm PR interval 0.12 sec QRS duration 0.06 sec Identification Sinus tachycardia at 167 bpm Copyright © 2006 by Mosby Inc. All rights reserved.
285
Rhythm Identification
This rhythm strip is from an 83-year-old woman with syncope. Copyright © 2006 by Mosby Inc. All rights reserved.
286
Ventricular rate/rhythm 36 bpm/regular
Atrial rate/rhythm 72 bpm/regular PR interval 0.20 to 0.22 sec QRS duration 0.06 to 0.08 sec Identification 2:1 AV block, probably type I Copyright © 2006 by Mosby Inc. All rights reserved.
287
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
288
Ventricular rate/rhythm 150 bpm/essentially regular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.12 to 0.16 sec Identification Monomorphic VT Copyright © 2006 by Mosby Inc. All rights reserved.
289
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
290
100% ventricular-paced rhythm
Atrial pacing? No Ventricular pacing? Yes Paced interval 79 Identification 100% ventricular-paced rhythm Copyright © 2006 by Mosby Inc. All rights reserved.
291
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
292
Ventricular rate/rhythm
63 bpm (sinus beats)/regular except for the event (every third beat is a PJC) Atrial rate/rhythm PR interval 0.12 to 0.16 sec (sinus beats) QRS duration 0.06 sec (sinus beats) Identification Sinus rhythm with PJCs Copyright © 2006 by Mosby Inc. All rights reserved.
293
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
294
Ventricular rate/rhythm 180/min/regular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.04 sec Identification AVNRT at 180 bpm, ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
295
Rhythm Identification
This rhythm strip is from a 61-year-old woman complaining of shortness of breath. Blood pressure 176/110. Copyright © 2006 by Mosby Inc. All rights reserved.
296
Ventricular rate/rhythm 125 bpm/essentially regular except for events
Atrial rate/rhythm PR interval 0.12 sec (sinus beats) QRS duration 0.06 sec (sinus beats) Identification Sinus tachycardia with multiform PVCs Copyright © 2006 by Mosby Inc. All rights reserved.
297
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
298
Ventricular rate/rhythm 107 bpm/regular
Atrial rate/rhythm PR interval 0.24 sec QRS duration 0.08 sec Identification Sinus tachycardia with first-degree AV block Copyright © 2006 by Mosby Inc. All rights reserved.
299
Rhythm Identification
Copyright © 2006 by Mosby Inc. All rights reserved.
300
Ventricular rate/rhythm 71 bpm/regular
Atrial rate/rhythm Unable to determine PR interval QRS duration 0.12 sec Identification Accelerated idioventricular rhythm (AIVR) with ST-segment elevation Copyright © 2006 by Mosby Inc. All rights reserved.
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