1. Practice Rhythms Strips
Chapter 4
Practice Rhythms Strips
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2. Figure 4-23
This rhythm strip is from at 35-year-old woman complaining of chest pain and palpitations.
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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3. Figure 4-23
This rhythm strip is from at 35-year-old woman complaining of chest pain and palpitations.
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
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4. Figure 4-24 Ventricular rate/rhythm Atrial rate/rhythm PR interval
QRS duration
Identification
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5. Figure 4-24 Ventricular rate/rhythm
83 (sinus beats) / regular except for events
Atrial rate/rhythm
PR interval
0.16 sec
QRS duration
sec
Identification
Sinus rhythm at 83 bpm with frequent PACs (atrial bigeminy), ST-segment depression, inverted T waves
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6. Figure 4-25 Ventricular rate/rhythm Atrial rate/rhythm PR interval
QRS duration
Identification
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7. Figure 4-25 Ventricular rate/rhythm 98 bpm/ regular Atrial rate/rhythm
PR interval
0.16 sec
QRS duration
sec
Identification
Sinus rhythm at 98 bpm;
ST-segment elevation
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8. Figure 4-26
This rhythm strip is from a 96-year-old man complaining of chest pain and palpitations. Medications include Lanoxin and Coumadin.
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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9. Figure 4-26
This rhythm strip is from a 96-year-old man complaining of chest pain and palpitations. Medications include Lanoxin and Coumadin.
Ventricular rate/rhythm
88-130/min / irregular
Atrial rate/rhythm
Unable to determine
PR interval
QRS duration
0.08 second
Identification
Atrial fibrillation at bpm
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10. Figure 4-27 Ventricular rate/rhythm Atrial rate/rhythm PR interval
QRS duration
Identification
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11. Figure 4-27 Ventricular rate/rhythm
93/min / regular except for the event
Atrial rate/rhythm
PR interval
0.16 sec
QRS duration
0.04 sec
Identification
Sinus rhythm at 93 bpm with a PAC
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12. This rhythm strip is from a 57-year-old man with no cardiac history.
Figure 4-28
This rhythm strip is from a 57-year-old man with no cardiac history.
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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13. This rhythm strip is from a 57-year-old man with no cardiac history.
Figure 4-28
This rhythm strip is from a 57-year-old man with no cardiac history.
Ventricular rate/rhythm
111 bpm / regular except for event
Atrial rate/rhythm
PR interval
0.18 second
QRS duration
0.08 sec
Identification
Sinus tachycardia at 111 bpm with a nonconducted PAC
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14. Figure 4-29
This rhythm strip is from a 74-year-old woman with difficulty breathing.
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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15. Figure 4-29
This rhythm strip is from a 74-year-old woman with difficulty breathing.
Ventricular rate/rhythm
75-107/min / irregular
Atrial rate/rhythm
Unable to determine
PR interval
QRS duration
0.08 sec
Identification
Atrial flutter at /min
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16. Figure 4-30
This rhythm strip is from a 71-year-old man complaining of shoulder pain that has been present for 3 weeks.
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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17. Figure 4-30
This rhythm strip is from a 71-year-old man complaining of shoulder pain that has been present for 3 weeks.
Ventricular rate/rhythm
115/min / regular except for events
Atrial rate/rhythm
PR interval
0.12 second (sinus beats)
QRS duration
0.08 second (sinus beats)
Identification
Sinus tachycardia at 115/min with PACs and ST-segment elevation
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18. Figure 4-31 Ventricular rate/rhythm Atrial rate/rhythm PR interval
QRS duration
Identification
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19. Figure 4-31 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
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20. This rhythm strip is from an 82-year-old man complaining of back pain.
Figure 4-32
This rhythm strip is from an 82-year-old man complaining of back pain.
Lead II
Lead MCL1
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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21. This rhythm strip is from an 82-year-old man complaining of back pain.
Figure 4-32
This rhythm strip is from an 82-year-old man complaining of back pain.
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
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22. Figure 4-33 Ventricular rate/rhythm Atrial rate/rhythm PR interval
QRS duration
Identification
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23. Figure 4-33 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
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24. Figure 4-34 Ventricular rate/rhythm Atrial rate/rhythm PR interval
QRS duration
Identification
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25. Figure 4-34 Ventricular rate/rhythm 70/min / regular
Atrial rate/rhythm
70/min (sinus beats) / Unable to determine
PR interval
Varies
QRS duration
Identification
Underlying rhythm is sinus but pacemaker site varies; ventricular rate approx 70 bpm; patient with known WPW; note delta waves
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26. Figure 4-35
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.
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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27. Figure 4-35
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.
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
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28. Figure 4-36 Ventricular rate/rhythm Atrial rate/rhythm PR interval
QRS duration
Identification
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29. Figure 4-36 Ventricular rate/rhythm 29/min / regular
Atrial rate/rhythm
Unable to determine
PR interval
QRS duration
0.10 sec
Identification
Controlled atrial fibrillation at 29/min
Note: This patient was diagnosed with digitalis toxicity.
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30. Figure 4-37
This rhythm strip is from a 67-year-old woman complaining of dizziness and a “funny feeling” in her chest. She denies chest pain and is not short of breath.
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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31. Figure 4-37
This rhythm strip is from a 67-year-old woman complaining of dizziness and a “funny feeling” in her chest. She denies chest pain and is not short of breath.
Ventricular rate/rhythm
186/min / regular
Atrial rate/rhythm
Unable to determine
PR interval
QRS duration
0.06 sec
Identification
AVNRT at 186 bpm with
ST-segment depression
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32. Figure 4-38 Ventricular rate/rhythm Atrial rate/rhythm PR interval
QRS duration
Identification
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33. Figure 4-38 Ventricular rate/rhythm 170/min / regular
Atrial rate/rhythm
PR interval
0.08 sec
QRS duration
0.06 sec
Identification
Atrial tachycardia at 170 bpm
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34. Figure 4-39 Ventricular rate/rhythm Atrial rate/rhythm PR interval
QRS duration
Identification
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35. Figure 4-39 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
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36. Questions?
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