Chapter 5
Practice Rhythm Strips
1
Figure 5-9
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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2
Figure 5-9
Ventricular rate/rhythm
45 bpm/regular
Atrial rate/rhythm
None
PR interval
None
QRS duration
0.06 sec
Identification
Junctional rhythm at 45 bpm
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3
Figure 5-10
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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4
Figure 5-10
Ventricular rate/rhythm
115 bpm (sinus beats)/regular except
for the event
Atrial rate/rhythm
115 bpm (sinus beats)/regular except
for the event
PR interval
0.16 sec (sinus beats)
QRS duration
0.06 sec (sinus beats)
Identification
Sinus tachycardia with a PJC
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5
Figure 5-11
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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6
Figure 5-11
Ventricular rate/rhythm
63 bpm (sinus beats)/regular except for the
event (every third beat is a PJC)
Atrial rate/rhythm
63 bpm (sinus beats)/regular except for the
event (every third beat is a PJC)
PR interval
0.12 to 0.16 sec (sinus beats)
QRS duration
0.06 sec (sinus beats)
Identification
Sinus rhythm with PJCs
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7
Figure 5-12
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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8
Figure 5-12
Ventricular rate/rhythm
138 bpm/regular
Atrial rate/rhythm
Unable to determine
PR interval
Unable to determine
QRS duration
0.10 sec
Identification
Narrow-QRS tachycardia, probably
junctional tachycardia
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9
Figure 5-13
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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10
Figure 5-13
Ventricular rate/
rhythm
33 bpm (sinus beats)
32 bpm (junctional beats)
Atrial rate/rhythm
33 bpm (sinus beats)
Unable to determine (junctional beats)
PR interval
0.20 sec (sinus beats)
QRS duration
0.04 to 0.06 sec
Identification
Sinus bradycardia to junctional bradycardia
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11
Figure 5-14
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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12
Figure 5-14
Ventricular rate/rhythm
75 bpm/regular
Atrial rate/rhythm
None
PR interval
None
QRS duration
0.08 sec
Identification
Accelerated junctional rhythm;
ST-segment depression
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13
Figure 5-15
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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14
Figure 5-15
Ventricular rate/rhythm
30/min (junctional beats) to 56/min (sinus
beats)/irregular
Atrial rate/rhythm
None (junctional beats) to 56/min (sinus
beats)
PR interval
None (junctional beats) to 0.18 (sinus
beats)
QRS duration
0.04 second (junctional beats) to 0.08
(sinus beats)
Identification
Junctional bradycardia at 30 bpm to sinus
bradycardia at 56 bpm
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15
Figure 5-16
This rhythm strip is from a 74-year-old woman complaining of
difficulty breathing. Blood pressure 158/122. Identify the
rhythm (lead II).
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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16
Figure 5-16
This rhythm strip is from a 74-year-old woman complaining of
difficulty breathing. Blood pressure 158/122. Identify the
rhythm (lead II).
Ventricular rate/rhythm
65 to 103 bpm/irregular
Atrial rate/rhythm
Unable to determine
PR interval
Unable to determine
QRS duration
0.06 to 0.08 second
Identification
Atrial fibrillation at 65 to 103 bpm
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17
Figure 5-17
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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18
Figure 5-17
Ventricular rate/rhythm
75 bpm/regular
Atrial rate/rhythm
None
PR interval
None
QRS duration
0.06 second
Identification
Accelerated junctional rhythm at 75
bpm
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19
Figure 5-18
This rhythm strip is from a 63-year-old woman who is
complaining of dizziness. Identify the rhythm (lead II).
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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20
Figure 5-18
This rhythm strip is from a 63-year-old woman who is
complaining of dizziness. Identify the rhythm (lead II).
Ventricular rate/rhythm
64 bpm (sinus beats)/regular except for the
event
Atrial rate/rhythm
64 bpm (sinus beats)/regular except for the
event
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
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21
Figure 5-19
This rhythm strip is from an 88-year-old woman who experienced a
syncopal episode. Blood sugar is 96. Medications include
verapamil. History: Myocardial infarction 9 years ago, stroke 5
years ago, hypertension, and diabetes.
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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22
Figure 5-19
This rhythm strip is from an 88-year-old woman who experienced a
syncopal episode. Blood sugar is 96. Medications include
verapamil. History: Myocardial infarction 9 years ago, stroke 5
years ago, hypertension, and diabetes.
Ventricular rate/rhythm
75 bpm/regular
Atrial rate/rhythm
75 bpm/regular
PR interval
0.16 sec
QRS duration
0.08 sec
Identification
Accelerated junctional rhythm
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23
Figure 5-20
This rhythm strip is from a 51-year-old man found unresponsive. He
has a history of esophageal varices and gastrointestinal bleeding.
Blood pressure 182/100. Identify the rhythm (lead I).
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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24
Figure 5-20
This rhythm strip is from a 51-year-old man found unresponsive. He
has a history of esophageal varices and gastrointestinal bleeding.
Blood pressure 182/100. Identify the rhythm (lead I).
Ventricular rate/rhythm
75 bpm/regular
Atrial rate/rhythm
75 bpm/regular
PR interval
0.12 sec
QRS duration
0.08 sec
Identification
Sinus rhythm at 75 bpm
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25
Figure 5-21
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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26
Figure 5-21
Ventricular rate/rhythm
45 bpm/regular
Atrial rate/rhythm
None
PR interval
None
QRS duration
0.08 sec
Identification
Junctional rhythm; ST-segment
elevation
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27
Figure 5-22
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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28
Figure 5-22
Ventricular rate/rhythm
58 to 79 bpm/irregular
Atrial rate/rhythm
Unable to determine
PR interval
Unable to determine
QRS duration
Unable to determine
Identification
Atrial flutter at 58 to 79 bpm
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29
Figure 5-23
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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30
Figure 5-23
Ventricular rate/rhythm
79 bpm/regular (junctional beats)
Atrial rate/rhythm
Not measurable in junctional beats
PR interval
Not measurable in junctional beats
QRS duration
0.06 sec
Identification
Sinus rhythm changing to an accelerated
junctional rhythm, back to a sinus rhythm
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31
Figure 5-24
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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32
Figure 5-24
Junctional escape beat
Nonconducted PAC
Ventricular rate/rhythm
70 bpm/regular except for the event
Atrial rate/rhythm
70 bpm/regular except for the event
PR interval
0.16 sec
QRS duration
0.08 sec
Identification
Sinus rhythm with a nonconducted PAC and
a junctional escape beat
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33
Figure 5-25
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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34
Figure 5-25
Ventricular rate/rhythm
44 bpm/regular
Atrial rate/rhythm
44 bpm/regular
PR interval
0.14 sec
QRS duration
0.08 sec
Identification
Junctional rhythm; ST-segment elevation
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35
Questions?
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