2 EKG strip questions

Nurses General Nursing

Published

Can you PLEASE help me to identify these 2 rhythm strips?

I think the first one is Sinus Rhythm with 3 PAC's OR 2nd degree AV block Type 2.

I think the second is Paroxysmal Atrial Tachycardia.

(Click image to enlarge).

LaceyRN12

101 Posts

Can you PLEASE help me to identify these 2 rhythm strips?

I think the first one is Sinus Rhythm with 3 PAC's OR 2nd degree AV block Type 2.

I think the second is Paroxysmal Atrial Tachycardia.

(Click image to enlarge).

LaceyRN12

101 Posts

Can you PLEASE help me to identify these 2 rhythm strips?

I think the first one is Sinus Rhythm with 3 PAC's OR 2nd degree AV block Type 2.

I think the second is Paroxysmal Atrial Tachycardia.

(Click image to enlarge).

MendedHeart

663 Posts

I think the first one is sinus arrhythmia/sinus pauses or PJCs, not sure

I think the second one looks like SVT with a conversion to normal sinus

Chisca, RN

745 Posts

Specializes in Dialysis.

Are you guessing or have you really analyzed each strip? Always do the same thing with every EKG strip. What is the atrial rate? What is the ventricular rate? Is there a P wave for every QRS? What is the PR interval? What is the QRS? In the first strip after you ask these questions you will notice that there is a lengthening PR interval then there is a dropped beat or a P wave without a QRS. That would be interpreted as sinus rhythm with 2nd degree AVHB type 1. Type 2 would have a fixed PR interval and would be more serious as this could progress to 3rd degree or complete heart block. Get into the habit of being able to defend your interpretation based what you see and measure on the strip. Look at the second strip and answer the questions you should ask with every EKG.

LaceyRN12

101 Posts

I'm not just throwing a random guess. The squares are SO TINY and the EKG line is too thick that it's hard to interpret the strips sometimes and just thought I'd ask for a little help, that's all.

The second strip is an SVT, which could also be paroxysmal atrial tachycardia because it goes in and out of the rhythm. Correct??

I think everyone else is confused and not sure themselves. No one's saying anything. :yawn:

kool-aide, RN

594 Posts

Specializes in Cardiac.

Strip 1 looks like SR with PACs

Strip 2 looks like PSVT into SR.

pmabraham, BSN, RN

2 Articles; 2,563 Posts

Specializes in Hospice, Palliative Care.
Specializes in PCCN.

1st- sinus with pac's ( compensatory pauses)

2nd SVT to NSR

? anyone else

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

duplicate threads merged.....

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I'm not just throwing a random guess. The squares are SO TINY and the EKG line is too thick that it's hard to interpret the strips sometimes and just thought I'd ask for a little help, that's all.

The second strip is an SVT, which could also be paroxysmal atrial tachycardia because it goes in and out of the rhythm. Correct??

I think everyone else is confused and not sure themselves. No one's saying anything. :yawn:

or people haven't had a chance to help......

You ask your self the same questions every time....is there a discernible "P" wave....is there one before every QRS? are the R-R intervals regular?

http://www.mauvila.com/ECG/ecg_atrial.htm

http://www.mauvila.com/ECG/ecg_junctional.htm

First tell me why you think strip #1 is second degree heart block? What is the criteria for 2 degree HB? where is your dropped beat to qualify as a HB? Is there a QRS for every "P" wave. Section 11 : AV Heart Blocks

The second tell me why it's atrial tachycardia.....can you see how this fast rhythm started? We know it isn't ventricular right? why? because the QRS morphology is the same/similar to the underlying rhythm so we know it is "above the ventricle" it is regular and it is fast...how fast? What is the rate?

Now what is the criteria for PSVT?

Section 8 : Supraventricular Tachycardias

EKG Reference Guide

prep8611

72 Posts

The first one is sinus arrhythmia and the second is a run of supraventricular tachycardia. It's not PACs because the underlying rhythm is irregular, with PACs u have extra p wave with a qrs following but the underlying rhythm must be regular.

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