Having trouble interpreting this ECG

[JuliusSeizure]

At first I though it supraventricular tachycardia, but I'm having doubts since this doesn't have a regular pattern, which supraventricular tachycardia does.

I mean it's definitely some sort of tachycardia, I count the HR at 140

[TheCommuter, BSN, RN]

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[icuRNmaggie, BSN, RN]

Atrial Fibrillation with RVR.

[mrsboots87]

Also remember that SVT will always be a HR over 150 and usually higher than that. This rate seems to be somewhere between 140-150. Hard to get very accurate since its irregular. But another poster already gave you the answer. I have not learned this rhythm. My program focused on about 20 of the most common arrhythmia and this wasnt one of them so I'm not able to break it down as to why that is the rhythm. I just know its not SVT. Maybe someone will come along with how to break this down to see what it is.

[nursej22, MSN, RN]

The most common irregular rhythm is atrial fibrillation. When you hear hoof beats...

[mrsboots87]

I was talking about RVR. I know what a-fib is and what the strip will look like. But I am not familiar with a-fib with RVR. I'm thinking it means rapid ventricular response since I have heard of it and understand the concept of a rapid ventricular response, but as for testing we weren't required to know what a-fib with RVR looks like on a strip. Is it common?

[nursej22, MSN, RN]

A fib with rvr refers to the rate being greater than 100.

[Cohiba]

I'm going a sliiiightly different route and voting for multifocal atrial tachycardia since the P-waves I see aren't consistent between QRS complexes.

[Mavrick, BSN, RN]

Atrial Fibrillation. There are no "p" waves. Rhythm is irregularly irregular. Mostly normal "qrs complex" with depressed "st" segment. Rate greater than 100.

Is there a patient associated with this rhythm or from a book?

[MunoRN, RN]

It's SVT and A-fib with RVR. Remember that supraventricular tachycardia is any tachycardic rhythm that originates above the ventricles, this can include sinus tach, A-flutter, A-fib, etc.

Reentry SVT occurs when a patient's conduction gets stuck in loop where the electrical impulse is bouncing back and forth between the upper and lower conduction pathways, this is what we use adenosine for, it blocks that loop long enough to break the rhythm. Because of this consistent cycle of conduction, the R-R intervals in reentry SVT are regular.

[Mavrick, BSN, RN]

It's SVT and A-fib with RVR. Remember that supraventricular tachycardia is any tachycardic rhythm that originates above the ventricles, this can include sinus tach, A-flutter, A-fib, etc.

Reentry SVT occurs when a patient's conduction gets stuck in loop where the electrical impulse is bouncing back and forth between the upper and lower conduction pathways, this is what we use adenosine for, it blocks that loop long enough to break the rhythm. Because of this consistent cycle of conduction, the R-R intervals in reentry SVT are regular.

A-fib is more accurate as it is more specific.

[emtpbill, ASN, RN, EMT-P]

Fast push of Adenosine might slow it up enough to see the actual underlying rhythm if the rate is too fast to identify the markers.