Copyright © 2006 by Mosby Inc. All rights reserved. Chapter 4 Practice Rhythms Strips

Copyright © 2006 by Mosby Inc. All rights reserved.

Chapter 4Chapter 4

Practice Rhythms StripsPractice Rhythms Strips


Figure 4-23Figure 4-23 This rhythm strip is from at 35-year-old woman This rhythm strip is from at 35-year-old woman

complaining of chest pain and palpitations. complaining of chest pain and palpitations.

Ventricular rate/rhythmVentricular rate/rhythm

Atrial rate/rhythmAtrial rate/rhythm

PR intervalPR interval

QRS durationQRS duration

IdentificationIdentification


Figure 4-23Figure 4-23 This rhythm strip is from at 35-year-old woman This rhythm strip is from at 35-year-old woman

complaining of chest pain and palpitations. complaining of chest pain and palpitations.

Ventricular rate/rhythmVentricular rate/rhythm 188/min, regular188/min, regular

Atrial rate/rhythmAtrial rate/rhythm Unable to determineUnable to determine

PR intervalPR interval Unable to determine Unable to determine

QRS durationQRS duration 0.06 sec0.06 sec

IdentificationIdentification Narrow-QRS tachycardia (AVNRT) Narrow-QRS tachycardia (AVNRT) with ST-segment depressionwith ST-segment depression


Figure 4-24Figure 4-24

Ventricular Ventricular rate/rhythmrate/rhythm







Ventricular rate/rhythmVentricular rate/rhythm 83 (sinus beats) / regular except for events83 (sinus beats) / regular except for events

Atrial rate/rhythmAtrial rate/rhythm 83 (sinus beats) / regular except for events83 (sinus beats) / regular except for events

PR intervalPR interval 0.16 sec 0.16 sec

QRS durationQRS duration 0.04-0.08 sec 0.04-0.08 sec

IdentificationIdentification Sinus rhythm at 83 bpm with frequent PACs Sinus rhythm at 83 bpm with frequent PACs (atrial bigeminy), ST-segment depression, (atrial bigeminy), ST-segment depression, inverted T wavesinverted T waves










Ventricular rate/rhythmVentricular rate/rhythm 98 bpm/ regular 98 bpm/ regular

Atrial rate/rhythmAtrial rate/rhythm 98 bpm/ regular 98 bpm/ regular

PR intervalPR interval 0.16 sec0.16 sec

QRS durationQRS duration 0.04-0.06 sec0.04-0.06 sec

IdentificationIdentification Sinus rhythm at 98 bpm; Sinus rhythm at 98 bpm;

ST-segment elevation ST-segment elevation








This rhythm strip is from a 96-year-old man complaining of chest pain and palpitations. Medications include Lanoxin and Coumadin.



Ventricular rate/rhythmVentricular rate/rhythm 88-130/min / irregular88-130/min / irregular

Atrial rate/rhythmAtrial rate/rhythm Unable to determine Unable to determine


QRS durationQRS duration 0.08 second0.08 second

IdentificationIdentification Atrial fibrillation at 88-130 bpm Atrial fibrillation at 88-130 bpm

This rhythm strip is from a 96-year-old man complaining of chest pain and palpitations. Medications include Lanoxin and Coumadin.











93/min / regular except for the event 93/min / regular except for the event

Atrial rate/rhythmAtrial rate/rhythm 93/min / regular except for the event 93/min / regular except for the event

PR intervalPR interval 0.16 sec 0.16 sec


IdentificationIdentification Sinus rhythm at 93 bpm with a PACSinus rhythm at 93 bpm with a PAC








This rhythm strip is from a 57-year-old man with no cardiac history.



Ventricular rate/rhythmVentricular rate/rhythm 111 bpm / regular except for event111 bpm / regular except for event

Atrial rate/rhythmAtrial rate/rhythm 111 bpm / regular except for event111 bpm / regular except for event

PR intervalPR interval 0.18 second0.18 second


IdentificationIdentification Sinus tachycardia at 111 bpm with Sinus tachycardia at 111 bpm with a nonconducted PACa nonconducted PAC

This rhythm strip is from a 57-year-old man with no cardiac history.








This rhythm strip is from a 74-year-old woman with difficulty breathing.





PR intervalPR interval Unable to determineUnable to determine


IdentificationIdentification Atrial flutter at 75-107/minAtrial flutter at 75-107/min

This rhythm strip is from a 74-year-old woman with difficulty breathing.








This rhythm strip is from a 71-year-old man complaining of shoulder pain that has been present for 3 weeks.



Ventricular rate/rhythmVentricular rate/rhythm 115/min / regular except for events115/min / regular except for events

Atrial rate/rhythmAtrial rate/rhythm 115/min / regular except for events115/min / regular except for events

PR intervalPR interval 0.12 second (sinus beats)0.12 second (sinus beats)

QRS durationQRS duration 0.08 second (sinus beats)0.08 second (sinus beats)

IdentificationIdentification Sinus tachycardia at 115/min with Sinus tachycardia at 115/min with PACs and ST-segment elevationPACs and ST-segment elevation

This rhythm strip is from a 71-year-old man complaining of shoulder pain that has been present for 3 weeks.











180/min / regular180/min / regular




IdentificationIdentification AVNRT at 180 bpm, ST-segment AVNRT at 180 bpm, ST-segment elevationelevation








This rhythm strip is from an 82-year-old man complaining of back pain.

Lead II

Lead MCL1




75/min / regular except for event 75/min / regular except for event

Atrial rate/rhythmAtrial rate/rhythm 75/min / regular except for event 75/min / regular except for event



IdentificationIdentification Sinus rhythm at 75 bpm with a wide Sinus rhythm at 75 bpm with a wide QRS and a nonconducted PACQRS and a nonconducted PAC

This rhythm strip is from an 82-year-old man complaining of back pain.

Lead II

Lead MCL1















IdentificationIdentification Atrial flutter at 88 bpm Atrial flutter at 88 bpm

with ST-segment depressionwith ST-segment depression











70/min / regular 70/min / regular

Atrial rate/rhythmAtrial rate/rhythm 70/min (sinus beats) / Unable to determine70/min (sinus beats) / Unable to determine

PR intervalPR interval Varies Varies

QRS durationQRS duration VariesVaries

IdentificationIdentification Underlying rhythm is sinus but pacemaker site varies; ventricular rate approx 70 bpm;

patient with known WPW; note delta waves








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.







IdentificationIdentification Controlled atrial fibrillation at 55-94 bpm Controlled atrial fibrillation at 55-94 bpm

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/rhythmVentricular rate/rhythm 29/min / regular29/min / regular




IdentificationIdentification Controlled atrial fibrillation at 29/minControlled atrial fibrillation at 29/min

Note: This patient was diagnosed with Note: This patient was diagnosed with digitalis toxicity.digitalis toxicity.








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.








IdentificationIdentification AVNRT at 186 bpm with AVNRT at 186 bpm with

ST-segment depression ST-segment depression

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/rhythmVentricular rate/rhythm 170/min / regular170/min / regular

Atrial rate/rhythmAtrial rate/rhythm 170/min / regular170/min / regular



IdentificationIdentification Atrial tachycardia at 170 bpmAtrial tachycardia at 170 bpm











78/min / regular except for the event 78/min / regular except for the event

Atrial rate/rhythmAtrial rate/rhythm 78/min / regular except for the event 78/min / regular except for the event



IdentificationIdentification Sinus rhythm at 78 bpm with a PACSinus rhythm at 78 bpm with a PAC


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Copyright © 2006 by Mosby Inc. All rights reserved. Chapter 4 Practice Rhythms Strips