Practice ECGStrips

Rhythm Identification
Copyright 2006 by Mosby Inc. All rights reserved.
Ventricular rate/rhythm
Atrial rate/rhythm PR interval QRS duration Identification
68 bpm/regular
68 bpm/regular 0.24 sec 0.06 to 0.08 sec Sinus rhythm with first-degree AV block, ST-segment elevation
Ventricular rate/rhythm Atrial rate/rhythm PR interval
83/min (sinus beats)/ Regular except for the event 83/min (sinus beats)/ Regular except for the event 0.20 sec
QRS duration
Identification
0.08 to 0.10 sec

Sinus rhythm with two PJCs, ST-segment elevation
This rhythm strip is from an 83-year-old woman with syncope.
Ventricular rate/rhythm Atrial rate/rhythm PR interval QRS duration Identification
38 to 75 bpm/irregular 75 bpm/regular Lengthening 0.06 to 0.08 sec Second-degree AV block, type I
This rhythm strip is from an 82-year-old man complaining of back pain. Top = lead II, bottom = MCL1
41 to 73 bpm/irregular 56 to 125 bpm/irregular 0.20 sec
QRS duration
Identification
0.12 sec
Sinus rhythm with a nonconducted PAC
This rhythm strip is from an 86-year-old woman who experienced a cardiopulmonary arrest. The initial rhythm was asystole. The following rhythm resulted after IV administration of epinephrine and atropine.
40 bpm/regular
Atrial rate/rhythm
PR interval QRS duration Identification
None
None 0.18 sec Idioventricular rhythm (IVR) (ventricular escape rhythm)
This rhythm strip is from a 69-year-old man complaining of shortness of breath. Lung sounds reveal bilateral rales. Blood pressure: 160/58.
107 bpm (sinus beats)/ Regular except for the events 107 bpm (sinus beats)/ Regular except for the events 0.20 sec (sinus beats) 0.08 sec (sinus beats) Sinus tachycardia with uniform PVCs
68 bpm/regular
68 bpm/regular 0.28 sec 0.06 sec Sinus rhythm with first-degree AV block, ST-segment depression
214 bpm/regular
Unable to determine Unable to determine 0.14 sec Monomorphic ventricular tachycardia
214 bpm (VT) to 71 bpm (atrial fib)/ Irregular Unable to determine Unable to determine 0.12 to 0.16 sec (VT) to 0.06 sec (atrial fib) Monomorphic VT to atrial fibrillation
Ventricular rate/rhythm Atrial rate/rhythm PR interval QRS duration
88 bpm/regular Unable to determine Unable to determine 0.06 sec
Identification
Atrial flutter with ST-segment depression
Ventricular rate/rhythm Atrial rate/rhythm
32 bpm/regular 32 bpm (sinus beats)/ None (junctional beats) to regular (sinus beats) 0.14 sec (sinus beats) 0.04 to 0.06 sec Junctional bradycardia with STsegment depression to sinus bradycardia, inverted T waves
35 bpm/regular 71 bpm/regular Varies 0.12 sec
Identification
Complete (third-degree) AV block with inverted T waves
This rhythm strip is from a 52-year-old man found unresponsive, apneic, and pulseless.
88 bpm/regular
Atrial rate/rhythm
None
None 0.12 to 0.14 sec Accelerated idioventricular rhythm (AIVR)
79 bpm (sinus beats)/ Regular except for the event(s) 79 bpm (sinus beats)/ Regular except for the event(s) 0.24 sec (sinus beats)
QRS duration
Identification
0.08 sec (sinus beats)

Sinus rhythm with first-degree AV block and PACs
48 to 83 bpm/irregular
167 bpm/regular 0.24 sec 0.12 sec Second-degree AV block type II with ST-segment depression
Atrial paced activity? Paced interval rate
Yes 71
Ventricular paced activity? Yes
Identification
100% paced rhythm AV sequential pacemaker
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.
Unable to determine Unable to determine 0.10 sec Atrial fibrillation (controlled)
This rhythm strip is from a 97-year-old woman after a fall.
88 bpm/regular 88 bpm/regular 0.24 sec 0.06 sec
Identification
Sinus rhythm with first-degree AV block, ST-segment depression
This rhythm strip is from a 70-year-old man complaining of a sharp pain across his shoulders. Blood pressure: 218/86.
115/min (sinus beats)/ Regular except for the events 115/min (sinus beats)/ Regular except for the events 0.18 sec (sinus beats) 0.06 sec (sinus beats) Sinus tachycardia with uniform PVCs
This rhythm strip is from a 76-year-old man complaining of indigestion.
32 bpm/regular
Atrial rate/rhythm
None
None 0.06 sec Junctional bradycardia with ST-segment depression and inverted T waves
This rhythm strip is from an 80-year-old woman complaining of weakness.
Atrial paced activity? Paced interval rate Identification
No 83 100% ventricular paced rhythm
55/min (sinus beats)/ Regular except for the event (every other beat is an ectopic beat)
Atrial rate/rhythm
55/min (sinus beats)/ Regular except for the event (every other beat is an ectopic beat)
PR interval
QRS duration
Identification
0.08 to 0.10 sec (sinus beats)

Sinus bradycardia with ventricular bigeminy
This rhythm strip is from a 90-year-old woman complaining of hip pain after a fall.
75 bpm/regular
75 bpm/regular 0.18 sec 0.08 to 0.10 sec Sinus rhythm with ST-segment depression
This rhythm strip is from an 86-year-old woman complaining of chest pain that she rates a 4 on a scale of 0 to 10. Blood pressure: 142/72.
Identification
Sinus rhythm
This rhythm strip is from a 78-year-old man complaining of palpitations. Note the point at which the patient was defibrillated.
63 to 79 bpm (sinus beats)/ Irregular (sinus beats)
Atrial rate/rhythm
PR interval QRS duration
63 to 79 bpm (sinus beats)/ Irregular (sinus beats)

0.12 sec (sinus beats) 0.04 to 0.06 sec (sinus beats)
Identification
Monomorphic ventricular tachycardia shock ventricular beats sinus arrhythmia

68 bpm (sinus beats)/ Regular except for the event 68 bpm (sinus beats)/ Regular except for the event 0.18 sec (sinus beats) 0.06 sec (sinus beats) Sinus rhythm with uniform PVCs
115 bpm (sinus beats)/ Regular except for the event 115 bpm (sinus beats)/ Regular except for the event 0.16 sec
QRS duration
Identification
0.08 to 0.10 sec

Sinus tachycardia with PACs
This rhythm strip is from a 3-month-old infant who had an altered level of responsiveness. She was limp with a respiratory rate of 4 breaths/min. Blood sugar was 174.
125 bpm/regular
Atrial rate/rhythm
125 bpm/regular
0.12 to 0.16 sec 0.06 sec (sinus beats) Sinus tachycardia with an interpolated PVC
This rhythm strip is from an 83-year-old man complaining of chest pain. He had a new pacemaker implanted 5 days ago. His blood pressure is 148/60.
79 bpm/regular Unable to determine Unable to determine 0.08 sec Atrial fibrillation (controlled)
This rhythm strip is from a 52-year-old man with substernal chest pain. He has a history of COPD and mitral valve regurgitation. Blood pressure: 140/78.
75 bpm/regular 75 bpm/regular 0.14 sec 0.06 to 0.08 sec
Identification
Sinus rhythm with ST-segment depression
34 bpm/regular
Atrial rate/rhythm
68 bpm/regular
0.14 to 0.16 sec 0.10 sec 2:1 AV block, probably type I
60 to 98 bpm/irregular 111 bpm/regular Lengthens 0.08 sec Second-degree AV block, type I
75 bpm/regular None None 0.08 sec
Identification
Accelerated junctional rhythm
54 bpm/regular
Unable to determine Unable to determine 0.08 sec Atrial fibrillation (controlled)
None None None None
Identification
Asystole
Atrial paced activity?
No
Paced interval rate

Identification
65
100% ventricular paced rhythm
These rhythm strips are from a 46-year-old woman complaining of abdominal pain.
Atrial rate/rhythm
107 bpm (sinus beats)/ Regular except for the events

107 bpm (sinus beats)/ Regular except for the events
PR interval
QRS duration Identification

0.06 sec (sinus beats) Sinus tachycardia with uniform PVCs
This rhythm strip is from a 61-year-old man with a history of heart failure.
65 to 75 bpm (sinus beats)/Irregular
Atrial rate/rhythm
65 to 75 bpm (sinus beats)/Irregular

0.32 sec (sinus beats) 0.18 sec (sinus beats) Sinus rhythm with first-degree AV block, wide QRS (bundle branch block), multiform PVCs, and STsegment elevation
This rhythm strip is from a 1-month-old infant after a 3-minute seizure.
130 bpm/regular
130 bpm/regular 0.14 to 0.16 sec 0.06 to 0.08 sec Sinus tachycardia
45 bpm/regular
Atrial rate/rhythm
115 bpm/regular
Varies 0.16 sec Complete (third-degree) AV block
This rhythm strip is from a 72-year-old man complaining of chest pain.
This rhythm strip is from a 77-year-old woman with a congested cough.
107 to 200 bpm/irregular Unable to determine Unable to determine 0.06 to 0.08 sec
Identification
Atrial fibrillation (uncontrolled)
30 bpm (junctional beats) to 56 bpm (sinus beats)/ Irregular (junctional beats) to regular (sinus beats) None (junctional beats) to 56 bpm (sinus beats)/ None (junctional beats) to regular (sinus beats) None (junctional beats) to 0.18 (sinus beats)
QRS duration
Identification
0.04 sec (junctional beats) to 0.08 (sinus beats)

Junctional bradycardia to sinus bradycardia
83 bpm (sinus beats)/regular 83 bpm (sinus beats)/regular 0.20 sec (sinus beats) 0.06 to 0.08 sec (sinus beats)
Identification
Atrial flutter to sinus rhythm
96 bpm (sinus beats)/ Regular except for the event 96 bpm (sinus beats)/ Regular except for the event 0.12 sec (sinus beats)
QRS duration
Identification

Sinus rhythm with uniform PVCs
This rhythm strip is from a 54-year-old man who had a syncopal episode.
58 bpm/regular
58 bpm/regular 0.20 sec 0.08 sec Sinus bradycardia
This rhythm strip is from a 66-year-old man complaining of chest pain. Blood pressure: 170/96.
107 bpm/regular 107 bpm/regular 0.24 sec 0.08 sec Sinus tachycardia with first-degree AV block
This rhythm strip is from a 43-year-old woman complaining of palpitations.
214 bpm/regular Unable to determine Unable to determine
QRS duration
Identification
0.08 sec
Narrow-QRS tachycardia
A 43-year-old woman is complaining of palpitations. The patient has a history of SVT and states she cannot tolerate adenosine. The following rhythm is observed on the cardiac monitor after diltiazem administration.
187 bpm (atrial beats)/ Regular (atrial beats) Unable to determine Unable to determine 0.08 sec (atrial beats)
Identification
Junctional to sinus to narrow-QRS tachycardia
Unable to determine
Unable to determine Unable to determine Unable to determine Ventricular fibrillation (coarse)
37 bpm/regular 75 bpm/regular 0.28 sec
QRS duration
Identification
0.06 sec
2:1 AV block, probably type I
27 bpm/regular
Atrial rate/rhythm
27 bpm/regular
0.22 sec 0.12 sec Sinus bradycardia with first-degree AV block, wide-QRS (probable bundle branch block), ST-segment depression
This rhythm strip is from a 76-year-old woman complaining of back pain. Her medical history includes a myocardial infarction 2 years ago.
Atrial paced activity? Paced interval rate
No 65
Identification
100% ventricular paced rhythm
This rhythm strip is from an 80-year-old man found sitting in a chair. He is unresponsive, apneic, and pulseless.
None None None None Asystole the electrical activity shown is caused by pacemaker spikes from the patients permanent pacemaker (no capture)
This rhythm strip is from an 88-year-old woman complaining of hip pain after a fall injury.
Unable to determine Unable to determine 0.08 sec Atrial fibrillation
68 bpm/regular Lengthens 0.10 sec Second-degree AV block type I with a ventricular complex
48 bpm (junctional beats)/ regular
Atrial rate/rhythm
Unable to determine (junctional beats)

Unable to determine (junctional beats) 0.06 to 0.08 sec Sinus bradycardia with a first-degree AV block to junctional escape rhythm
This rhythm strip is from a 67-year-old woman found unresponsive on the side of the road. Outdoor temperature is 112F. Blood pressure: 238/110, respiratory rate: 60/min.
Identification
Sinus tachycardia with ST-segment depression
This rhythm strip is from an 84-year-old man complaining of dizziness. He had a triple bypass 4 days ago.
60 bpm (sinus beats)/ Regular except for the event (every other beat is an ectopic beat) 60 bpm (sinus beats)/ Regular except for the event 0.16 sec (sinus beats)
Atrial rate/rhythm PR interval
QRS duration
Identification

Sinus rhythm with ventricular bigeminy, ST-segment depression
This rhythm strip is from an 81-year-old woman with an altered level of responsiveness. blood pressure: 160/70, blood sugar: 114.
56 bpm/regular 56 bpm/regular 0.24 sec 0.06 sec Sinus bradycardia with first-degree AV block
This rhythm strip is from a 80-year-old woman who was playing Bingo when she felt dizzy and slumped over in her chair. Bystanders state she was unresponsive for approximately 5 minutes. A pulse is present.
75 to 94 bpm/irregular Unable to determine Unable to determine 0.08 sec
Identification
Atrial fibrillation (controlled)
This rhythm strip is from a 91-year-old woman complaining of chest pain and difficulty breathing.
Atrial rate/rhythm
Unable to determine
Unable to determine 0.10 sec Atrial fibrillation with ST-segment elevation
This rhythm strip is from an 85-year-old woman complaining of numbness in her legs.
Identification
Sinus bradycardia
This rhythm strip is from a 59-year-old woman who complained of sudden weakness in her legs and fell to the floor in her kitchen.
50 to 79 bpm/irregular Unable to determine Unable to determine 0.12 sec
Identification
Atrial fibrillation (controlled) with ST-segment elevation
This rhythm strip is from an 82-year-old woman with vomiting x 2 days.
115 bpm/regular
115 bpm/regular 0.18 sec 0.06 sec Sinus tachycardia
This rhythm strip is from a 62-year-old woman complaining of chest pain. Her blood pressure is 146/104, respirations are 20. Breath sounds are clear.
167 bpm/regular
Unable to determine Unable to determine 0.06 sec Narrow-QRS tachycardia (SVT) with ST-segment depression
This rhythm strip is from a 6-year-old boy immediately after a seizure.
68 to 88 bpm/irregular 68 to 88 bpm/irregular 0.12 sec 0.08 sec Sinus arrhythmia
This rhythm strip is from a 76-year-old man who was playing golf and experienced a syncopal episode.
Identification
Sinus rhythm with ST-segment elevation
These rhythm strips are from a 44-year-old woman complaining of chest pain.
176 bpm/regular None None 0.12 to 0.14 sec Monomorphic ventricular tachycardia
29 bpm/regular 71 bpm/regular Varies 0.16 sec Complete (third-degree) AV block with ST-segment elevation
This rhythm strip is from an 81-year-old woman complaining of chest pain.
76 bpm/regular None None 0.12 to 0.14 sec
Identification
Accelerated idioventricular rhythm (AIVR)
This rhythm strip is from a 74-year-old woman complaining of weakness.
No 68 Ventricular demand pacemaker
Unable to determine Unable to determine 0.08 sec Atrial flutter
42 bpm (sinus beats)/ Regular except for the event (every other beat is an ectopic beat)
Atrial rate/rhythm
42 bpm (sinus beats)/ Regular except for the event

0.12 sec (sinus beats) 0.08 to 0.10 sec (sinus beats) Sinus bradycardia with ventricular bigeminy
42 bpm/regular None None 0.24 sec
Identification
Accelerated idioventricular rhythm (AIVR)
These rhythm strips are from a 63-year-old woman who experienced a syncopal episode. Blood pressure is 200/90, blood sugar is 98.
44 bpm/regular 88 bpm/regular 0.20 sec 0.10 sec 2:1 AV block, probably type I
This rhythm strip is from an 84-year-old woman with a nosebleed. Blood pressure: 250/74.
Identification
Sinus rhythm
This rhythm strip is from a 79-year-old man complaining of palpitations. His initial blood pressure was 112/84. His second blood pressure, 8 minutes after the first, was 78/P.
147 bpm/regular
Unable to determine Unable to determine 0.06 to 0.08 sec Narrow-QRS tachycardia (SVT) with ST-segment depression

This rhythm strip is from an 80-year-old man complaining of weakness and dizziness. Blood pressure is 160/98, blood sugar is 88.
63 to 100 bpm/irregular Unable to determine Unable to determine 0.08 to 0.10 sec Atrial fibrillation (controlled)
42 to 71 bpm/irregular 125 bpm/regular 0.24 sec 0.10 to 0.12 sec Second-degree AV block type II
This rhythm strip is from a 58-year-old man with chest pain that he rates as a 2 on a scale of 0 to 10. He states he recently began taking pills for weight control.
91 bpm (sinus beats)/ Regular except for the event(s)
Atrial rate/rhythm
91 bpm (sinus beats)/ Regular except for the event(s)

0.20 sec (sinus beats) 0.06 sec (sinus beats) Sinus rhythm with uniform PVCs, ST-segment depression
This rhythm strip is from a 60-year-old woman complaining of palpitations and shortness of breath.
130 to 214 bpm/ irregular

Unable to determine Unable to determine 0.08 sec Atrial fibrillation with a rapid ventricular response (RVR)
This rhythm strip is from a 60-year-old woman complaining of palpitations and shortness of breath after administration of adenosine 6 mg IV.
28 to 63 bpm/irregular Unable to determine Unable to determine
QRS duration
Identification
0.08 sec
Atrial fibrillation
This rhythm strip is from a 60-year-old woman complaining of palpitations and shortness of breath 1 minute after administration of adenosine 12 mg IV.
Unable to determine Unable to determine 0.08 sec Atrial fibrillation
This rhythm strip is from a 60-year-old woman complaining of palpitations and shortness of breath two minutes after administration of adenosine 6 mg IV.

Unable to determine Unable to determine 0.08 sec Atrial fibrillation with a rapid ventricular response (RVR)
30 bpm (junctional beats)/irregular None (junctional beats)/irregular 0.16 sec (sinus beats) 0.06 sec
Identification
Sinus beat, two junctional beats, sinus beat; ST-segment depression
This rhythm strip is from a 90-year-old woman with shortness of breath.
75 bpm (sinus beats)/ Regular except for the event(s) 75 bpm (sinus beats)/ Regular except for the event(s) 0.16 to 0.18 sec (sinus beats) 0.04 to 0.06 sec (sinus beats) Sinus rhythm with uniform PVCs
100 bpm (sinus beats) to 150 bpm (VT)/Regular
Atrial rate/rhythm
100 bpm (sinus beats)/ Regular to unable to determine

0.24 sec (sinus beats) 0.08 sec (sinus beats) Sinus rhythm with first-degree AV block to monomorphic ventricular tachycardia (VT)
47 bpm/regular 115 bpm/regular Varies 0.08 sec
Identification
Complete (third-degree) AV block with ST-segment elevation
88 to 167 bpm/irregular Unable to determine Unable to determine
QRS duration
Identification
0.06 to 0.08 sec

Atrial fibrillation
None 94 bpm/regular None None P-wave asystole
This rhythm strip is from a 74-year-old woman with chest pain. Blood pressure: 192/90. She rates her pain as a 9 on a scale of 0 to 10.
136 bpm/regular
136 bpm/regular 0.14 sec 0.08 sec Sinus tachycardia
91 bpm/ Regular except for the event 91 bpm/ Regular except for the event 0.16 sec 0.06 sec Sinus rhythm with a nonconducted PAC
Ventricular rate/rhythm Atrial rate/rhythm PR interval QRS duration Note Identification
35 bpm/regular 35 bpm/regular 0.16 sec 0.06 sec U waves are present (they follow the T waves) Sinus bradycardia with ST-segment depression
This rhythm strip is from a 97-year-old man with chest pain.
Yes 60 AV sequential pacemaker with failure to capture
This rhythm strip is from an 85-year-old woman with an altered level of responsiveness. Blood pressure: 136/78, blood sugar is 96.
115 bpm (sinus beats)/ Regular except for the event 115 bpm (sinus beats)/ Regular except for the event 0.20 sec (sinus beats)
QRS duration
Identification

Sinus tachycardia with a PVC and a ventricular couplet
This rhythm strip is from an 88-year-old man complaining of chest pain that he rates as a 6 on a scale of 0 to 10. Blood pressure: 170/80.
115 bpm (sinus beats)/ Regular except for the event 115 bpm (sinus beats)/ Regular except for the event 0.16 sec 0.08 sec Sinus tachycardia with PACs
29 bpm/essentially regular
None None 0.04 to 0.06 sec Junctional bradycardia with ST-segment depression
88 bpm/regular

88 bpm/regular 0.28 sec

0.08 sec Sinus rhythm with first-degree AV block; ST-segment elevation
This rhythm strip is from a 44-year-old construction worker with a sudden onset of chest pressure.
52 to 94 bpm/irregular 52 to 94 bpm/irregular 0.12 sec 0.08 sec Sinus arrhythmia at 52 to 94 bpm
Atrial pacing?
Ventricular pacing? Paced interval Identification
No
Yes 80 Ventricular-paced rhythm with pacemaker malfunction (failure to capture)

This rhythm strip is from an 82-year-old man complaining of back pain. Top = lead II, bottom = MCL1.
QRS duration
Identification
0.12
Sinus rhythm at 41 to 73 bpm with a nonconducted PAC
78/min/regular except for the event 78/min/regular except for the event 0.16 sec 0.06 sec Sinus rhythm at 78 bpm with a PAC
Atrial rate/rhythm PR interval QRS duration
44 bpm/regular
44 bpm/regular 0.14 sec 0.08 sec
Identification
Junctional rhythm; ST-segment elevation
115 bpm (sinus beats)/regular except for the event 115 bpm (sinus beats)/regular except for the event 0.16 sec (sinus beats) 0.06 sec (sinus beats) Sinus tachycardia with a PJC
This rhythm strip is from an 82-year-old man complaining of chest pain.
245 bpm/regular 245 bpm/regular None
QRS duration
Identification
0.28 sec
Monomorphic ventricular tachycardia
21 bpm/irregular
Atrial rate/rhythm
21 bpm/irregular
0.36 sec 0.08 to 0.10 sec Sinus bradycardia with junctional escape beats
Ventricular rate/rhythm 48 to 83 bpm/irregular

Atrial rate/rhythm PR interval QRS duration Identification 167 bpm/regular 0.24 sec 0.12 sec Second-degree AV block type II; ST-segment depression
115 to 215 bpm/irregular Unable to determine/irregular Varies 0.04 to 0.06 sec
Identification
Multifocal atrial tachycardia with ST-segment depression
Ventricular rate/rhythm 71/min, regular Atrial rate/rhythm PR interval QRS duration Identification 71/min, regular 0.16 to 0.20 sec 0.12 to 0.14 sec Sinus rhythm at 71 bpm with a wide QRS, ST-segment depression
Ventricular rate/rhythm 94 (sinus beats)/irregular Atrial rate/rhythm 94 (sinus beats)/irregular
PR interval

0.08 sec (sinus beats) Sinus rhythm with an episode of couplets and a run of VT
This rhythm strip is from a 73-year-old man complaining of chest pain. History of hypertension and lung disease. Medications include aspirin, albuterol, and Lotensin.
U wave
44 bpm/regular
44 bpm/regular 0.16 sec 0.06 sec
Sinus bradycardia at 44 bpm, ST-segment depression. Note the upright U waves following each T wave.

Atrial rate/rhythm PR interval QRS duration Identification 111 bpm/regular Lengthens 0.08 sec Second-degree AV block type I; ST-segment depression
This rhythm strip is from a 69-year-old man who is disoriented. He knows his name but has no idea where he is or how he got there. BP: 172/98, R: 20. Blood sugar: 127 mg/dL.
79 bpm/regular 79 bpm/regular
PR interval
0.18 sec
0.06 to 0.08 sec Sinus rhythm at 79 bpm
This rhythm strip is from a 35-year-old woman complaining of chest pain and palpitations.
188/min/regular
Unable to determine Unable to determine 0.06 sec Narrow-QRS tachycardia (AVNRT) with ST-segment depression
Ventricular rate/rhythm 64 bpm (sinus beats)/regular except for the event Atrial rate/rhythm PR interval QRS duration Identification 64 bpm (sinus beats)/regular except for the event 0.16 to 0.18 sec 0.08 sec Sinus rhythm with an episode of sinus arrest and a junctional escape beat
This rhythm strip is from an 82-year-old man complaining of back pain.
Lead II Lead MCL1
Lead II Lead MCL1 Ventricular rate/rhythm 75/min/regular except for event Atrial rate/rhythm PR interval QRS duration Identification 75/min/regular except for event 0.20 sec 0.12 sec Sinus rhythm at 75 bpm with a wide QRS and a nonconducted PAC
This rhythm strip is from a 51-year-old man complaining of dull chest pain that began about 2 hours ago. He rates his discomfort as a 6 on a scale of 1 to 10. BP: 70/48, R: 24. His skin is cool, pale, and diaphoretic.
48 bpm/regular
71 bpm/slightly irregular Varies 0.08 to 0.10 sec Complete AV block with ST-segment elevation

Unable to determine Unable to determine

0.16 sec Polymorphic VT
Atrial pacing? Paced interval Identification
Ventricular pacing? Yes
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 PR interval Unable to determine Unable to determine
QRS duration
Identification
0.10 sec
Controlled atrial fibrillation at 55-94 bpm
Ventricular rate/rhythm 50 bpm/regular Atrial rate/rhythm PR interval

167 bpm/regular Varies

0.06 sec Third-degree AV block; ST-segment elevation
This rhythm strip is from a 1-year-old girl. Mom says the infant suddenly went limp and her limbs began shaking. The episode lasted about 45 sec. Her temperature is normal.
215 bpm/regular 215 bpm/regular 0.10 sec 0.08 sec Sinus tachycardia at 215 bpm
This rhythm strip is from an 81-year-old woman complaining of weakness. BP: 122/59, R: 12. Blood sugar is 109 mg/dL.
PR interval
0.16 to 0.20 sec

0.06 sec Sinus bradycardia
71 bpm/regular 71 bpm/regular 0.14 sec 0.08 sec Accelerated junctional rhythm; ST-segment elevation
This rhythm strip is from a 26-year-old man after a seizure.
QRS duration
Identification
0.06 to 0.08 sec

Sinus arrhythmia at 64 to 94 bpm
This rhythm strip is from an 18-year-old man with a gunshot wound to his chest.
Ventricular rate/rhythm Unable to determine Atrial rate/rhythm PR interval None None
QRS duration
Identification
None
Coarse ventricular fibrillation
Atrial pacing? Ventricular pacing? Paced interval
Yes Yes 71
Identification
100% paced rhythm AV sequential pacemaker
88/min/regular
Unable to determine Unable to determine 0.06 sec Atrial flutter at 88 bpm with ST-segment depression
This rhythm strip is from a 77-year-old woman who states that she feels fine. She stopped at a blood pressure machine in WalMart and the machine would not read her pulse rate. She later went to her physicians office and then to the emergency department.
30 bpm/regular
68 bpm/regular 0.28 sec 0.16 sec 2:1 AV block, probably type II; ST-segment elevation
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

111 bpm/regular except for event

0.18 sec 0.08 sec Sinus tachycardia at 111 bpm with a nonconducted PAC
Two ventricular complexes to none

None None 0.14 sec to none Agonal rhythm/asystole
Ventricular rate/rhythm 30 bpm (sinus beats)/regular except for events

Atrial rate/rhythm PR interval QRS duration 30 bpm (sinus beats)/regular except for events 0.12 to 0.16 sec (sinus beats) 0.06 sec (sinus beats)
Identification
Sinus bradycardia with ventricular bigeminy, inverted T waves, horizontal ST-segments
These rhythm strips are from a 52-year-old man with syncope.
Atrial pacing? Paced interval Identification
Yes 79 Atrial pacemaker

Ventricular pacing? No
This
rhythm strip is from a 79-year-old woman with a nosebleed. Blood pressure is 222/118.
130 bpm/regular 130 bpm/regular 0.16 sec
QRS duration
Identification
0.12 sec
Sinus tachycardia at 130 bpm with a wide-QRS and ST-segment depression
Ventricular rate/rhythm 52 bpm/regular

Atrial rate/rhythm PR interval QRS duration Identification None None 0.06 sec Sinus beat to junctional escape rhythm with inverted T waves
Ventricular rate/rhythm 54 bpm/regular (sinus beats)

Atrial rate/rhythm PR interval QRS duration Identification 54 bpm/regular (sinus beats) 0.12 sec (sinus beats) 0.06-0.08 sec (sinus beats) Sinus bradycardia with ventricular bigeminy

Atrial rate/rhythm PR interval QRS duration Identification 83 bpm/regular 0.24 sec 0.10 sec 2:1 AV block, probably type I; ST-segment depression

72 bpm/regular 0.32 sec

0.10 sec 2:1 AV block, probably type 1
167 bpm/regular 167 bpm/regular 0.12 sec 0.06 sec Sinus tachycardia at 167 bpm
This rhythm strip is from an 83-year-old woman with syncope.
PR interval
0.20 to 0.22 sec

0.06 to 0.08 sec 2:1 AV block, probably type I
150 bpm/essentially regular Unable to determine Unable to determine 0.12 to 0.16 sec Monomorphic VT
Atrial pacing? Ventricular pacing? Paced interval Identification
No Yes 79 100% ventricular-paced rhythm
Ventricular rate/rhythm 63 bpm (sinus beats)/regular except for the event (every third beat is a PJC) Atrial rate/rhythm PR interval QRS duration Identification 63 bpm (sinus beats)/regular except for the event (every third beat is a PJC) 0.12 to 0.16 sec (sinus beats) 0.06 sec (sinus beats) Sinus rhythm with PJCs
Ventricular rate/rhythm 180/min/regular

Atrial rate/rhythm PR interval QRS duration Identification Unable to determine Unable to determine 0.04 sec AVNRT at 180 bpm, ST-segment elevation
This rhythm strip is from a 61-year-old woman complaining of shortness of breath. Blood pressure 176/110.
Ventricular rate/rhythm 125 bpm/essentially regular except for events Atrial rate/rhythm PR interval QRS duration Identification 125 bpm/essentially regular except for events 0.12 sec (sinus beats) 0.06 sec (sinus beats) Sinus tachycardia with multiform PVCs
107 bpm/regular
107 bpm/regular 0.24 sec 0.08 sec Sinus tachycardia with first-degree AV block
71 bpm/regular
Unable to determine Unable to determine 0.12 sec Accelerated idioventricular rhythm (AIVR) with ST-segment elevation

Practice ECGStrips

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Rhythm Identification

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Ventricular rate/rhythm Atrial rate/rhythm PR interval

0.08 to 0.10 sec

This rhythm strip is from an 83-year-old woman with syncope.

Copyright 2006 by Mosby Inc. All rights reserved.

Ventricular rate/rhythm Atrial rate/rhythm PR interval QRS duration Identification

38 to 75 bpm/irregular 75 bpm/regular Lengthening 0.06 to 0.08 sec Second-degree AV block, type I

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Ventricular rate/rhythm Atrial rate/rhythm PR interval

41 to 73 bpm/irregular 56 to 125 bpm/irregular 0.20 sec

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Ventricular rate/rhythm Atrial rate/rhythm PR interval QRS duration Identification

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Ventricular rate/rhythm Atrial rate/rhythm PR interval QRS duration Identification

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Ventricular rate/rhythm Atrial rate/rhythm PR interval QRS duration

88 bpm/regular Unable to determine Unable to determine 0.06 sec

Atrial flutter with ST-segment depression

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Ventricular rate/rhythm Atrial rate/rhythm

PR interval QRS duration Identification

Copyright 2006 by Mosby Inc. All rights reserved.

Ventricular rate/rhythm Atrial rate/rhythm PR interval QRS duration

35 bpm/regular 71 bpm/regular Varies 0.12 sec

Complete (third-degree) AV block with inverted T waves

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Ventricular rate/rhythm Atrial rate/rhythm PR interval

0.08 sec (sinus beats)

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Atrial paced activity? Paced interval rate

Ventricular paced activity? Yes

100% paced rhythm AV sequential pacemaker

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

This rhythm strip is from a 97-year-old woman after a fall.

Copyright 2006 by Mosby Inc. All rights reserved.

Ventricular rate/rhythm Atrial rate/rhythm PR interval QRS duration

88 bpm/regular 88 bpm/regular 0.24 sec 0.06 sec

Sinus rhythm with first-degree AV block, ST-segment depression

Copyright 2006 by Mosby Inc. All rights reserved.

Copyright 2006 by Mosby Inc. All rights reserved.

Ventricular rate/rhythm Atrial rate/rhythm PR interval QRS duration Identification

Copyright 2006 by Mosby Inc. All rights reserved.

This rhythm strip is from a 76-year-old man complaining of indigestion.