Practice ECG Strips 2010 All leads are Lead II(unless otherwise noted…)

ECG #1

Rate: ___38_______________________________Rhythm: ___Regular___________________________P waves:: +(present) ↑(upright) ~ (same conformation) 1:1 (with QRS Complexes)PR Interval: __0.34 sec, = (PRIs=throughout strip)QRS: _0.08-0.10 = ~ (QRS = throughout strip)

Dx: Sinus Bradycardia, 1st Degree AV Block

ECG #2

Rate: __80s-90sRhythm: _ Irregular________________________P waves: _ Absent________________________PR Interval: _ Not Applicable (N/A)__________________________QRS: _0.08-0.10 =

Dx: Atrial Fibrillation (controlled)

300 150 100 75 60 50 43 Rate=38

ECG #3

Rate: _30’s (or less)_______________________Rhythm: Irregular______________________P waves: _+ ↑ ~ NOT 1:1_______PR Interval: _Variable (N/A)______________________QRS: _0.16 ~_________________________

Dx: _3rd Degree AV Block_______

ECG #4

Rate: __70s ( 75)__________________________Rhythm: __Regular_________________________P waves: _ Absent (Flutter waves present= ‘sawtooth’)______PR Interval: _N/A_______________________QRS: 0.06-0.08_______________

Dx: __Atrial Flutter (3:1)_________________________

ECG #5

Rate: ____0___________________________Rhythm: ____None_____________________________P waves: ____None___________________________PR Interval: ____None___________________________QRS: ____None___________________________

Dx: ___Ventricular Fibrillation (“fine V-Fib”)__

ECG #6

Rate: _____ “70s” (78)_____________________Rhythm: _____Regular_____________________P waves: ____Absent________________________PR Interval: ____N/A_________________________QRS: ___0.08____________________________

Dx: _Junctional Rhythm (Accelerated?)__with inverted T Waves_

ECG #7

Rate: __40-60________________________Rhythm: _Irregular__________________________P waves: + ↑ ~ NOT 1:1 w/QRS____PR Interval: Not measured, though tell-tale cyclical gradually prolonged PRI until QRS complex is dropped or absent (meets Wenkebach criteria, i.e., 2nd degree AV block, Mobitz I)QRS: __0.08-0.10 = ~______________

Dx: 2nd degree AV Block, Mobitz I

ECG #8

Rate: 250_________________________Rhythm: Regular__________________________________P waves: Absent______________________________PR Interval: N/A______________________________QRS: 0.06-0.08_______________________________

Dx: ___Supraventricular Tachycardia (SVT)______

ECG #9

Rate: _____250__________________________Rhythm: _____Regular___________________________P waves: _____(-) Absent__________________________PR Interval: _____N/A________________________QRS: _____0.20 = ~_________________________

Dx: ________Ventricular Tachycardia____(“V-Tach”)____________

ECG #10

Rate: ______70’s (77)______________________Rhythm: ______Regular______________________P waves: _____ + ↑ ~ 1:1 _________________PR Interval: _______0.16 -0.18 = ________________QRS: ________0.08-0.10 = ~_______________

Dx: __Sinus Rhythm (↓ST Segment)___

ECG #11

Rate: __80s-90s ________________________Rhythm: __Irregular__________________________P waves: __+ ↑ ~ NOT 1:1 (No P wave w/ beat 6 & 8)PR Interval: __0.16__ No P wave w/ beat 6 & 8______QRS: 0.10Dx: ____Sinus Rhythm with PVCs (“uniform” or “unifocal”) beat 6 & 8 ________

ECG #12

Rate: ______136_____________________Rhythm: ____Regular________________________P waves: ___+ ↑ ~ 1:1 ___________________PR Interval: 0.14 =__________________________QRS: ___0.08-0.10 = ~__________________

Dx: __Sinus Tachycardia with ST Segment Elevation_

Comment: Careful—turns out this was not a 6-second strip!

1 2 3 4 5 6 7 8 9

ECG #13

Rate: ______96_____________________Rhythm: _____Regular________________________P waves: ___+ ↑ ~ 1:1 ______________________PR Interval: ____0.08 = ____________________QRS: 0.10-0.12Dx: Junctional Rhythm (Accelerated) Comments: Note Lead 6; Red Arrow is ‘calibration check’

ECG #14

Rate: ___”Really Fast!” (>300)_____________Rhythm: _____Regular_________________P waves: ___Absent________________________PR Interval: ___N/A__________________________QRS: ____0.16__________________________

Dx: Polymorphic Ventricular Tachycardia (Torsades des Pointes) “Twist Around the Point”Comment: Think: Mag Sulfate!

ECG #15

Rate: 180’s________________________Rhythm: __Regular_______________________P waves: __Absent (Buried)__PR Interval: __N/A__________________________QRS: ___0.10__________________________

Dx: ___Supraventricular Tachycardia_____________

ECG #16 1 2 3 4 5 6 7 8

Rate: ______90’s__________________Rhythm: ____Irregular__________________P waves: ___+ ↑ ~ NOT 1:1 __(Missing, @ beats 2,4,6,8)__PR Interval: 0.12 (where present)________________________________QRS: 0.10 = ~________________________________

Dx: Sinus Rhythm, with Premature Junctional Contractions (PJCs), beats 2,4,6,8Comments: “Regularly-Irregular” PJC~PAC

ECG #17

Rate: ___20?_____________________Rhythm: ___N/A___________________________P waves: ___None_____________________________PR Interval: ___N/A____________________________QRS: ___”Wide & Bizarre”____________________________

Dx: __Agonal Rhythm (“Dying Heart”)_______________________

ECG #18

Rate: __30?____________________Rhythm: __Regular________________________P waves: Absent________________________________PR Interval: N/A____________________________QRS: _0.16 = ~___________________________

Dx: Tough One! Could be: Underlying Atrial Fibrillation with a Intraventricular Conduction Delay (IVCD) or Bundle Branch Block; Probably underlying atrial fibrillation with a 3rd degree AV Block. Definitely needs a pacemaker!

ECG #19

Rate: ___30? Very Slow!____________________Rhythm: _____Irregular_________________________P waves: ___+ ↑ ~ NOT 1:1_________________________PR Interval: ____VariableQRS: ___0.08_______________________

Dx: _____(Probably) Sick Sinus Syndrome? Definitely needs a pacemaker!_____

ECG #20

Rate: __120s_____________________Rhythm: __Regular__________________________P waves: _+ ↑ ~ 1:1 RETROGRADE!=Junctional (See Red Arrow)_PR Interval: ___N/A________________________QRS: ___0.10_______________________

Dx: ___Junctional Tachycardia________________

ECG #21

Rate: ____80s_______________________Rhythm: ____Regular_____________________P waves: + ↑ ~ 1:1PR Interval: __0.16 =_________________________QRS: __0.08 = ~________________________

Dx: __Sinus Rhythm Inverted T Wave (↓T)

ECG #22

Rate: ~54__________________________Rhythm: ___Regular_______________________P waves: ___Absent________________________PR Interval: __N/A_________________________QRS: ____0.14 = ~________________________

Dx: Junctional Rhythm with Intraventricular Conduction Delay (IVCD) / Bundle Branch Block)

ECG 23

Rate: ___Fast_____________________Rhythm: __Irregular_______________________P waves: __None________________________PR Interval: _N/A________________________QRS: ____N/A______________________

Dx: Ventricular Fibrillation (“Coarse”)__________

ECG #24

Rate: ______150+___________________Rhythm: ____Regular________________________P waves: ___N/A_________________________PR Interval: ___N/A_________________________QRS: “Very Wide & Bizarre” Dx: _Ventricular tachycardia_____________

ECG #25

Rate: _____80s_____________________Rhythm: ____Irregular______________________P waves: _+ ↑ ~ NOT 1:1_No P: beat 2,4,6,8PR Interval: ___0.14 (where P waves are present)__QRS: 0.08 , beats 1.3.5.7 “ Wide & Bizarre,” beats 2.4.6.8

Dx: __Sinus Rhythm with Unifocal PVCs every other beat (Also known as Ventricular Bigeminy

ECG #26

1 2 3 4 5 6 7 8

Rate: ____________50_________________Rhythm: Regular_______________________P waves: __+ ↓ ~ 1:1________________PR Interval: __0.08-0.10 = ________________________QRS: _____0.10 =_____________________

Dx: ___Junctional Rhythm_________________

ECG #27

Rate: ___130-150_____________________Rhythm: ___Irregular________________________P waves: __Absent_________________________PR Interval: ____N/A__________________________QRS: ____0.10____________________________

Dx: __Atrial Fibrillation (uncontrolled) ↑ST segment____________

ECG 28

Rate: ____50__________________________Rhythm: ____Regular__________________________P waves: __+ ↑ ~ 1:1 _______________________PR Interval: ___0.32 = _______________________QRS: _____0.10 = ~_______________________

Dx: Sinus Bradycardia, 1st degree AV Block, ↓ T Waves

ECG #29

Rate: ______30______________________Rhythm: _____Regular__________________________P waves: ______+ ↑ ~ 1:1__________________________PR Interval: _0.16 =________________________QRS: ____0.10________________________

Dx: __Sinus Bradycardia ↓ T Waves___________________

ECG # 30ECG # 30

Rate: ___80’s____________________Rhythm: __Irregular_______________________P waves: __+ ↑ ~ NOT 1:1(No P: beats 3 & 7)PR Interval: __0.14 = (except beat 3 & 7)___________QRS: __0.08 (except beats 3 & 7; 3 & 7 are wide, BUT HAVE a Different form; therefore “multifocal” or “multiform” PVCs)__

Dx: ___Sinus Rhythm with MultiFocal PVCs__________

ECG # 31ECG # 31

Rate: ___188________________________Rhythm: __Regular_________________________P waves: __+ ↑ ~ 1:1 ________________________PR Interval: __0.12 =__________________________QRS: __0.08____________________________

Dx: ___Supraventricular Tachycardia________________

1 2 3 4 5 6 7 8

ECG # 32ECG # 32

Rate: ____80s______________________Rhythm: ___Irregular___________________P waves: __+ ↑ ~ NOT 1:1_(No P waves=green arrows)PR Interval: _0.14 = (where P waves present)_____QRS: ______0.10___________________

Dx: Sinus Rhythm with PACs (Premature Atrial Contractions)

ECG # 33ECG # 33

Rate: ____80s______________________Rhythm: ____Irregular________________________P waves: ___+ ↑ ~ NOT 1:1 (Beat 2, 7)______PR Interval: ___0.16 = ___________________________QRS: ___0.10 (Except #2 & 7=’wide & bizarre,’ similar shape=”unifocal”

Dx: _Sinus Rhythm w/ Unifocal PVCs___________

ECG # 34ECG # 34

Rate: _____80_____________________Rhythm: __Regular_________________________P waves: ___Absent “Pacer Spikes=Green Arrow”_PR Interval: __N/A___________________________QRS: __0.16 = _________________________

Dx: Ventricular Pacemaker (V-Paced 100%; 100% Capture)__

ECG # 35ECG # 35

Rate: __100____________________________Rhythm: __regular_________________________P waves: __Absent (Flutter Waves)___________________________PR Interval: _____N/A________________________QRS: ___0.08 =___________________________

Dx: ___Atrial Flutter (2:1)__________________

ECG # 36 ECG # 36

Rate: ____54_______________________Rhythm: ____Regular________________________P waves: ___+ ↓ ~ 1:1 ______________________PR Interval: __0.08 =___________________________QRS: ___0.10 =_____________________________

Dx: ___Junctional Rhythm______________

ECG # 37 ECG # 37

Rate: ___88______________________________Rhythm: ___Regular____________________________P waves: __absent_________________________PR Interval: __n/a________________________________QRS: __0.10_______________________________

Dx: ____Junctional Rhythm (Accelerated)__________

ECG # 38 ECG # 38

Rate: _____90__________________________Rhythm: _____Regular_____________________P waves: _____+ ↑ ~ 1:1 __________________PR Interval: __0.16 =______________________________QRS: ____0.14-0.16 = ~ ___________________

Dx: __Sinus Rhythm , IVCD (BBB) ↓T Wave________________

ECG # 39ECG # 39

Rate: ____90s________________________Rhythm: ___Irregular_________________________P waves: ___Absent_________________________PR Interval: ____N/A____________________________QRS: ____0.08 = ~_________________________

Dx: __Atrial Fibrillation________________

ECG # 40ECG # 40

Rate: ____Very Fast ________________________Rhythm: __Irregular_____________________P waves: ___Absent___________________PR Interval: _____N/A________________________QRS: ______N/A__________________________

Dx: ___Ventricular Fibrillation__Coarse_(_transitioning from Torsades_)____

ECG # 41ECG # 41

Rate: ____~80s__________________________Rhythm: ____Irregular_________________________P waves: _+ ↑ ~ NOT 1:1 (missing in beats 2,3,6,7)__________PR Interval: __0.14 (where Ps present)____________________________QRS: ___0.10 (except beats 2,3,7,8=’wide & bizarre, but similar in form; PVCs in ‘couplets’ x 2___________

Dx: ___Sinus Rhythm, with PVC ‘couplets’ (unifocal) x 2________

Ecg # 42Ecg # 42

Rate: ___0__________________________Rhythm: __0______________________________P waves: ___0_____________________________PR Interval: ___0______________________________QRS: __0________________________________

Dx: ____asystole_________________

ECG # 43ECG # 43

Rate: ____56____________________________Rhythm: __Regular_____________________________P waves: ___+ ↑ ~ 1:1_______________________PR Interval: ___0.14 =____________________________QRS: ____0.10__________________________

Dx: Sinus Bradycardia

ECG # 44ECG # 44

Rate: ___65________________________Rhythm: ____Regular__________________________P waves: ___+ ↑ ~ 1:1 _________________________PR Interval: ___0.32 = _________________________QRS: ___0.10___________________________

Dx: ___Sinus Rhythm, 1st Degree AV Block________

ECG # 45ECG # 45

Rate: ___30s__________________________Rhythm: ___Irregular_________________________P waves: __+ ↑ ~ NOT 1:1 PR Interval: ___Variable____________________________QRS: ___0.14-0.16 = ~ ____________________________

Dx: ___3rd degree AV Block (“Complete Heart Block”) _________________

ECG # 46ECG # 46

Rate: ____280-300__________________________Rhythm: ____Regular________________________P waves: ____Absent__________________________PR Interval: ______N/A___________________________QRS: ____0.20-0.24__”Wide & Bizarre”________________________

Dx: Ventricular Tachycardia

ECG # 47ECG # 47

Rate: ____80s_________________________Rhythm: ___Regular________________________P waves: ___Absent (flutter waves)____________PR Interval: __N/A_____________________________QRS: __0.12 = ~ ____________________________

Dx: ____Atrial Flutter (3:1)_________________