Practice ECGs Flashcards

Practice Strip 1
AR: 85
VR: 85
Rhythm: regular
P waves: normal
PR interval: 0.20 sec
QRS complex: narrow (0.08 sec)
Interpretation: normal sinus rhythm

Practice Strip 2
AR: 300
VR: 70
Rhythm: regular
P waves: replaced by flutter waves
PR interval: none (there are no P waves
)
QRS complex: narrow (0.06 sec)
Interpretation: atrial flutter (with 4:1 conduction)

Practice Strip 3
- AR: not measurable
- VR: 150-160
- Rhythm: irregular
- P waves: none
- PR interval: none
- QRS complex: narrow (0.04 sec)
Interpretation: atrial fibrillation

Practice Strip 4
- AR: 60
- VR: 60
- Rhythm: regular
- P waves: normal
- PR interval: 0.34 sec
- QRS complex: narrow (0.08 sec)
- Interpretation: first degree AV block
- (of note: inverted T waves)

Practice Strip 5
- AR: 185
- VR: 185
- Rhythm: regular
- P waves: normal, very close to T waves and difficult to see
- PR interval: 0.14 sec
- QRS complex: narrow (0.06 sec)
- Interpretation: PAT (because the Ps are hard to see, you might say they are buried, and the rhythm could be JT. If unsure, you can call it SVT)

Practice Strip 6
- AR: 115
- VR: 115
- Rhythm: regular
- P waves: normal
- PR interval: 0.20 sec
- QRS complex: narrow (0.08 sec)
- Interpretation: sinus tachycardia

Practice Strip 7
- AR: 70-75
- VR: 70-75
- Rhythm: regular, except for the premature 4th beat
- P waves: normal (except for 4th complex where the P is inverted)
- PR interval: 0.16 sec
- QRS complex: narrow (0.05 sec)
- Interpretation: normal sinus rhythm, with a PJC

Practice Strip 8
- AR: 50
- VR: 50
- Rhythm: regular
- P waves: follow the QRS complexes
- PR interval: none
- QRS complex: narrow
- Interpretation: junctional escape rhythm

Practice Strip 9
- AR: not measurable (no obvious P waves)
- VR: about 35
- Rhythm: irregular
- P waves: none, fibrillatory line only
- PR interval: none
- QRS complex: narrow (0.08 sec)
- Interpretation: slow atrial fibrillation
- (of note: inverted T waves)

Practice Strip 10
- AR: 50
- VR: 100
- Rhythm: regularly irregular
- P waves: normal before narrow QRSs, and absent before wide QRSs
- PR interval: 0.16 sec (when measurable)
- QRS complex: narrow ones are 0.10 sec, and every second QRS is wide
Interpretation: ventricular bigeminy (every 2nd complex is a PVC

Practice Strip 11
- AR: not measurable (no obvious P waves)
- VR: 110
- Rhythm: irregular
- P waves: none, fibrillatory line only
- PR interval: none
- QRS complex: narrow
- Interpretation: atrial fibrillation

Practice Strip 12
- AR: about 70
- VR: about 70
- Rhythm: irregular
- P waves: normal
- PR interval: 0.14 sec
- QRS complex: narrow
- Interpretation: sinus arrhythmia

Practice Strip 13
- AR: 72
- VR: 72
- Rhythm: regular except for the premature 2nd and the last beats
- P waves: normal except for the 2nd and last beat
- PR interval: 0.16 sec
- QRS complex: narrow
- Interpretation: normal sinus rhythm, with PACs (might be considered PJCs, as the Ps are almost fully inverted)

Practice Strip 14
- AR: not measurable
- VR: 155
- Rhythm: irregular
- P waves: none (fibrillatory line only)
- PR interval: none
- QRS complex: narrow
- Interpretation: atrial fibrillation
- (of note: the QRS complexes consist only of Q waves)

Practice Strip 15
- AR: 72
- VR: 72
- Rhythm: regular, except for the premature 4th beat
- P waves: normal, except for 4th beat, which is inverted
- PR interval: 0.16 sec (except for 4th beat which is 0.08 sec)
- QRS complex: narrow
- Interpretation: normal sinus rhythm with a PJC

Practice Strip 16
- AR: 300
- VR: 50-60
- Rhythm: irregular
- P waves: none, replaced by flutter waves
- PR interval: none
- QRS complex: narrow
- Interpretation: atrial flutter, with variable conduction

Practice Strip 17
- AR: 80
- VR: 80
- Rhythm: irregular
- P waves: normal
- PR interval: 0.14 sec
- QRS complex: narrow
- Interpretation: sinus arrhythmia

Practice Strip 18
- AR: 300
- VR: 70
- Rhythm: regular
- P waves: none, replaced by flutter waves
- PR interval: none
- QRS complex: narrow
- Interpretation: atrial flutter, with 4:1 conduction

Practice Strip 19
- AR: not measurable
- VR: 200-210
- Rhythm: regular
- P waves: no obvious P waves
- PR interval: none
- QRS complex: narrow, 0.08 sec
- Interpretation: SVT (it could be PAT with Ps that are difficult to see because of the rapid rate, or it could be PJT with Ps that are buried)

Practice Strip 20
- AR: 55
- VR: 55
- Rhythm: regular
- P waves: normal
- PR interval: 0.30 sec
- QRS complex: narrow
- Interpretation: first degree AV block
Practice Strip 21
- AR: 50-55
- VR: about 40
- Rhythm: irregular
- P waves: normal, but there’s an extra P wave after the 3rd QRS
- PR interval: variable: 0.24 sec, 0.32 sec, 0.40 sec, then a P with no QRS that follows. Then the sequence starts over again (the PR prolongs until a QRS is missing)
- QRS complex: narrow
- Interpretation: second degree AV block, type I (Wenckebach)
Practice Strip 22
- AR: 90
- VR: 90
- Rhythm: regular
- P waves: inverted before each QRS
- PR interval: 0.10 sec
- QRS complex: narrow
- Interpretation: accelerated junctional rhythm
Practice Strip 23
- AR: about 90 (if you find 2 obvious consecutive P waves, such as the two between the 2nd and 3rd QRSs, then use either the “caliper” or “scrap paper” method learned to determine regularity of the rhythm, you should find 9 P waves on this strip)
- VR: 30
- Rhythm: regular
- P waves: lots of extras
- PR interval: variable: 0.60 sec, 0.12 sec, 0.70 sec, 0.36 sec
- QRS complex: narrow
- Interpretation: third degree AV block
Practice Strip 24
- AR: about 120 (again, find 2 obvious consecutive P waves, such as the two after the 1st QRS, and using either method to determine the regularity, you should find 12 P waves on this strip, though some blend in with the QRS complexes)
- VR: 45
- Rhythm: regular
- P waves: lots of extras
- PR interval: variable: 0.24 sec, 0.12 sec, 0.42 sec, 0.26 sec
- QRS complex: wide
- Interpretation: third degree AV block
Practice Strip 25
- AR: not measurable (no obvious P waves)
- VR: 120
- Rhythm: irregular
- P waves: none, replaced with a fibrillatory line
- PR interval: none
- QRS complex: narrow
- Interpretation: atrial fibrillation
- (of note: ST segment depression)

Practice Strip 26
- AR: not measurable
- VR: 160
- Rhythm: regular
- P waves: none
- PR interval: none
- QRS complex: wide
- Interpretation: VT

Practice Strip 27
- AR: not measurable
- VR: about 30
- Rhythm: regular
- P waves: none
- PR interval: none
- QRS complex: wide
- Interpretation: IVR

Practice Strip 28
- AR: none
- VR: none
- Rhythm: irregular
- P waves: none
- PR interval: none
- QRS complex: none
- Interpretation: VF

Practice Strip 29
- AR: 45
- VR: 135
- Rhythm: regular
- P waves: normal, lots of extras
- PR interval: constant 0.14 sec
- QRS complex: narrow
- Interpretation: second degree AV block type II (Mobitz II)

Practice Strip 30
- AR: about 90
- VR: about 70
- Rhythm: irregular
- P waves: normal, with extras
- PR interval: variable 0.14 sec, 0.20 sec, 0.28 sec, then a P wave does not conduct. The sequence then starts over again
- QRS complex: narrow
- Interpretation: second degree type I (Wenckebach)

Practice Strip 31
- AR: 65
- VR: 65
- Rhythm: irregular
- P waves: normal
- PR interval: 0.12 sec
- QRS complex: narrow
- Interpretation: sinus arrhythmia

Practice Strip 32
- AR:72
- VR: 72
- Rhythm: regular
- P waves: normal
- PR interval: 0.32 sec
- QRS complex: narrow
- Interpretation: first degree AV block
- (of note: inverted T waves)

Practice Strip 33
- AR: 35-40
- VR: 35-40
- Rhythm: regular
- P waves: normal
- PR interval: 0.30 sec
- QRS complex: narrow
- Interpretation: first degree AV block

Practice Strip 34
- AR: 70
- VR: 70
- Rhythm: regular
- P waves: normal
- PR interval: 0.22 sec
- QRS complex: narrow
- Interpretation: first degree AV block

Practice Strip 35
- AR: not measurable
- VR: about 70
- Rhythm: irregular
- P waves: none, replaced by fibrillatory line
- PR interval: none
- QRS complex: narrow, except for the premature 5th one
- Interpretation: atrial fibrillation with a PVC