Rhythm Strip Flash Card Practice

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Sinus Brady - Arrhythmia: the rate is slow and the rhythm is irregular

1 Sinus Brady — Arrhythmia The rate is slow and the rhythm is irregular

Sinus Brady - heart rate is less than 60

2 Sinus Brady — heart rate is less than 60

Normal Sinus Rhythm

3 Normal Sinus Rhythm

Normal Sinus Rhythm

4 Normal Sinus Rhythm

Supraventricular Tachycardia (SVT) Narrow complex tachycardia

5 Supraventricular Tachycardia (SVT) Narrow complex tachycardia

Sinus Tachycardia - heart rate greater than 100

6 Sinus Tachycardia — heart rate greater than 100

Normal Sinus Rhythm

7 Normal Sinus Rhythm

Normal Sinus Rhythm

8 Normal Sinus Rhythm

Sinus Arrhythmia (rhythm slightly irregular)

9 Sinus Arrhythmia (rhythm slightly irregular)

Supraventricular Tachycardia (SVT) Narrow complex tachycardia

10 Supraventricular Tachycardia (SVT) Narrow complex tachycardia

Sinus Rhythm (Could be sinus tachycardia HR=100)

11 Sinus Rhythm (Could be sinus tachycardia HR=100)

Sinus Bradycardia (heart rate less than 60)

12 Sinus Bradycardia (heart rate less than 60)

Sinus Rhythm (Could be sinus tachycardia HR=100)

13 Sinus Rhythm (Could be sinus tachycardia HR=100)

Sinus Bradiycardia - 1st Degree AV Block (PR 0.22 seconds)

14 Sinus Bradiycardia — 1st Degree AV Block (PR 0.22 seconds)

Sinus Tachycardia - heart rate greater than 100

15 Sinus Tachycardia — heart rate greater than 100

Sinus Brady arrhytnmia (HR< 60 and rhythm irregular) Wandering Atrial Pacer

16 Sinus Brady arrhytnmia (HR < 60 and rhythm irregular) Wandering Atrial Pacer

Wandering atrial pacemaker (p waves look different)

17 Wandering atrial pacemaker (p waves look different)

Atrial Fibrillation (rate 140): Irregular without discernible P waves

18 Atrial Fibrillation (rate 140): Irregular without discernible P waves

Sinus Rhythm with a PAC: 4th beat is early and narrow with compensatory pause

19 Sinus Rhythm with a PAC: 4th beat is early and narrow with compensatory pause

Atrial Fibrillation (rate 100): Irregular without discernible P waves

20 Atrial Fibrillation (rate 100): Irregular without discernible P waves

Sinus Arrhythmia (rhythm slightly irregular)

21 Sinus Arrhythmia (rhythm slightly irregular)

Sinus Rhythm with Unifocal PVCs ( 3 & 6) Could be Ventricular Trigeminiy

22 Sinus Rhythm with Unifocal PVCs ( 3 & 6) Could be Ventricular Trigeminiy

Atrial Fibrillation rate of 90 (irregular with no discernable P waves)

23 Atrial Fibrillation rate of 90 (irregular with no discernable P waves)

Second Degree AV Block Type I (Wenchebach) PR longer, longer, dropped beat

24 Second Degree AV Block Type I (Wenchebach) PR longer, longer, dropped beat

Sinus Rhythm with multifocal PVC's (PVCs look different from each other)

25 Sinus Rhythm with multifocal PVC's (PVCs look different from each other)

Sinus Rhythm with a PVC (Premature wide complex beat)

26 Sinus Rhythm with a PVC (Premature wide complex beat)

Sinus Rhythm with ventricular trigeminey (PVC every 3rd beat)

27 Sinus Rhythm with ventricular trigeminey (PVC every 3rd beat)

Sinus Arrhythmia with wandering atrial pacemaker

28 Sinus Arrhythmia with wandering atrial pacemaker

Accellerated Junctional Rhythm (heart rate is 80)

29 Accellerated Junctional Rhythm (heart rate is 80)

Sinus Bradycardia with 1st degree AV block (PR 0.22 seconds) HR=50

30 Sinus Bradycardia with 1st degree AV block (PR 0.22 seconds) HR=50

Atrial flutter with varying conduction (saw tooth baseline)

31 Atrial flutter with varying conduction (saw tooth baseline); however, from a cardiologist or EP perspective, this is coarse atrial fibrillation (pseudo flutter waves changing morphology and rate)

Sinus Tachycardia - heart rate greater than 100

32 Sinus Tachycardia — heart rate greater than 100

Normal Sinus Rhythm

33 Normal Sinus Rhythm

Normal Sinus Rhythm

34 Normal Sinus Rhythm

Atrial Fibrillation (irregular rhythm without discernible P waves)

35 Atrial Fibrillation (irregular rhythm without discernible P waves)

Atrial Fib (would accept Atrial Flutter) at rate of 140

36 Atrial Fib (would accept Atrial Flutter) at rate of 140

Second Degree AV Block Type I (Wenchebach) PR longer, longer, dropped beat

37 Second Degree AV Block Type I (Wenchebach) PR longer, longer, dropped beat

Atrial flutter (basic) Atrial Tachycardia with block if more advanced

38 Atrial flutter (basic) Atrial Tachycardia with block if more advanced

Atrial Fibrillation/Flutter Goes between no discernible P's and flutter waves.

39 Atrial Fibrillation/Flutter Goes between no discernible P's and flutter waves.

Sinus arrhythmia (basic) Sinus rhythm with blocke PAC if more advanced

40 Sinus arrhythmia (basic) Sinus rhythm with blocke PAC if more advanced

Atrial Flutter with 3:1 conduction

41 Atrial Flutter with 3:1 conduction

Sinus Tachycardia - heart rate greater than 100

42 Sinus Tachycardia — heart rate greater than 100

Normal Sinus Rhythm

43 Normal Sinus Rhythm

Accellerated Junctional Rhythm (heart rate is 70)

44 Accellerated Junctional Rhythm (heart rate is 70)

Sinus Bradycardia with PVCs

45 Sinus Bradycardia with PVCs

Sinus Rhythm with PVC

46 Sinus Rhythm with PVC

Junctional Rhythm (rate of 30)

47 Junctional Rhythm (rate of 30)

Sinus Rhythm with Premature Atrial Contraction (PAC 3rd beat)

48 Sinus Rhythm with Premature Atrial Contraction (PAC 3rd beat)

Normal Sinus Rhythm

49 Normal Sinus Rhythm

Sinus Rhythm with a PAC (second beat)

50 Sinus Rhythm with a PAC (second beat)

Atrial flutter (basic) Atrial Tachycardia with block if more advanced

51 Atrial flutter (basic) Atrial Tachycardia with block if more advanced

Sinus Tachycardia - heart rate greater than 100

52 Sinus Tachycardia — heart rate greater than 100

Ventricular Fibrillation

53 Ventricular Fibrillation

Sinus Rhythm with ventricular Bigeminey (PVC every other beat)

54 Sinus Rhythm with ventricular Bigeminey (PVC every other beat)

Ventricular Fibrillation

55 Ventricular Fibrillation

Sinus Bradycardia with 1st degree AV block (PR 0.26 seconds) HR=50

56 Sinus Bradycardia with 1st degree AV block (PR 0.26 seconds) HR=50

Sinus Rhythm with 1st Degree AV block (PR -.26 seconds)

57 Sinus Rhythm with 1st Degree AV block (PR -.26 seconds)

Atrial Fibrillation (irregular rhythm without discernible P waves)

58 Atrial Fibrillation (irregular rhythm without discernible P waves)

Sinus Rhythm (Could call this sinus tachycardia HR 100)

59 Sinus Rhythm (Could call this sinus tachycardia HR 100)

Normal Sinus Rhythm

60 Normal Sinus Rhythm

Sinus Bradycardia HR 40

61 Sinus Bradycardia HR 40

Normal Sinus Rhythm

62 Normal Sinus Rhythm

Sinus Rhythm with Premature Atrial Contraction (PAC 4th beat)

63 Sinus Rhythm with Premature Atrial Contraction (PAC 4th beat)

Atrial Fibrillation

64 Atrial Fibrillation

Sinus Rhythm with ventricular Bigeminey (PVC every other beat)

65 Sinus Rhythm with ventricular Bigeminey (PVC every other beat)

Sinus rhythm with AV sequential pacing (atrial firing and conducting)

66 Sinus rhythm with AV sequential pacing (atrial firing and conducting)

Sinus Bradycardia (HR=50)

67 Sinus Bradycardia (HR=50)

Normal Sinus Rhythm

68 Normal Sinus Rhythm

Atrial Fibrillation (Irregular rhythm without discernible P waves)

69 Atrial Fibrillation (Irregular rhythm without discernible P waves)

Normal Sinus Rhythm

70 Normal Sinus Rhythm

Sinus Rhythm with 1st Degree AV block (PR -.26 seconds)

71 Sinus Rhythm with 1st Degree AV block (PR -.26 seconds)

Atrial Fibrillation (with a few flutter beats)

72 Atrila Fibrillation (with a few flutter beats)

Juntional Rhythm (P waves occur after the QRS with HR 50)

73 Juntional Rhythm (P waves occur after the QRS with HR 50)

2nd Degree AV Block Mobitz I (Wenchebach) PR gets longer, longer then dropped QRS

74 2nd Degree AV Block Mobitz I (Wenchebach) PR gets longer, longer then dropped QRS

SR (beginning) to supraventricular tachycardia (SVT) : Narrow complex tachycardia

75 SR (beginning) to supraventricular tachycardia (SVT) : Narrow complex tachycardia

Sinus Rhythm with ventricular Bigeminey (PVC every other beat)

76 Sinus Rhythm with ventricular Bigeminey (PVC every other beat)

Sinus Tachycardia - heart rate greater than 100

77 Sinus Tachycardia — heart rate greater than 100

Atrial Fibrillation (irregular rhythm without discernible P waves)

78 Atrial Fibrillation (irregular rhythm without discernible P waves)

Wandering atrial pacemaker (p waves look different)

79 Wandering atrial pacemaker (p waves look different)

Sinus Bradycardia (heart rate less than 60)

80 Sinus Bradycardia (heart rate less than 60)

Complete heart block (3rd degree) with ventricular (wide) response

81 Complete heart block (3rd degree) with ventricular (wide) response

Sinus Tachycardia - heart rate greater than 100

82 Sinus Tachycardia — heart rate greater than 100

Sinus Arrhythmia

83 Sinus Arrhythmia

Sinus Tachycardia - heart rate greater than 100

84 Sinus Tachycardia — heart rate greater than 100

Junctional Rhythm (rate of 60)

85 Junctional Rhythm (rate of 60)

Normal Sinus Rhythm

86 Normal Sinus Rhythm

Normal Sinus Rhythm

87 Normal Sinus Rhythm

Sinus Tachycardia

88 Sinus Tachycardia

Asystole

89 Asystole

Sinus Rhythm with vetricular couplet (two PVC's in a row)

90 Sinus Rhythm with vetricular couplet (two PVC's in a row)

Sinus rhythm with a Premature Atrial Contraction (PAC 7th beat)

91 Sinus rhythm with a Premature Atrial Contraction (PAC 7th beat)

Ventricular Tachycardia

92 Ventricular Tachycardia

Accelerated Junctional Rhythm (regular, no P waves, rate >60)

93 Accelerated Junctional Rhythm (regular, no P waves, rate >60)

Wandering atrial pacemaker with PAC

94 Wandering atrial pacemaker with PAC

2nd Degree AV Block Mobitz I (Wenchebach) PR gets longer, longer then dropped QRS

95 2nd Degree AV Block Mobitz I (Wenchebach) PR gets longer, longer then dropped QRS

Sinus Tachycardia - heart rate greater than 100

96 Sinus Tachycardia — heart rate greater than 100

Atrial Flutter with 2:1 conduction (would accept SVT)

97 Atrial Flutter with 2:1 conduction (would accept SVT)

Junctional rhythm or accelerated idioventricular rhythm

98 Junctional rhythm or accelerated idioventricular rhythm

Ventricular Tachycardia

99 Ventricular Tachycardia

Sinus Rhythm with PVCs

100 Sinus Rhythm with PVCs

Atrial Fibrillation (irregular rhythm without discernible P waves)

101 Atrial Fibrillation (irregular rhythm without discernible P waves)

Sinus Tachycardia - heart rate greater than 100

102 Sinus Tachycardia — heart rate greater than 100

Sinus Bradycardia - heart rate 40

103 Sinus Bradycardia — heart rate 40

Sinus Rhythm with 1st Degree AV block (PR -.30 seconds)

104 Sinus Rhythm with 1st Degree AV block (PR -.30 seconds)

Sinus Bradycardia with a sinus pause

105 Sinus Bradycardia with a sinus pause

Sinus Rhythm with atrial bigeminey (PAC every other beat)

106 Sinus Rhythm with atrial bigeminey (PAC every other beat)

Sinus Tachycardia - heart rate greater than 100

107 Sinus Tachycardia — heart rate greater than 100

Normal Sinus Rhythm

108 Normal Sinus Rhythm

Sinus Tachycardia - heart rate greater than 100

109 Sinus Tachycardia — heart rate greater than 100

Junctional Rhythm

110 Junctional Rhythm

Junctional Tachycardia

111 Junctional Tachycardia

Junctional Rhythm

112 Junctional Rhythm

Accellerated Junctional Rhythm (Inverted P wave Rate >60)

113 Accellerated Junctional Rhythm (Inverted P wave Rate >60)

Sinus Tachycardia - heart rate greater than 100

114 Sinus Tachycardia — heart rate greater than 100

Sinus Rhythm with atrial bigeminey (PAC every other beat)

115 Sinus Rhythm with atrial bigeminey (PAC every other beat)

Sinus Rhythm with PVCs

116 Sinus Rhythm with PVCs

Atrial Flutter (advanced Atrial Tachycardia with Block)

117 Atrial Flutter (advanced Atrial Tachycardia with Block)

Atrial Fibrillation

118 Atrial Fibrillation

Sinus Arrhythmia

119 Sinus Arrhythmia

Sinus Rhythm

120 Sinus Rhythm

Sinus Rhythm with PACs

121 Sinus Rhythm with PACs

Sinus Tachycardia - heart rate greater than 100

122 Sinus Tachycardia — heart rate greater than 100

Accellerated Junctional Rhythm

123 Accellerated Junctional Rhythm

Sinus Bradycardia with 1st Degree AV Block of .26 seconds

124 Sinus Bradycardia with 1st Degree AV Block of .26 seconds

Mobitz I Heart Block (the last beat is actually a juntional beat)

125 Mobitz I Hearr Block (the last beat is actually a juntional beat)

Sinus rhythm with a 1st degree AV Block

126 Sinus rhythm with a 1st degree AV Block

3rd Degree Heart Block (Complete Heart Block)

127 3rd Degree Heart Block (Complete Heart Block)

2nd Degree AV Block Mobitz II (2 or more P waves for every QRS)

128 2nd Degree AV Block Mobitz II (2 or more P waves for every QRS)

Sinus Rhythm with 1st Degree AV Block

129 Sinus Rhythm with 1st Degree AV Block

2nd Degree AV Block Mobitz Type I (Wenckebach) PR longer, longer, dropped QRS

130 2nd Degree AV Block Mobitz Type I (Wenckebach) PR longer, longer, dropped QRS

Multifocal atrial tachycardia

131 Multifocal atrial tachycardia

Sinus Rhythm (could be Junctional Tachycardia) Hard to see P waves

132 Sinus Rhythm (could be Junctional Tachycardia) Hard to see P waves

Wandering Atrial Pacemaker

133 Wandering Atrial Pacemaker

Sinus Tachycardia - heart rate greater than 100

134 Sinus Tachycardia — heart rate greater than 100

Normal Sinus Rhythm

135 Normal Sinus Rhythm

Sinus Rhythm Changing into SVT

136 Sinus Rhythm Changing into SVT

Sinus Rhythm with a PAC

137 Sinus Rhythm with a PAC

Complete heart block (3rd degree) with ventricular (wide) response

138 Complete heart block (3rd degree) with ventricular (wide) response

Second Degree AV Block Type II 2:1 Block

139 Second Degree AV Block Type II 2:1 Block

Complete heart block (3rd degree)

140 Complete heart block (3rd degree)

Sinus Tachycardia - heart rate greater than 100

141 Sinus Tachycardia — heart rate greater than 100

Sinus Tachycardia - Possibility of atrial flutter with 2:1 block

142 Sinus Tachycardia — Possibility of atrial flutter with 2:1 block

Sinus Rhythm with PACs

143 Sinus Rhythm with PACs

Sinus Rhythm

144 Sinus Rhythm

Sinus Rhytmn with Ventricular Bigeminy

145 Sinus Rhytmn with Ventricular Bigeminy

Atrial Flutter with 4:1 Block (sawtooth baseline)

146 Atrial Flutter with 4:1 Block (sawtooth baseline)

Sinus Rhythm with frequent PVCs and a ventricular couplet

147 Sinus Rhythm with frequent PVCs and a ventricular couplet

Supraventricular Tachycardia (SVT) Narrow complex tachycardia

148 Supraventricular Tachycardia (SVT) Narrow complex tachycardia

Sinus Rhythm with multifocal PVC's (PVCs look different from each other)

149 Sinus Rhythm with multifocal PVC's (PVCs look different from each other)

Sinus Bradycardia (HR 40)

150 Sinus Bradycardia (HR 40)

Atrial Fibrillation (irregular rhythm without discernible P waves)

151 Atrial Fibrillation (irregular rhythm without discernible P waves)

Sinus Rhythm with Premature Atrial Contractions (PACs)

152 Sinus Rhythm with Premature Atrial Contractions (PACs)

Sinus Rhythm with Frequent PACs

153 Sinus Rhythm with Frequent PACs

Atrial Fibrillation (irregular rhythm without discernible P waves)

154 Atrial Fibrillation (irregular rhythm without discernible P waves)

Atrial Flutter with 4:1 Block (sawtooth baseline)

155 Atrial Flutter with 4:1 Block (sawtooth baseline)

Sinus Rhythm with a Sinus Pause

156 Sinus Rhythm with a Sinus Pause

Sinus Bradycardia

157 Sinus Bradycardia

Sinus Rhythm with PAC (3rd beat)

158 Sinus Rhythm with PAC (3rd beat)

Atrial Fibrillation (irregular rhythm without discernible P waves)

159 Atrial Fibrillation (irregular rhythm without discernible P waves)

Sinus Rhythm with Premature Atrial Contraction

160 Sinus Rhythm with Premature Atrial Contraction

Sinus Rhythm (note the ST elevation)

161 Sinus Rhythm (note the ST elevation)

Sinus Rhythm with PAC (2nd beat)

162 Sinus Rhythm with PAC (2nd beat)

Sinus Tachycardia

163 Sinus Tachycardia

Supraventricular Tachycardia (SVT) Narrow complex tachycardia

164 Supraventricular Tachycardia (SVT) Narrow complex tachycardia

Atrial Flutter with variable block

165 Atrial Flutter with variable block

Sinus Rhythm with 1st Degree AV Block (PR 0.22 seconds) and PACs

166 Sinus Rhythm with 1st Degree AV Block (PR 0.22 seconds) and PACs

Ventricular Tachycardia

167 Ventricular Tachycardia

Atrial Fibrillation

168 Atrial Fibrillation

Complete heart block (3rd degree) with ventricular (wide) response

169 Complete heart block (3rd degree) with ventricular (wide) response

Second Degree AV Block Mobitz Type II

170 Second Degree AV Block Mobitz Type II

Sinus Rhythm with 1st Degree AV block and a Pacer with Failure to Sense

171 Sinus Rhythm with 1st Degree AV block and a Pacer with Failure to Sense

Sinus Rhythm with a run of PAT (would accept run of SVT)

172 Sinus Rhythm with a run of PAT (would accept run of SVT)

Ventricular Tachycardia (Polymorphic VT or Torsades de Pointes)

173 Ventricular Tachycardia (Polymorphic VT or Torsades de Pointes)

Sinus Rhythm with ventricular Bigeminey (PVC every other beat)

174 Sinus Rhythm with ventricular Bigeminey (PVC every other beat)

Sinus Rhythm with Vetricular Quadgeminey (PVC evvery 4th beat)

175 Sinus Rhythm with Vetricular Quadgeminey (PVC evvery 4th beat)

Sinus Arrhythmia

176 Sinus Arrhythmia

Sinus Bradycardia

177 Sinus Bradycardia

Sinus Tachycardia with 1st degree AV Block (0.24 seconds PR)

178 Sinsu Tachycardia with 1st degree AV Block (0.24 seconds PR)

Supraventricular Tachycardia (SVT) Narrow complex tachycardia

179 Supraventricular Tachycardia (SVT) Narrow complex tachycardia

Ventricular Fibrillation

180 Ventricular Fibrillation

Ventriciular Tachycardia

181 Ventriciular Tachycardia

Asystole

182 Asystole

Ventricular Fibrillation

183 Ventricular Fibrillation

Ventricular Tachycardia

184 Ventricular Tachycardia

Last reviewed and updated by Sarah Gehrke, MSN, RN on Dec 5, 2017

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