KAISER EKG 2026
ELECTROCARDIOGRAPHY FUNDAMENTALS
ASSESSMENT QUESTIONS SOLUTIONS
FINAL STUDY GUIDE
◉ Junctional Rhythm
Answer: Impulse starts in the AV junction
• P waves are absent, short, inverted or retrograde
• Ventricular Rhythm: Regular
• Ventricular Rate: 40-60 bpm
• QRS is usually within normal limits
◉ Accelerated Junctional Rhythm
Answer: Accelerated Junctional
Same criteria as Junctional Rhythm, except the Ventricular rate is 60-
100
For stable patients: IV access, vagal maneuvers, adenosine, O2, Beta
blockers, calcium channel blockers
,◉ Idioventricular Rhythm (IVR)
Answer: Impulse originates in the ventricles
▪ Rhythm: Ventricular is usually regular
▪ Rate: Ventricular between 20-40
▪ QRS: ≥ 0.12
▪ Atrial rate, rhythm, and PRI: N/A
- Treatment: assess pt, check for DNR in chart, transcutaneous
pacing, atropine. NEVER GIVE ANTI-ARRYTHMICS MEDICATIONS
◉ Accelerated Idioventricular Rhythm
Answer: Follows the same criteria as IVR, except Ventricular rate is
40-100.
• If no intervention happens, the patient will deteriorate.
- Treatment: assess pt, atropine, transcutaneous pacing. NEVER
GIVE ANTI-ARRHYTHMIC MEDICATIONS
◉ Ventricular Pacing
Answer: • The pacemaker lead is placed in to right ventricle.
• The pacemaker generator fires an impulse Initiating ventricular
activity.
• The right ventricle will contract first followed by the left ventricle.
This results in a wide QRS
, • Atrial activity is typically absent. Therefore, Atrial rhythm, rate,
and PRI are non- measurable
• Rhythm: Ventricular regular
• Rate: Ventricular within set pacer limits. Measured from pacer
spike to pacer spike
• QRS: Wide; Pacer spike seen before each QRS. Measured from
pacer spike to end
of QRS
◉ Atrial-ventricular Pacing
Answer: One pacemaker lead is placed into the right atria and
another is placed into the right
ventricle.
• The pacemaker generator fires an impulse to the atria and then to
the ventricle sequentially
causing atrial then ventricular contraction.
• Rhythm: Atrial and Ventricular regular
• Rate: Atrial and Ventricular same & within set limits
• P waves: Pacer spike seen at beginning of atrial activity P waves
may or may not be seen
(lead type dependent)
• PRI: WNL - Measured from atrial spike to ventricular spike
• QRS: Wide - Measured from ventricular spike to end of QRS
ELECTROCARDIOGRAPHY FUNDAMENTALS
ASSESSMENT QUESTIONS SOLUTIONS
FINAL STUDY GUIDE
◉ Junctional Rhythm
Answer: Impulse starts in the AV junction
• P waves are absent, short, inverted or retrograde
• Ventricular Rhythm: Regular
• Ventricular Rate: 40-60 bpm
• QRS is usually within normal limits
◉ Accelerated Junctional Rhythm
Answer: Accelerated Junctional
Same criteria as Junctional Rhythm, except the Ventricular rate is 60-
100
For stable patients: IV access, vagal maneuvers, adenosine, O2, Beta
blockers, calcium channel blockers
,◉ Idioventricular Rhythm (IVR)
Answer: Impulse originates in the ventricles
▪ Rhythm: Ventricular is usually regular
▪ Rate: Ventricular between 20-40
▪ QRS: ≥ 0.12
▪ Atrial rate, rhythm, and PRI: N/A
- Treatment: assess pt, check for DNR in chart, transcutaneous
pacing, atropine. NEVER GIVE ANTI-ARRYTHMICS MEDICATIONS
◉ Accelerated Idioventricular Rhythm
Answer: Follows the same criteria as IVR, except Ventricular rate is
40-100.
• If no intervention happens, the patient will deteriorate.
- Treatment: assess pt, atropine, transcutaneous pacing. NEVER
GIVE ANTI-ARRHYTHMIC MEDICATIONS
◉ Ventricular Pacing
Answer: • The pacemaker lead is placed in to right ventricle.
• The pacemaker generator fires an impulse Initiating ventricular
activity.
• The right ventricle will contract first followed by the left ventricle.
This results in a wide QRS
, • Atrial activity is typically absent. Therefore, Atrial rhythm, rate,
and PRI are non- measurable
• Rhythm: Ventricular regular
• Rate: Ventricular within set pacer limits. Measured from pacer
spike to pacer spike
• QRS: Wide; Pacer spike seen before each QRS. Measured from
pacer spike to end
of QRS
◉ Atrial-ventricular Pacing
Answer: One pacemaker lead is placed into the right atria and
another is placed into the right
ventricle.
• The pacemaker generator fires an impulse to the atria and then to
the ventricle sequentially
causing atrial then ventricular contraction.
• Rhythm: Atrial and Ventricular regular
• Rate: Atrial and Ventricular same & within set limits
• P waves: Pacer spike seen at beginning of atrial activity P waves
may or may not be seen
(lead type dependent)
• PRI: WNL - Measured from atrial spike to ventricular spike
• QRS: Wide - Measured from ventricular spike to end of QRS
