EKG Interpretation (HCA) QUESTIONS & ANSWERS
2026 ( A+ GRADED 100% VERIFIED)
1. Atrial Rhythms
Answer: • Are not classic "P-wave" rhythms, if equal/consistent/nonvarying P-waves are easily iden- tified then the
rhythm is NOT atrial in origin
• Atrial rhythms are routinely fast
• Ventricular rates can be controlled (<100) or uncontrolled (>100)
• Ventricular responses and rates can reach up to 220 - 240 ppm
• Ventricular regularity can be regular or irregular, depending on the rhythm
- AFib, WAP & MAT = ALWAYS IRREGULAR
- Aflutter = Regular or Irregular
- SVT/PSVT, ATach = ALWAYS REGULAR
• QRS-complexes can be Narrow (<0.12 sec) or Wide (>0.12 sec). This is measured using the ECG paper (<0.12 = less
than 3 small boxes; <0.12 = greater than 3 small boxes)
,2. Atrial Rhythms & Associated Rates
Answer: • A-Fib Atria Rate >350 - 500; Ventricular Rate >220 - 240 ppm
• A-Flutter Atrial Rate >250 - 450; Ventricular Rate >220 - 240 ppm
• Atrial Tachycardia Atria > 220 - 240; Ventricular Rate = Atrial Rate (1;1 ratio)
• Supraventricular Tachycardia >150 - 160 ppm, even upwards of 220 - 240 ppm; Ventricular Rate = Atrial Rate (1
Answer:1 ratio)
• Wandering Atrial Pacemaker (WAP) Atrial Rate <100 ppm; Ventricular Rate = Atrial Rate
• Multifocal Atrial Tachycardia (MAT) Atrial Rate >100 ppm; Ventricular Rate = Atrial Rate
3. Premature Atrial Contraction (PAC)
Answer: Atrial ectopy (not a rhythm) similar to an ill timed hiccup within the atria, or the atria playing a game of
interrupting cow.
4. Atrial Fibrillation (A-Fib)
Answer: Wavy and chaotic baseline, noted overall irregularity, AFib QRS complexes can be 'wide' or 'narrow'
5. Narrow QRS Complex
Answer: <0.12 seconds (3 small boxes)
6. Wide QRS Complex
Answer: >0.12 seconds (3 small boxes)
7. Atrial Flutter (A-Flutter)
, Answer: Consistent atrial depolarization waves creating "flutter" or "saw-tooth" appear-
ance on baseline.
Can be regular or irregular.
QRS complexes can be 'wide' or 'narrow'
Ditterent ratios (2;1, 3;1, 4;1) possible
8. Atrial Tachycardia (A-Tach)
Answer: Atrial Tachycardia is caused when abnormal electrical signals inersect with
signals coming from the SA node.
It can prevent the heart from filling normally and refuse the overall blood flow out of the heart due to rapid rate.
'Teeny-tiny' P's noted, FAST rate, narrow complexes and REGULAR
9. Supraventricular Tachycardia (SVT)
Answer: Abnormal heart rhythm arising from aberrant electrical activity
in the heart; originates at or above the AV node
No P's noted, FAST rate, narrow complexes and REGULAR
10. Multifocal Atrial Tachycardia (MAT)
Answer: 3 or more varying P-Waves, overall irregular and rate is >100 ppm. Note the DIFFERENT P's
presented.
11. Wandering Atrial Pacemaker (WAP)
2026 ( A+ GRADED 100% VERIFIED)
1. Atrial Rhythms
Answer: • Are not classic "P-wave" rhythms, if equal/consistent/nonvarying P-waves are easily iden- tified then the
rhythm is NOT atrial in origin
• Atrial rhythms are routinely fast
• Ventricular rates can be controlled (<100) or uncontrolled (>100)
• Ventricular responses and rates can reach up to 220 - 240 ppm
• Ventricular regularity can be regular or irregular, depending on the rhythm
- AFib, WAP & MAT = ALWAYS IRREGULAR
- Aflutter = Regular or Irregular
- SVT/PSVT, ATach = ALWAYS REGULAR
• QRS-complexes can be Narrow (<0.12 sec) or Wide (>0.12 sec). This is measured using the ECG paper (<0.12 = less
than 3 small boxes; <0.12 = greater than 3 small boxes)
,2. Atrial Rhythms & Associated Rates
Answer: • A-Fib Atria Rate >350 - 500; Ventricular Rate >220 - 240 ppm
• A-Flutter Atrial Rate >250 - 450; Ventricular Rate >220 - 240 ppm
• Atrial Tachycardia Atria > 220 - 240; Ventricular Rate = Atrial Rate (1;1 ratio)
• Supraventricular Tachycardia >150 - 160 ppm, even upwards of 220 - 240 ppm; Ventricular Rate = Atrial Rate (1
Answer:1 ratio)
• Wandering Atrial Pacemaker (WAP) Atrial Rate <100 ppm; Ventricular Rate = Atrial Rate
• Multifocal Atrial Tachycardia (MAT) Atrial Rate >100 ppm; Ventricular Rate = Atrial Rate
3. Premature Atrial Contraction (PAC)
Answer: Atrial ectopy (not a rhythm) similar to an ill timed hiccup within the atria, or the atria playing a game of
interrupting cow.
4. Atrial Fibrillation (A-Fib)
Answer: Wavy and chaotic baseline, noted overall irregularity, AFib QRS complexes can be 'wide' or 'narrow'
5. Narrow QRS Complex
Answer: <0.12 seconds (3 small boxes)
6. Wide QRS Complex
Answer: >0.12 seconds (3 small boxes)
7. Atrial Flutter (A-Flutter)
, Answer: Consistent atrial depolarization waves creating "flutter" or "saw-tooth" appear-
ance on baseline.
Can be regular or irregular.
QRS complexes can be 'wide' or 'narrow'
Ditterent ratios (2;1, 3;1, 4;1) possible
8. Atrial Tachycardia (A-Tach)
Answer: Atrial Tachycardia is caused when abnormal electrical signals inersect with
signals coming from the SA node.
It can prevent the heart from filling normally and refuse the overall blood flow out of the heart due to rapid rate.
'Teeny-tiny' P's noted, FAST rate, narrow complexes and REGULAR
9. Supraventricular Tachycardia (SVT)
Answer: Abnormal heart rhythm arising from aberrant electrical activity
in the heart; originates at or above the AV node
No P's noted, FAST rate, narrow complexes and REGULAR
10. Multifocal Atrial Tachycardia (MAT)
Answer: 3 or more varying P-Waves, overall irregular and rate is >100 ppm. Note the DIFFERENT P's
presented.
11. Wandering Atrial Pacemaker (WAP)
