Advent Health EKG

ADVENT HEALTH EKG QUESTIONS
WITH CORRECT ANSWERS

Afibk-kCORRECTkANSWER-The kimpulse koriginateskinkthekAtria

•kThe kAtrial krate kisk>k300kandkunablektokmeasurek[N/A]

•kNokdiscernablekPkwavesk-kPRIk&kAtrialkrhythmkcannotkbekmeasuredk[N/A]

•kThe kVentricularkrhythmkiskirregular

•kQRSkwithinknormalklimits

•kIfkthe kVentricularkratekisk<100kthe krhythmkiskcontrolledkA-fib;

ifkthe kVentricularkratekisk>k100kthe krhythmkiskuncontrolledkA-fib

•kThiskiskakchronickrhythmkforksomekpatientsk

Treatment:kcontrolledkpatients:kanticoagulantskandkantiarrythmics;kuncontrolledkbutkstablekpatients:kBet
akblockers,kcalciumkchannelkblockers,korkdigoxin;kUnstablekpatients:kcardioversion



Junctional kRhythmk-kCORRECTkANSWER-Impulsekstartskinkthe kAVkjunction

•kPkwaveskare kabsent,kshort,kinvertedkorkretrograde

•kVentricularkRhythm:kRegular

•kVentricularkRate:k40-60kbpm

•kQRSkiskusuallykwithinknormalklimits



AcceleratedkJunctionalkRhythmk-kCORRECTkANSWER-AcceleratedkJunctional

Same kcriteriakaskJunctional kRhythm,kexceptkthe kVentricularkratekisk60-100

Forkstable kpatients:kIVkaccess,kvagalkmaneuvers,kadenosine,kO2,kBetakblockers,kcalciumkchannelkblockers



IdioventricularkRhythmk(IVR) k-kCORRECTkANSWER-Impulsekoriginateskinkthe kventricles

▪kRhythm:kVentricularkiskusuallykregular

▪kRate:kVentricularkbetweenk20-40

▪kQRS:k≥k0.12

, ▪kAtrial krate,krhythm,kandkPRI:kN/A

-kTreatment:kassesskpt,kcheckkforkDNRkinkchart,ktranscutaneouskpacing,katropine.kNEVERkGIVEkANTI-
ARRYTHMICSkMEDICATIONS



AcceleratedkIdioventricularkRhythmk-kCORRECTkANSWER-
FollowsktheksamekcriteriakaskIVR,kexceptkVentricularkratekisk40-100.

•kIfknokinterventionkhappens,kthekpatientkwillkdeteriorate.

-kTreatment:kassesskpt,katropine,ktranscutaneouskpacing.kNEVERkGIVEkANTI-ARRHYTHMICkMEDICATIONS



VentricularkPacingk-kCORRECTkANSWER-•kThekpacemakerkleadkiskplacedkinktokrightkventricle.

•kThe kpacemakerkgeneratorkfireskankimpulse kInitiatingkventricularkactivity.

•kThe krightkventriclekwillkcontractkfirstkfollowedkbykthekleftkventricle.kThiskresultskinkakwidekQRS

•kAtrial kactivitykisktypicallykabsent.kTherefore,kAtrial krhythm,krate,kandkPRIkareknon- kmeasurable

•kRhythm:kVentricularkregular
•kRate:kVentricularkwithinksetkpacerklimits.kMeasuredkfromkpacerkspike ktokpacerkspike

•kQRS:kWide;kPacerkspikekseenkbeforekeachkQRS.kMeasuredkfromkpacerkspikektokend

ofkQRS



Atrial-ventricularkPacingk-kCORRECTkANSWER-
One kpacemakerkleadkiskplacedkintokthekrightkatriakandkanotherkiskplacedkintokthekright

ventricle.

•kThe kpacemakerkgeneratorkfireskankimpulse ktokthekatriakandkthenktokthekventricleksequentially

causingkatrial kthenkventricularkcontraction.

•kRhythm:kAtrial kandkVentricularkregular

•kRate:kAtrial kandkVentricularksamek&kwithinksetklimits

•kPkwaves:kPacerkspikekseenkatkbeginningkofkatrialkactivitykPkwaveskmaykorkmayknotkbekseen

(leadktypekdependent)

•kPRI:kWNLk-kMeasuredkfromkatrialkspikektokventricularkspike

•kQRS:kWide k- kMeasuredkfromkventricularkspike ktokendkofkQRS