EKG Interpretation (HCA) UPDATED ACTUAL Questions and CORRECT
Answers
1. Atrial Rhythms • Are not classic "P-wave" rhythms, if equal/consistent/nonvarying P-waves are
easily identified 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 & • A-Fib: Atria Rate >350 - 500; Ventricular Rate >220 - 240 ppm
Associated Rates • 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 (1:1 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 Atrial ectopy (not a rhythm) similar to an ill timed hiccup within the atria, or the
Contraction (PAC) atria playing a game of interrupting cow.
4. Atrial Fibrillation Wavy and chaotic baseline, noted overall irregularity, AFib QRS complexes can be
(A-Fib) 'wide' or 'narrow'
, EKG Interpretation (HCA) UPDATED ACTUAL Questions and CORRECT
Answers
5. Narrow QRS <0.12 seconds (3 small boxes)
Complex
6. Wide QRS Com- >0.12 seconds (3 small boxes)
plex
7. Atrial Flutter Consistent atrial depolarization waves creating "flutter" or "saw-tooth" appearance
(A-Flutter) on baseline.
Can be regular or irregular.
QRS complexes can be 'wide' or 'narrow'
Different ratios (2:1, 3:1, 4:1) possible
8. Atrial Tachycardia Atrial Tachycardia is caused when abnormal electrical signals inersect with signals
(A-Tach) 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 Abnormal heart rhythm arising from aberrant electrical activity in the heart; origi-
Tachycardia (SVT) nates at or above the AV node
No P's noted, FAST rate, narrow complexes and REGULAR
10. Multifocal Atri- 3 or more varying P-Waves, overall irregular and rate is >100 ppm. Note the
al Tachycardia DIFFERENT P's presented.
(MAT)
Answers
1. Atrial Rhythms • Are not classic "P-wave" rhythms, if equal/consistent/nonvarying P-waves are
easily identified 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 & • A-Fib: Atria Rate >350 - 500; Ventricular Rate >220 - 240 ppm
Associated Rates • 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 (1:1 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 Atrial ectopy (not a rhythm) similar to an ill timed hiccup within the atria, or the
Contraction (PAC) atria playing a game of interrupting cow.
4. Atrial Fibrillation Wavy and chaotic baseline, noted overall irregularity, AFib QRS complexes can be
(A-Fib) 'wide' or 'narrow'
, EKG Interpretation (HCA) UPDATED ACTUAL Questions and CORRECT
Answers
5. Narrow QRS <0.12 seconds (3 small boxes)
Complex
6. Wide QRS Com- >0.12 seconds (3 small boxes)
plex
7. Atrial Flutter Consistent atrial depolarization waves creating "flutter" or "saw-tooth" appearance
(A-Flutter) on baseline.
Can be regular or irregular.
QRS complexes can be 'wide' or 'narrow'
Different ratios (2:1, 3:1, 4:1) possible
8. Atrial Tachycardia Atrial Tachycardia is caused when abnormal electrical signals inersect with signals
(A-Tach) 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 Abnormal heart rhythm arising from aberrant electrical activity in the heart; origi-
Tachycardia (SVT) nates at or above the AV node
No P's noted, FAST rate, narrow complexes and REGULAR
10. Multifocal Atri- 3 or more varying P-Waves, overall irregular and rate is >100 ppm. Note the
al Tachycardia DIFFERENT P's presented.
(MAT)
