This EKG practice test is designed to help you learn to recoginze all of the EKG rhythms that you will encounter during emergencies and during the AHA ACLS provider course. Use these EKG practice tests to help you become proficient in your rapid rhythm identification.
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kimberly hunter says
#13 is torsades it’s a variation of a v tach
Kerri Borton says
I think the difference would be that in torsades, it would have a more regular QRS complex shape. So, because they are irregular, it would indicate vfib
Spammie says
Hi. For #9, I am unsure of where the fine chaotic p waves are. I know a-fib is my weakest rhythm so I know it’s a me-issue but I just don’t understand why this type of EKG is a-fib as when I think of “fine chaotic p waves” I expect more of a visual representation of it. Is this what they call “controlled a-fib”? thank you.
ACLS says
Frequently with atrial fibrillation, the P waves will be absent. The easiest way to identify atrial fibrillation, is to identify an irregular ventricular rhythm with the absence of regular clearly defined P waves.
Kind regards,
Jeff
Vikas says
Cheers jeff
Your explanation helps a lot!
Kayla says
Can you explain how #9 is A fib. It looks more like a accelerated junctional rhythm and I know it’s not a answer choice. \
Thank you.
ACLS says
The rhythm is irregular and p-waves are absent.
Kim nimoh says
Is #9 Afib RVR?
ACLS says
Yes. It is afib. Irregular rate and no p-waves.
Mack says
#9 is not Atrial Fib! The QRS is Wide, there are no P waves and the rate is 150. To be Atrial Fib a P waves MUSTR be present!
ACLS says
An irregular rhythm without P waves is a key characteristic of atrial fibrillation on an ECG. There are a few additional important factors to consider for a definitive diagnosis:
Key ECG Features of Atrial Fibrillation
Irregularly irregular rhythm: The R-R intervals vary in an unpredictable pattern.
Absence of P waves: Normal P waves are not visible.
Fibrillatory waves: The baseline may show rapid, irregular oscillations called fibrillatory or “f” waves, which can be fine or coarse.
Normal QRS complexes: The QRS duration is typically less than 120 ms, unless there is a pre-existing conduction abnormality.
Variable ventricular rate: The heart rate is often between 110-160 beats per minute, but can vary.
Kind regards,
Jeff
k lewis says
re: #8
150 is arbitrary — 150 is sinus. unless you see the sudden start then it’s SVT plus patient presentation will assist in interpretation.
if you like I can send you clearer expamples. your rhythm generator leaves a bit to be desired.
respecfully
k
k says
#4 Is not first degree. the PR segment is not prolonged. P was mildly distorted — not a good example of fist.
k
ACLS says
When the PR interval is greater than 0.2 sec (5 small squares) this would indicate prolonged PR interval.
Kind regards,
Jeff
klewis says
you’d be more correct to address the subsequent asystole. that in fact, is what would be treated.
k
klewis says
#2 you could use this strip as a possible TdP
ACLS says
Yes. That is correct. It is torsades de pointes which is a form of ventricular tachycardia.
Kathryn Lewis says
Only 2 QRS complexes then asystole thus not enuf to say the QRS rhythm is regular or irredular… there is no return of the QRS complexes thus into ventircular asystole.
regards
kl
Michelle Lynch says
i really appreciate these practice stripe it is a good help for review
Ronald Batiste says
Very good examples to study .
Jay says
I have a question about strip number 3. With third-degree heart block, shouldn’t each beat be regular on its own, even if the atria and ventricles are beating independently? The ventricular beat should have appeared before the short strip ended. Can you provide an explanation for this?
ACLS says
Third-degree block does not require that either the atrial or ventricular firing be regular. As is the case in the rhythm strip for question #3, the ventricular rate is irregular. Kind regards, Jeff