Arrhythmia Recognition: The Art of Interpretation
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Practice Rhythm Strips

Practice Rhythm Strip 8
Rate:About 98 BPMPR intervals:Normal, except in events
Regularity:Regular with eventsQRS width:Wide
P waves:Present, except in eventGrouping:None
   Morphology:Normal, except in eventsDropped Beats:Present
   Axis:Normal, except in eventsRhythm:Sinus rhythm with a unifocal couplet and a PVC
P:QRS ratio:1:1, except in events

The rhythm strip shows an underlying sinus rhythm that is undisturbed by the extra events occurring in the ventricles (P waves timing is represented by the pink dots, QRS timing by the blue dots). Notice that the pauses are fully compensatory. The P waves show through and fuse with the morphology of the PVCs at the start of the complexes. The underlying ventricular depolarizations during the sinus complexes demonstrate a varying degree of aberrancy in ventricular conduction.

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