ELECTROCARDIOGRAM (EKG/ECG) RHYTHMS
EXAMINATION 2026
Cardiac Rhythm Identification, Interpretation, and Clinical Application
Assessment
Examination Level: Medical / Nursing / Allied Health Sciences
Subject Area: Cardiac Monitoring and Electrocardiography
SPRING SEMESTER EXAM 2026
Normal Sinus Rhythm
60-100 bpm
all complexes normal and evenly spaced (P, QRS, T)
Sinus Arrest
- SA node doesn't fire
- notice absence of P-wave for a complete cycle (a missed cycle)
Sinus arrhythmia
all complexes normal but rhythmically irreg
- normal finding (esp in young pts) that has to do with breathing (rate: inhale-increase, exhale-
decrease)
1|Page
,Sinus Bradycardia
<60
normal sinus rhythm
Sinus Tachycardia
>100 (100-150)
normal sinus rhythm
Wandering atrial pacemaker
Hint: try never to pick this
- impulse originate from varying points in atria
- variation in P wave contour, PR-I, PP-I and thus RR-I
P wave vs T wave
P generally smaller than T
MAT (multifocal atrial tachy)
- impulse originates at diff places in atria so P waves diff and intervals might not be consistent
- assoc w/ severe pulm dz
2|Page
, Atrial Fibrillation
A: 350-450 (atria quivering)
- irreg-irreg rhythm (R-RI=irreg)
*unsure/no P-wave (non-distinguishable)*
- irreg rhythm BUT reg QRS!
Danger: increase the risk of thromboemoblic events don't convert unless occurring less than 48
hrs, if don't know pt need to be put on thrombolytics)
Atrial Flutter
A: 250-350
- "saw tooth" p-waves
- a continuous rapid sequence of atrial complexes from a single rapid-firing atrial focus
(hint: if see 2 P waves and QRS think A Flutter)
Junctional Escape beats
retrograde atrial depolarization
P' is inverted
Junctional rhythm
40-60 Regular!
-impulse from AV node w/ retro/antegrade transmission
- P wave often inverted/buried/follow QRS
3|Page
EXAMINATION 2026
Cardiac Rhythm Identification, Interpretation, and Clinical Application
Assessment
Examination Level: Medical / Nursing / Allied Health Sciences
Subject Area: Cardiac Monitoring and Electrocardiography
SPRING SEMESTER EXAM 2026
Normal Sinus Rhythm
60-100 bpm
all complexes normal and evenly spaced (P, QRS, T)
Sinus Arrest
- SA node doesn't fire
- notice absence of P-wave for a complete cycle (a missed cycle)
Sinus arrhythmia
all complexes normal but rhythmically irreg
- normal finding (esp in young pts) that has to do with breathing (rate: inhale-increase, exhale-
decrease)
1|Page
,Sinus Bradycardia
<60
normal sinus rhythm
Sinus Tachycardia
>100 (100-150)
normal sinus rhythm
Wandering atrial pacemaker
Hint: try never to pick this
- impulse originate from varying points in atria
- variation in P wave contour, PR-I, PP-I and thus RR-I
P wave vs T wave
P generally smaller than T
MAT (multifocal atrial tachy)
- impulse originates at diff places in atria so P waves diff and intervals might not be consistent
- assoc w/ severe pulm dz
2|Page
, Atrial Fibrillation
A: 350-450 (atria quivering)
- irreg-irreg rhythm (R-RI=irreg)
*unsure/no P-wave (non-distinguishable)*
- irreg rhythm BUT reg QRS!
Danger: increase the risk of thromboemoblic events don't convert unless occurring less than 48
hrs, if don't know pt need to be put on thrombolytics)
Atrial Flutter
A: 250-350
- "saw tooth" p-waves
- a continuous rapid sequence of atrial complexes from a single rapid-firing atrial focus
(hint: if see 2 P waves and QRS think A Flutter)
Junctional Escape beats
retrograde atrial depolarization
P' is inverted
Junctional rhythm
40-60 Regular!
-impulse from AV node w/ retro/antegrade transmission
- P wave often inverted/buried/follow QRS
3|Page
