Question

identify this rhythm

• ventricular tachycardia
• accelerated junctional rhythm
• supraventricular tachycardia
• accelerated idioventricular rhythm
• 3rd degree heart block

Explanation:

Analyze the rate and rhythm

• The rhythm is regular.
• The R-R interval is approximately 19 small boxes.
• Rate calculation: \(1500 / 19 \approx 79\text{ bpm}\).

Evaluate QRS morphology and P waves

• The QRS complexes are wide (\(> 0.12\text{ s}\)) with a bizarre, ventricular morphology.
• There are no associated P waves preceding the QRS complexes.

Determine the rhythm classification

• A ventricular rhythm with a rate between \(50\text{ bpm}\) and \(110\text{ bpm}\) (specifically \(\approx 79\text{ bpm}\)) is classified as Accelerated Idioventricular Rhythm (AIVR).
• Ventricular Tachycardia typically requires a rate \(> 100\text{ bpm}\) (usually \(> 120\text{ bpm}\)).
• Idioventricular escape rhythm typically has a rate of \(20\text{--}40\text{ bpm}\).

Answer:

• (A) Ventricular Tachycardia
• (B) Accelerated Junctional Rhythm
• (C) Supraventricular Tachycardia
• (D) Accelerated Idioventricular Rhythm (Correct answer)
• (E) 3rd Degree Heart Block