Question

identify this rhythm

sinus bradycardia with a pvc
sinus bradycardia with sinus arrest (pause) and ventricular escape complex
sinus rhythm with pac
sinus rhythm with pvc

Explanation:

Analyze the underlying rhythm and rate

$$ \text{R-R intervals for the first three beats} \approx 23 \text{ small boxes} \implies \text{Heart Rate} \approx \frac{1500}{23} \approx 65 \text{ bpm} $$

$$ \text{P waves are present, upright in lead II, preceding each QRS} \implies \text{Normal Sinus Rhythm} $$

Analyze the pause and the final beat

$$ \text{Pause duration after the third beat} \approx 42 \text{ small boxes} \implies \text{Sinus Arrest / Pause} $$

$$ \text{The fourth beat is wide, bizarre, lacks a preceding P wave, and occurs late} \implies \text{Ventricular Escape Complex} $$

Match with the correct option

$$ \text{Rhythm} = \text{Sinus Bradycardia with Sinus Arrest (pause) and Ventricular Escape Complex} $$

Answer:

• Sinus Bradycardia with a PVC
• Sinus Bradycardia with Sinus Arrest (pause) and Ventricular Escape Complex (Correct answer)
• Sinus Rhythm with PAC
• Sinus Rhythm with PVC