Certified EKG Technician (CET) Practice Exam 2025 – Comprehensive Test Prep

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How is a ventricular escape rhythm recognized on an EKG?

Slow heart rate with narrow QRS complexes

Slow heart rate with wide QRS complexes

A ventricular escape rhythm is characterized by a slower heart rate due to the heart relying on the ventricular pacemaker when higher pacemakers (like the atria) fail. This results in a heart rate generally between 20 to 40 beats per minute, which is classified as bradycardic.

The wide QRS complexes associated with a ventricular escape rhythm indicate that the impulse is generated from the ventricles, which conduct the electrical signal through the ventricular myocardium rather than through the normal conduction system (like the bundle of His and Purkinje fibers). This wider QRS complex is a hallmark of ectopic pacemaker activity within the ventricular tissue.

Recognizing a ventricular escape rhythm is crucial in the context of bradycardia because it indicates that the heart is attempting to stabilize itself in the absence of normal atrial activity. Understanding this rhythm helps in diagnosing potential underlying conditions that may require medical intervention.

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Normal rhythm with premature beats

Rapid heart rate with irregular rhythms

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