This rhythm strip shows sinus rhythm with complex ventricular ectopy. The underlying sinus rhythm is reflected by normal P waves preceding each sinus QRS at a rate of 95 beats per minute. The first two sets of early or premature ventricular complexes occur in couplets that are wide and different from the sinus QRS. The third is a multiform triplet. Note that there are no P waves associated with these complexes. Complex ventricular ectopy includes PVCs that are repetitive and may be multiform. In some clinical settings, this form of ectopy is associated with a risk of sudden death due to progression to ventricular tachycardia or ventricular fibrillation.