ECG rhythm strip interpretation worksheet with answers

Free printable ECG rhythm strip interpretation worksheet: 6 problems from easy to exam level, with an answer key. Print it or save it as a PDF.

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1.Easy
II25 mm/s · 10 mm/mV

This 6-second lead II strip is irregular, so the 300 and 1500 methods do not work. Use the 6-second method to estimate the ventricular heart rate in beats per minute.

lead II, 25 mm/s, 10 mm/mVstrip length 6 s (marks at 0, 3 and 6 s)
heart rate = bpm
2.Easy
II25 mm/s · 10 mm/mV

This lead II rhythm is regular. Count the small boxes between two consecutive R waves and use the 1500 method to find the heart rate in beats per minute, rounded to a whole number.

lead II, 25 mm/s, 10 mm/mV1 small box = 0.04 s, 1 large box = 0.20 sstrip length 6 s
heart rate = bpm
3.Medium
II25 mm/s · 10 mm/mV

This lead II strip shows sinus rhythm with one pause. Measure the pause, the R–R interval across it, in seconds.

lead II, 25 mm/s, 10 mm/mV1 small box = 0.04 s, 1 large box = 0.20 sstrip length 6 s
pause = s
4.Medium
II25 mm/s · 10 mm/mVatrial fibrillationsinus rhythm with PVCsjunctional rhythmatrial flutter, 2:1 conduction

Interpret this lead II rhythm strip. Which rhythm is it? Click your answer.

lead II, 25 mm/s, 10 mm/mV1 small box = 0.04 s, 1 large box = 0.20 sstrip length 6 s
  1. 1atrial fibrillation
  2. 2sinus rhythm with PVCs
  3. 3junctional rhythm
  4. 4atrial flutter, 2:1 conduction
5.Hard
II25 mm/s · 10 mm/mV

This lead II strip shows an AV block with an irregular ventricular rhythm. Use the 6-second method to find the ventricular rate in beats per minute.

lead II, 25 mm/s, 10 mm/mV1 small box = 0.04 s, 1 large box = 0.20 sstrip length 6 s
ventricular rate = bpm
6.Hard
II25 mm/s · 10 mm/mVidioventricular rhythmdual-chamber (AV) paced rhythmsecond-degree AV block type IIpaced rhythm, failure to capture

This patient has a pacemaker. Interpret the lead II strip. Click your answer.

lead II, 25 mm/s, 10 mm/mV1 small box = 0.04 s, 1 large box = 0.20 sstrip length 6 s
  1. 1idioventricular rhythm
  2. 2dual-chamber (AV) paced rhythm
  3. 3second-degree AV block type II
  4. 4paced rhythm, failure to capture

Answer key

  1. 1. heart rate = 50 bpm
  2. 2. heart rate = 75 bpm
  3. 3. pause = 1.48 s
  4. 4. atrial fibrillation
  5. 5. ventricular rate = 40 bpm
  6. 6. paced rhythm, failure to capture

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