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

Measure the PR interval on this lead II strip, in seconds.

lead II, 25 mm/s, 10 mm/mV1 small box = 0.04 s, 1 large box = 0.20 sstrip length 6 s
PR = s
2.Easy
II25 mm/s · 10 mm/mV

Measure the QRS duration on this lead II strip, in seconds.

lead II, 25 mm/s, 10 mm/mV1 small box = 0.04 s, 1 large box = 0.20 sstrip length 6 s
QRS = s
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/mV

This lead II strip shows atrial flutter. How many flutter waves per QRS complex are there (the n of n:1 conduction)?

lead II, 25 mm/s, 10 mm/mV1 small box = 0.04 s, 1 large box = 0.20 sstrip length 6 s
flutter waves per QRS =
5.Hard
II25 mm/s · 10 mm/mVthird-degree (complete) AV blockfirst-degree AV blocksecond-degree AV block type I (Wenckebach)atrial fibrillation

This lead II strip shows a conduction problem between the atria and the ventricles. 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. 1third-degree (complete) AV block
  2. 2first-degree AV block
  3. 3second-degree AV block type I (Wenckebach)
  4. 4atrial fibrillation
6.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

Answer key

  1. 1. PR = 0.2 s
  2. 2. QRS = 0.08 s
  3. 3. pause = 1.76 s
  4. 4. flutter waves per QRS = 4
  5. 5. second-degree AV block type I (Wenckebach)
  6. 6. ventricular rate = 50 bpm

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