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

The rhythm on this lead II strip is regular. Use the 300 method (300 ÷ the number of large boxes between two consecutive R waves) to estimate 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
2.Easy
II25 mm/s · 10 mm/mVregularregularly irregularirregularly irregular

Look at the R–R intervals on this lead II strip. How would you describe the ventricular rhythm? 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. 1regular
  2. 2regularly irregular
  3. 3irregularly irregular
3.Medium
II25 mm/s · 10 mm/mV

Measure the QT interval and the R–R interval on this regular lead II strip, then calculate the rate-corrected QTc with Fridericia’s formula QTc = QT/∛RR (both in seconds). Give the answer in seconds to three decimals.

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

This lead II strip shows an AV block, so the atria and the ventricles beat at different rates. Measure the P–P interval and find the atrial rate in beats per minute (1500 method, whole number).

lead II, 25 mm/s, 10 mm/mV1 small box = 0.04 s, 1 large box = 0.20 sstrip length 6 s
atrial rate = bpm
6.Hard
II25 mm/s · 10 mm/mVsinus rhythm with wide QRSdual-chamber (AV) paced rhythmidioventricular rhythmthird-degree (complete) AV block

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. 1sinus rhythm with wide QRS
  2. 2dual-chamber (AV) paced rhythm
  3. 3idioventricular rhythm
  4. 4third-degree (complete) AV block

Answer key

  1. 1. heart rate = 86 bpm
  2. 2. regular
  3. 3. QTc = 0.411 s
  4. 4. flutter waves per QRS = 4
  5. 5. atrial rate = 71 bpm
  6. 6. dual-chamber (AV) paced rhythm

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