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 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
2.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
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 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
5.Hard
II25 mm/s · 10 mm/mVraterhythmP wavesPR intervalQRS duration

Interpret this lead II strip with the five steps in order: rate, rhythm, P waves, PR interval, QRS duration. At which step do you find the first abnormal finding? Click it.

lead II, 25 mm/s, 10 mm/mV1 small box = 0.04 s, 1 large box = 0.20 sstrip length 6 s
  1. 1rate
  2. 2rhythm
  3. 3P waves
  4. 4PR interval
  5. 5QRS duration
6.Hard
II25 mm/s · 10 mm/mVsinus bradycardiathird-degree (complete) AV block2:1 AV block (type undetermined)second-degree AV block type I (Wenckebach)

Interpret this lead II strip. Which interpretation can you defend from this single 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 bradycardia
  2. 2third-degree (complete) AV block
  3. 32:1 AV block (type undetermined)
  4. 4second-degree AV block type I (Wenckebach)

Answer key

  1. 1. heart rate = 54 bpm
  2. 2. heart rate = 75 bpm
  3. 3. QTc = 0.375 s
  4. 4. pause = 1.92 s
  5. 5. P waves
  6. 6. 2:1 AV block (type undetermined)

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