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/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/mVatrial flutter, 3:1 conductionnormal sinus rhythmatrial fibrillationatrial 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 flutter, 3:1 conduction
  2. 2normal sinus rhythm
  3. 3atrial fibrillation
  4. 4atrial flutter, 2:1 conduction
4.Medium
II25 mm/s · 10 mm/mV

This lead II strip shows atrial flutter. Measure the flutter-wave interval and find the atrial 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
atrial rate = bpm
5.Hard
II25 mm/s · 10 mm/mVfirst-degree AV blockthird-degree (complete) AV blocksecond-degree AV block type I (Wenckebach)junctional rhythm

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. 1first-degree AV block
  2. 2third-degree (complete) AV block
  3. 3second-degree AV block type I (Wenckebach)
  4. 4junctional rhythm
6.Hard
II25 mm/s · 10 mm/mVthird-degree (complete) AV blockidioventricular rhythmventricular paced rhythmdual-chamber (AV) paced rhythm

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. 1third-degree (complete) AV block
  2. 2idioventricular rhythm
  3. 3ventricular paced rhythm
  4. 4dual-chamber (AV) paced rhythm

Answer key

  1. 1. heart rate = 70 bpm
  2. 2. regular
  3. 3. atrial flutter, 3:1 conduction
  4. 4. atrial rate = 300 bpm
  5. 5. third-degree (complete) AV block
  6. 6. ventricular paced rhythm

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