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/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/mVatrial fibrillationatrial flutter, 4:1 conductionsinus rhythm with PVCsjunctional rhythm

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. 2atrial flutter, 4:1 conduction
  3. 3sinus rhythm with PVCs
  4. 4junctional rhythm
4.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 Bazett’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
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. The QRS complexes are regular: find the ventricular 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
ventricular rate = bpm
6.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

Answer key

  1. 1. heart rate = 55 bpm
  2. 2. heart rate = 107 bpm
  3. 3. atrial fibrillation
  4. 4. QTc = 0.5 s
  5. 5. ventricular rate = 42 bpm
  6. 6. atrial rate = 60 bpm

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