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/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 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
QT = s
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. 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/mV

This lead II strip shows second-degree AV block type I (Wenckebach). By how much does the PR interval increase from the first to the second beat of a group (ΔPR), in seconds?

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

Answer key

  1. 1. heart rate = 80 bpm
  2. 2. heart rate = 86 bpm
  3. 3. QT = 0.44 s
  4. 4. QTc = 0.371 s
  5. 5. atrial rate = 100 bpm
  6. 6. ΔPR = 0.14 s

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