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

Measure the QRS duration 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
QRS = s
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/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
4.Medium
II25 mm/s · 10 mm/mVatrial flutter, 2:1 conductionsinus tachycardiaatrial flutter, 4:1 conductionatrial fibrillation

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, 2:1 conduction
  2. 2sinus tachycardia
  3. 3atrial flutter, 4:1 conduction
  4. 4atrial fibrillation
5.Hard
II25 mm/s · 10 mm/mVatrial fibrillationsecond-degree AV block type I (Wenckebach)second-degree AV block type IIthird-degree (complete) AV block

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. 1atrial fibrillation
  2. 2second-degree AV block type I (Wenckebach)
  3. 3second-degree AV block type II
  4. 4third-degree (complete) AV block
6.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

Answer key

  1. 1. QRS = 0.08 s
  2. 2. heart rate = 107 bpm
  3. 3. pause = 1.52 s
  4. 4. atrial flutter, 4:1 conduction
  5. 5. second-degree AV block type I (Wenckebach)
  6. 6. PR interval

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