Principles of Basic ECG

Activity 2 Instruction: Fill in the blanks with your answer. Choose from the word bank provided below.

Word Bank

Normal rate: 60-100 bpm

ECG P wave T wave

ECG strip or tracing PR interval Ventricular repolarization

ST segment QT interval 0.04

0.2
6 second strip
Vertical axis

0.5mv Depolarization of the ventricles 0.36-0.44

75 beats per minute Normal T waves (upright and round)

Determine the rhythm

70 beats per minute

1. _______ ECG ________ is a graphic recording of the electrical currents produced by the heart
muscle in association with the heartbeat.

Basic ECG Measurement

Waveforms produced by the hearts electrical current are recorded on graphed ECG
paper by a stylus. ECG paper consists of horizontal and vertical lines forming a grid. A
piece of ECG paper is called an 2. __ ECG strip or tracing ___.
The horizontal axis of the ECG strip represents time. Each small block equals 3. __ 0.04___
second, and five small blocks form a large block, which equals 4.____ 0.2_____ second.
The paper speed is 25mm per second. When measuring or calculating a patients heart
rate, a
5. __6 second strip__ consisting of 30 large blocks is usually used.
The ECG strips 6.___Vertical axis ____ measures amplitude in millimetres (mm) or
electrical voltage in millivolts (mv). Each small block represents 1mm or 0.1 mv; each large
block represents 5mm or 7._____ 0.5mv ______.
An ECG Complex

a. The 8.____P wave_________________

Represents atrial depolarization: conduction of electrical impulse through the atria
Location: precedes the QRS complex
Amplitude: 2-3mm high
Duration: 0.06 to 0.12 second
Configuration: usually rounded and upright
b. The 9._____PR interval _________________
Represents the time taken for the impulse from the atria through the AV node, bundle of
His, and the right and left bundle branches.
Location: from the beginning of the P wave to the beginning of the QRS complex
Duration: 0.12 to 0.20 seconds

c. The QRS complex

Represents 10.__ Depolarization of the ventricles ___
Location: follows the PR interval
Amplitude: 5-30mm high but differs for each lead used
Duration: 0.06-0.10 second
d. The 11. ST segment __
Represents the end of ventricular conduction or depolarization and beginning of
ventricular recovery or repolarization.
Location: extends from the S wave to the beginning of the 12.___T wave____________.
Deflection: usually isoelectric
e. The T wave
Represents 13. __ Ventricular repolarization __.
 Location: follows the S wave
Configuration: typically round and smooth
Duration: 0.16 seconds
f. The 14. ______ QT interval __________.
Measures ventricular depolarization and repolarization
Location: beginning of the QRS complex to the end of the T wave
Duration: 15.__ 0.36-0.44___ seconds

Calculation of Heart Rate

a. Method 1: Use when the heart rate is regular

o Count the number of large squares between 2 successive R waves o
Use 300 divided by this number
o E.g. The number of large squares between 2 successive R waves in the figure below is
4; so HR = 16. ___75 beats per minute_________.

b. Method 2: This method is more accurate to use when the heart rate is regular and
fast o Count the number of small squares between 2 successive R waves
o Use 1500 divide by this number
o E.g. the number of small squares between 2 successive R waves is 9; so HR = 1500/9=
167 beats per minute.

c. Method 3: Use when the heart rate is irregular; an average heart rate is calculated o
Count the number of R waves in a 6 second strip and multiply by 10
o E.g. See the figure below. HR = 17.____ 70 beats per minute____.
The Normal Sinus Rhythm

Normal sinus rhythm represents normal impulse conduction through the heart. The characteristics
of normal sinus rhythm are:

a. Regular rhythm
b. 18. Normal rate: 60-100 bpm
c. A P wave for every QRS complex; all P waves similar in size and shape
d. All QRS complexes similar in size and shape
e. Normal PR and QT intervals
f. 19. Normal T waves (upright and round)___

8 Steps to interpret a Rhythm Strip:

1. 20. _ Determine the rhythm __

2. Determine the rate
3. Evaluate the P wave
4. Measure the PR interval
5. Determine the QRS complex duration
6. Examine the T waves
7. Measure the QT interval duration
8. Check for ectopic beats and other abnormalities