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WEB ECG Basics: A Comprehensive Guide

Interpreting Rate, Rhythm, Axis, and Waveforms

Before Beginning ECG Interpretation

Before embarking on ECG interpretation, ensure the following details are verified:

• Patient identification
• Recording date and time
• Electrode placement
• Calibration
• Recording speed

Calculating Rate and Rhythm

The ECG strip provides vital information about the heart's rhythm and rate. The rate is typically derived from the R-R interval, which represents the time between two consecutive R waves. The speed of the recording should be taken into account when calculating the rate:

Rate = 60 / (R-R interval in seconds)

The rhythm is determined by the regularity and pattern of the beats. Regular rhythms include sinus rhythm, atrial fibrillation, and ventricular paced rhythm. Irregular rhythms may indicate underlying arrhythmias.

Determining Axis

The electrical axis of the heart refers to the direction of the mean electrical vector. It is determined by analyzing the QRS wave complex in the limb leads (I, II, III, aVR, aVL, aVF):

• Positive QRS complex in leads I and II: Normal axis (0° to +90°)
• Positive QRS complex in leads I and aVF: Left axis deviation (-30° to -90°)
• Positive QRS complex in leads II and III: Right axis deviation (+90° to +180°)

Interpreting Waveforms

The ECG wave complex consists of the P, Q, R, S, T, and U waves. Each waveform provides specific information about the electrical activity of the heart:

• P wave: Atrial depolarization
• QRS complex: Ventricular depolarization
• Q wave: Initial downward deflection of the QRS complex
• R wave: First upward deflection of the QRS complex
• S wave: Second downward deflection of the QRS complex
• T wave: Ventricular repolarization
• U wave: Often absent, may represent repolarization of Purkinje fibers

Conclusion

ECG interpretation is a fundamental skill for healthcare professionals. By understanding the basics of rate, rhythm, axis, and waveform analysis, practitioners can effectively analyze ECG recordings and identify potential cardiac abnormalities. Regular review and practice are essential for maintaining proficiency in ECG interpretation and ensuring accurate patient care.