How to read an ECG in 10 steps. I would recommend checking the rate, rhythm, axis, and QRS-complex first. If it is regular sinus rhythm + normal axis, then move onto Q-waves, ST-segment, and T-waves, and lastly the rest. If it is regular sinus rhythm + abnormal axis/QRS, then consider ventricular arrythmias, RV-hypertrophy or BBB, and lastly the rest. If it is not regular sinus rhythm check the rest of the ECG like P-waves, PR-interval, and QT-interval. Rhythm The rhythm can either be: Regularly regular (regular sinus rhythm). Regularly irregular (seen mostly in 2nd degree heart block type 2). Irregularly irregular (seen mostly in atrial fibrillation. How to check: See if the RR-interval is of equal length everywhere and if every R-wave is proceeded by a P-wave. Positive, positive, and negative in I, II, and aVR is sinus rhythm. You can also use this rule: P-wave upright in II, inverted in aVR, and every P-wave is followed by QRS-complex in II, then it is sinus rhythm. Rate How to ...
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