EKG

Lessons. Practice Strips and Drills

EKG Training Introduction

Use our lessons, drills and quizzes to improve your EKG knowledge and skills.

EKG Interpretation - Introduction

This introductory course reviews the main features of electrocardiogram strips. A method for analyzing an electrocardiogram is presented. This method includes assessment of rhythm, calculating heart rate, observing P-wave forms, measurement of wave intervals and segments and the evaluation of other relevant waves. In addition, our drills allow students to practice electrocardiogram identification.

EKG Basics

EKG Practice Drills

The EKG practice drills provide a fast and interactive method for learning EKGs. Users are asked to identify the arrhythmia category. Immediate feedback is available after answering a multiple choice question. A guide for common types of ekg strips is also available.

EKG Practice Drills

ECG Quiz

Our quiz presents twenty tracings for interpretation. At the end of the quiz, your score is compared to mean and top scores for all recent website visitors. A graded report of your answers compared to expert analysis is also provided. Quiz ekg tracings are randomly selected from our database of 375 tracing, so the quiz can be repeated many times.

ECG Quiz

Abnormal EKG Guide

Our Abnormal EKG guide provides information on over forty different types of arrhythmias. For each type there are patient tracings and simulated electrocardiograms. We also provide an annotated tracing with a summary of the key features and values. Interactive digital calipers can be used for measuring key features on each tracing.

Abnormal EKG Guide

ECG Interpretation Tutor

Try the ECG interpretation with immediate coaching.

ECG Rhythm Interpretation Tutor

EKG Interpretation Quiz

Try the EKG Quiz on EKG.Academy. Highly recommeded and its free!

12 Lead EKG Quiz

12 Lead EKG

A slide presentation on 12 lead EKG, written by Dr. Michael Mazzini, M.D., Boston University.

12 Lead EKG Lecture

Practice 12 lead EKG interpretation with immediate feedback.

12 Lead Tutor

ECG Monitor Quiz (beta version)

Our Monitor Quiz is similar to the standard Quiz, but with a twist. Instead of static tracings, the ECGs are presented using a simulated patient monitor. After the twenty tracings are evaluated, we present a graded report along with static images of each tracing. Your score is compared to a mean score for all recent website visitors. Don't worry, your score is kept private.

ECG Monitor Quiz

Spanish Edition

In cooperation with Project Semilla, we have recently launched Spanish Editions of several of our ECG training modules.

Guía de referencia de los ritmos cardíacos
Paciente Virtual Prueba con Monitor
Ejercicios de práctica de ritmos cardíacos
Conceptos Básicos ECG

How To Read An EKG - Lectures

Use EKG.Academy's library of free presentations on cardiac rhythms. These training materials present the fundamentals for each major category of cardiac rhythms. The fundamentals are reinforced with practice exercises throughout each lecture.

EKG Lectures

French, German & Spanish EKG Training

EKG Definition

An EKG, also called an ECG or electrocardiogram, is a recording of the heart's electrical activity. It is a quick and painless procedure. EKGs captures a tracing of cardiac electrical impulse as it moves from the atrium to thventricles. These electrical impulses cause the heart to contract and pump blood. EKGs are interpreted by medical professionals to understand the following:

Heart rate
Heartbeat regularity
Strength and timing of the electrical signals
Any possible abnormal conditions

Quick Links

Abnormal EKG Types

A summary of each of the most common EKG types is provided below.

Accelerated Idioventricular Rhythm

The EKG rhythm will appear regular with heart rate that is 50-120 bpm. The P wave features: absent. Observe that the PR interval is not measurable. The QRS complex will typically be wide (>0.10 sec), bizarre looking. .

Accelerated Junctional Rhythm

The EKG rhythm will appear regular with heart rate that is normal (60-100 bpm). The P wave features: present before, during (hidden) or after qrs, if visible it is inverted. Observe that the PR interval is not measurable. The QRS complex will typically be normal (0.06-0.10 sec). .

Asystole

The EKG rhythm will appear not present with heart rate that is absent. The P wave features: absent. Observe that the PR interval is absent. The QRS complex will typically be absent. confirm with multiple leads.

Atrial Fibrillation

The EKG rhythm will appear irregular with heart rate that is very fast (> 350 bpm) for atrial, but ventricular rate may be slow, normal or fast. The P wave features: absent - erratic waves are present. Observe that the PR interval is absent. The QRS complex will typically be normal but may be widened if there are conduction delays. .

Atrial Flutter

The EKG rhythm will appear regular or irregular with heart rate that is fast (250-350 bpm) for atrial, but ventricular rate is often slower. The P wave features: not observable, but saw-toothed flutter waves are present. Observe that the PR interval is not measureable. The QRS complex will typically be normal (0.06-0.10 sec). .

Bundle Branch Block

The EKG rhythm will appear regular with heart rate that is the underlying rate. The P wave features: normal. Observe that the PR interval is normal (0.12-0.20 sec). The QRS complex will typically be wide (>0.12 sec). .

First Degree Heart Block

The EKG rhythm will appear regular with heart rate that is the underlying rate. The P wave features: normal. Observe that the PR interval is prolonged (>0.20 sec). The QRS complex will typically be normal (0.06-0.10 sec). a first degree av block occurs when electrical impulses moving through the atrioventricular (av) node are delayed (but not blocked). first degree indicates slowed conduction without missed beats..

Idioventricular Rhythm

The EKG rhythm will appear regular with heart rate that is slow (20-40 bpm). The P wave features: absent. Observe that the PR interval is not measurable. The QRS complex will typically be wide (>0.10 sec), bizarre appearance. .

Junctional Escape Rhythm

The EKG rhythm will appear regular with heart rate that is slow (40-60 bpm). The P wave features: present before, during (hidden) or after qrs, if visible it is inverted. Observe that the PR interval is not measurable. The QRS complex will typically be normal (0.06-0.10 sec). .

Junctional Tachycardia

The EKG rhythm will appear regular with heart rate that is fast (100-180 bpm). The P wave features: present before, during (hidden) or after qrs, if visible it is inverted. Observe that the PR interval is absent or short. The QRS complex will typically be normal (0.06-0.10 sec). .

Multifocal Atrial Tachycardia

The EKG rhythm will appear irregular with heart rate that is fast (> 100 bpm). The P wave features: often changing shape and size from beat to beat (at least three differing forms). Observe that the PR interval is variable. The QRS complex will typically be normal (0.06-0.10 sec). t wave is often distorted also review wandering atrial pacemaker lesson.

Normal Sinus Rhythm

The EKG rhythm will appear regular with heart rate that is normal (60-100 bpm). The P wave features: normal (positive & precedes each qrs). Observe that the PR interval is normal (0.12-0.20 sec). The QRS complex will typically be normal (0.06-0.10 sec). .

Pacemaker Failure to Capture

The EKG rhythm will appear irregular with heart rate that is slow or normal. The P wave features: . Observe that the PR interval is . The QRS complex will typically be . pacemaker spikes are not followed by p waves or qrs complexes.

Pacemaker Failure to Pace

The EKG rhythm will appear irregular with heart rate that is . The P wave features: . Observe that the PR interval is . The QRS complex will typically be . pacemaker spikes do not appear.

Pacemaker Single Chamber Atrial

The EKG rhythm will appear regular with heart rate that is 60 bpm. The P wave features: normal. Observe that the PR interval is normal. The QRS complex will typically be normal. .

Premature Atrial Complex

The EKG rhythm will appear irregular with heart rate that is usually normal but depends on underlying rhythm. The P wave features: premature, positive and shape is abnormal. Observe that the PR interval is normal or longer. The QRS complex will typically be 0.10 sec or less. .

Premature Junctional Complex

The EKG rhythm will appear regular with premature beats with heart rate that is the underlying rate. The P wave features: present before, during (hidden) or after qrs, if visible it is inverted. Observe that the PR interval is absent or short. The QRS complex will typically be normal (0.06-0.10 sec). .

Premature Ventricular Complex

The EKG rhythm will appear irregular with heart rate that is the underlying rate. The P wave features: absent. Observe that the PR interval is not measurable. The QRS complex will typically be wide (> 0.10 sec), bizarre appearance. two pvcs together are termed a couplet while three pvcs in a row with a fast rhythm is ventricular tachycardia.

Premature Ventricular Complex Bigeminy

Premature Ventricular Complex Quadrigeminy

Premature Ventricular Complex Trigeminy

Second Degree Heart Block Type I

The EKG rhythm will appear irregular but with progressively longer pr interval lengthening with heart rate that is the underlying rate. The P wave features: normal. Observe that the PR interval is progressively longer until a qrs complex is missed, then cycle repeats. The QRS complex will typically be normal (0.06-0.10 sec). .

Second Degree Heart Block Type II

The EKG rhythm will appear regular (atrial) and irregular (ventricular) with heart rate that is characterized by atrial rate usually faster than ventricular rate (usually slow). The P wave features: normal form, but more p waves than qrs complexes. Observe that the PR interval is normal or prolonged. The QRS complex will typically be normal or wide. .

Sinoatrial Block

The EKG rhythm will appear irregular when sa block occurs with heart rate that is normal or slow. The P wave features: normal. Observe that the PR interval is normal (0.12-0.20 sec). The QRS complex will typically be normal (0.06-0.10 sec). pause time is an integer multiple of the p-p interval try to identify specific type of atrial tachycardia - see other pages.

Sinus Arrest

The EKG rhythm will appear irregular due to pause with heart rate that is normal to slow. The P wave features: normal. Observe that the PR interval is normal (0.12-0.20 sec). The QRS complex will typically be normal (0.06-0.10 sec). pause time is not an integer multiple of the p-p interval.

Sinus Arrhythmia

The EKG rhythm will appear irregular, varying with respiration with heart rate that is normal (60-100 bpm) and rate may increase during inspiration. The P wave features: normal. Observe that the PR interval is normal (0.12-0.20 sec). The QRS complex will typically be normal (0.06-0.10 sec). heart rate frequently increases with inspiration, decreasing with expiration.

Sinus Bradycardia

The EKG rhythm will appear regular with heart rate that is slow (< 60 bpm). The P wave features: normal. Observe that the PR interval is normal (0.12-0.20 sec). The QRS complex will typically be normal (0.06-0.10 sec). .

Sinus Tachycardia

The EKG rhythm will appear regular with heart rate that is fast (> 100 bpm). The P wave features: normal, may merge with t wave at very fast rates. Observe that the PR interval is normal (0.12-0.20 sec). The QRS complex will typically be normal (0.06-0.10 sec). qt interval shortens with increasing heart rate.

Supraventricular Tachycardia

The EKG rhythm will appear regular with heart rate that is fast (150-250 bpm). The P wave features: merged with t wave. Observe that the PR interval is normal (0.12 sec). The QRS complex will typically be normal (.10 sec). pr interval can be difficult to measure.

Third Degree Heart Block

The EKG rhythm will appear regular, but atrial and ventricular rhythms are independent with heart rate that is characterized by atrial rate usually normal and faster than ventricular rate. The P wave features: normal shape and size, may appear within qrs complexes. Observe that the PR interval is absent: the atria and ventricles beat independently.. The QRS complex will typically be normal, but wide if junctional escape focus. .

Ventricular Fibrillation

The EKG rhythm will appear highly irregular with heart rate that is unmeasurable. The P wave features: absent. Observe that the PR interval is not measurable. The QRS complex will typically be none. ekg tracings is a wavy line.

Ventricular Tachycardia

The EKG rhythm will appear regular with heart rate that is fast (100-250 bpm). The P wave features: absent. Observe that the PR interval is not measurable. The QRS complex will typically be wide (>0.10 sec), bizarre appearance. .

Ventricular Tachycardia Monomorphic

Ventricular Tachycardia Polymorphic

The EKG rhythm will appear regular or irregular with heart rate that is fast (100-300 bpm). The P wave features: absent. Observe that the PR interval is not measurable. The QRS complex will typically be normal or wide (>0.10 sec), bizarre looking. .

Ventricular Tachycardia Torsade de Pointes

The EKG rhythm will appear irregular with heart rate that is fast (200-250 bpm). The P wave features: absent. Observe that the PR interval is not measurable. The QRS complex will typically be wide (>0.10 sec), bizarre looking. .

Wandering Atrial Pacemaker

The EKG rhythm will appear may be irregular with heart rate that is normal (60-100 bpm). The P wave features: changing shape and size from beat to beat (at least three diffferent forms). Observe that the PR interval is variable. The QRS complex will typically be normal (0.06-0.10 sec). t wave normal. if heart rate exceeds 100 bpm, then rhythm may be multifocal atrial tachycardia (map).

Wolff-Parkinson-White Syndrome

The EKG rhythm will appear regular unless atrial fibrillation present with heart rate that is normal (60-100 bpm). The P wave features: normal. Observe that the PR interval is can be short (<0.12 sec). The QRS complex will typically be usually wide (> 0.12 sec). look for short pr interval and/or delta wave a delta wave (positive or negative) distorts the early part of the qrs complex.

Authors

Our website contributors and authors include:

Dr. Jon Keroes
Dr. Barbara Erikson
David Lieberman
Diane Wrigley
Dr. Michael Mazzini
Tom O'Brien
William French
The simulation software team at Medical Training and Simulation, LLC

EKG

EKG Training Introduction

EKG Interpretation - Introduction

EKG Practice Drills

ECG Quiz

Abnormal EKG Guide

ECG Interpretation Tutor

EKG Interpretation Quiz

12 Lead EKG

ECG Monitor Quiz (beta version)

Spanish Edition

How To Read An EKG - Lectures

French, German & Spanish EKG Training

EKG Definition

Quick Links

Abnormal EKG Types

Authors

Learn medical terms?

Learn medical terms?