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Positive impulses are
upward deflections
Negative impulses are
downward deflections
No electrical impulse creates
isoelectric line
Each small box is equal to
1 mm/0.04 seconds
Each large box is equal to
5 mm/0.20 seconds
Bipolar leads include
lead I, II, III
Lead I axis
0 degrees
Lead II axis
60 degrees
Lead III axis
120 degrees
Augmented leads include
aVR, aVL, aVF
AVR view comes from
RA lead
AVL view comes from
LA lead
AVF view comes from
LF lead
Precordial leads include
V1-V6
P wave represents
depolarizing atria
Part of ECG that represents atrial contraction and systole
P wave
PR interval represents
time it takes electrical impulse to travel from SA to ventricles
PR interval is measured from the beginning of the
P-wave to the beginning of the QRS
PR interval normal duration
0.12-0.20 seconds
QRS represents
depolarizing ventricles
Part of ECG that represents ventricular contraction and systole
QRS
QRS normal duration
0.04-0.12 seconds
T wave represents
repolarizing ventricles
Part of ECT that represents ventricular filling and diastole
T wave
QT interval represents
time it takes ventricles to depolarize then repolarize
QT interval normal duration
0.33-0.42 seconds
Absolute refractory period
a 2nd stimulus, no matter how strong, will not cause depolarization during this time
Relative refractory period
the earliest time the heart can depolarize with a stronger than normal stimulus
Relative refractory period starts in the
middle of T wave
5 step interpretation process
rate, regularity, P-waves, PRI, QRS
6-second rate calc method
count number of R-waves and multiply by 10
Large block rate calc method
count number of large blocks between R-waves
6 large blocks =
50 bpm
5 large blocks =
60 bpm
4 large blocks =
75 bpm
3 large blocks =
100 bpm
2 large blocks =
150 bpm
1 large block =
300 bpm
Regularly irregular is
predictable irregularity
Irregularly irregular is
unpredictable irregularity
Ectopic beat significance to rate count
include them unless they aren’t producing a pulse