This document outlines an ECG rhythm interpretation course containing multiple learning modules. The course objectives are to recognize normal sinus rhythm, the 13 most common rhythm disturbances, and acute myocardial infarction on ECGs. The modules will cover ECG basics, rhythm analysis, common rhythms, arrhythmias, myocardial infarction, and advanced 12-lead interpretation. It provides information on impulse conduction through the heart and how this relates to the PQRST waveform and intervals on an ECG strip. It also describes the heart's natural pacemakers and how to read timing markers on ECG paper. The document directs students to a practice quiz after reviewing the basics.

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ECG Rhythm Interpretation
Module I
ECG Basics

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Course Objectives
• To recognize the normal rhythm of the
heart - “Normal Sinus Rhythm.”
• To recognize the 13 most common
rhythm disturbances.
• To recognize an acute myocardial
infarction on a 12-lead ECG.

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Learning Modules
• ECG Basics
• How to Analyze a Rhythm
• Normal Sinus Rhythm
• Heart Arrhythmias
• Diagnosing a Myocardial Infarction
• Advanced 12-Lead Interpretation

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Normal Impulse Conduction
Sinoatrial node
AV node
Bundle of His
Bundle Branches
Purkinje fibers

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Impulse Conduction & the ECG
Sinoatrial node
AV node
Bundle of His
Bundle Branches
Purkinje fibers

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The “PQRST”
• P wave - Atrial
depolarization
• T wave - Ventricular
repolarization
• QRS - Ventricular
depolarization

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The PR Interval
Atrial depolarization
+
delay in AV junction
(AV node/Bundle of His)
(delay allows time for
the atria to contract
before the ventricles
contract)

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Pacemakers of the Heart
• SA Node - Dominant pacemaker with an
intrinsic rate of 60 - 100 beats/minute.
• AV Node - Back-up pacemaker with an
intrinsic rate of 40 - 60 beats/minute.
• Ventricular cells - Back-up pacemaker
with an intrinsic rate of 20 - 45 bpm.

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The ECG Paper
• Horizontally
– One small box - 0.04 s
– One large box - 0.20 s
• Vertically
– One large box - 0.5 mV

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The ECG Paper (cont)
• Every 3 seconds (15 large boxes) is
marked by a vertical line.
• This helps when calculating the heart
rate.
NOTE: the following strips are not marked
but all are 6 seconds long.
3 sec 3 sec

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End of Module I
ECG Basics
Proceed to Module I Practice Quiz
on WebCT

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