Reading Heart Rhythms – Basic ECG Interpretation

Reading Heart Rhythms

The heart is an important organ in the body because it pumps blood through the blood vessels which provide oxygen and nutrients throughout the body. It also helps in removing metabolic waste.

It is necessary to keep the heart healthy by maintain a healthy heart rate and rhythm. Counting resting heart rate and reading heart rhythms will help identify the condition of the heart.

Reading heart rhythms

The heart’s rhythm accompanies the pumping of the blood. It is defined by pace-making cells in the sinoatrial node that creates a current that causes the heart to contract.

The normal rhythmical heart beat is called a sinus rhythm. This is created by an electrical signal that travels through the heart that causes the contraction of the heart muscle.

The heart rhythm can be regular or irregular. Irregular heart rhythm can be regularly irregular or irregularly irregular.

How is heart rhythm determined?

Reading heart rhythms can be done with the help of an ECG or electrocardiogram. An ECG is a fast and painless piece of equipment that records the electrical activity of the heart.

According to Medical Training and Simulation, an ECG records cardiac electrical impulses which cause the heart to contract and pump blood while it moves to the ventricles from the atrium.

The heart rhythm shown by the ECG helps the doctors understand the following:

  • Heartbeat irregularity
  • Heart rate
  • Timing and strength of electrical signals
  • Any potential abnormal condition of the heart

It takes some time and patience to determine the heart rhythm using an ECG.  ECG interpretation requires memorization and pattern recognition. Here are some things you need to do to get started with reading heart rhythms:

Learn the basic parts of the ECG tracing

The basic parts of the ECG tracing are the foundation of everything else. These include the complexes, waves, and intervals. Learning what the normal P wave looks like and what it means is part of learning the basic parts of the ECG tracing. It does not involve the different P wave morphologies.

Identify the heart rate on the ECG

Identifying the heart rate on the ECG requires calculation. It helps identify if the bradycardia (a normal heart rate) or tachycardia occurs at the current state. The techniques for identifying the heart rate on the ECG involve the atrial rate (P wave rate) and the ventricular rate (QRS complex rate).

Understand the axis on the ECG

The only axis that you need when reading heart rhythms is the QRS complex. You should know what causes right axis deviation, left axis deviation, and a northwestern axis (or when the axis cannot be determined).

The axis helps in determining different pathologic conditions. For electro physiologists all kinds of axes, not only the QRS complex, should be determined.

Know the different abnormal heart rhythms

The first steps above help in determining the normal heart rhythms. Now it is time to determine the abnormal heart rhythms such as the following:

  • Atrial fibrillation
  • First degree atrioventricular block
  • Junctional rhythms
  • Sinus arrhythmia
  • Atrial flutter
  • Ventricular tachycardia
  • Wandering atrial pacemaker

Learn the chamber hypertrophies and bundle blocks

This is the most difficult part because the criteria for left ventricular hypertrophy are too numerous and difficult to determine. There’s no need to memorize all of the criteria though; you only need to know the two to three main criteria.

Learn the acute MI and Ischemic ECG findings

This is the easiest step in reading heart rhythms. Anterior ST segment elevations, inferior ST segment, and other acute MI ECG findings are easy to detect. The difficult par, though is determining the more subtle ECG alterations.

Reading heart rhythms is not easy and usually requires formal education and practice. However, anyone can determine the heart rate because it is easy.

How to measure heart rate

The normal heart rate ranges from 60 to 100 beats per minute. To measure your heart rate, locate your pulse on your neck or on your wrist. Count the beats in the span of 10 seconds. Count it for 3 times and get the average. Then, multiply this number to 6. This number is your heart rate.

It is important to keep your heart rate normal to ensure the healthy condition of your heart.