[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-571867-105":53,"doc-detail-571867-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","ecgpedia-72-step-plan-for-ecg-interpretation-quick-guide","ECGpedia - 7+2 step-plan for ECG interpretation - quick guide","","Structured ECG interpretation guide using a “7+2 step-plan”. It starts with rhythm assessment (sinus rhythm, atrial fibrillation/flutter, AVNRT, ventricular tachycardia, ventricular fibrillation, and bradycardia) and defines key conduction abnormalities including AV blocks. It then covers heart rate calculation, conduction intervals (PQ, QRS, QT/QTc) with thresholds and WPW recognition, axis determination, and detailed morphology checks for P waves, QRS complexes, and ST-T patterns. It closes with comparison to prior ECGs and a one-sentence conclusion, emphasizing immediate cardiology consultation for high-risk findings.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":51,"@type":70,"position":76},"https://docshare.wps.com/template/general/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/ecgpedia-72-step-plan-for-ecg-interpretation-quick-guide/571867/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/ecgpedia-72-step-plan-for-ecg-interpretation-quick-guide/571867.png","ImageObject",442,249,{"name":88,"@type":89},"Maya Linwood","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-25","2026-10-13",true,{"@type":98,"interactionType":99,"userInteractionCount":47},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What is the “7+2 step-plan” used for in this guide?","Question",{"text":108,"@type":109},"It provides a structured method to interpret an ECG by sequentially evaluating rhythm, heart rate, conduction intervals, heart axis, P-wave morphology, QRS morphology, and ST morphology, then comparing with the previous ECG and making a one-sentence conclusion.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What thresholds define normal conduction intervals (PQ, QRS, QTc) in the document?",{"text":113,"@type":109},"Normal PQ is \u003C200 ms, normal QRS is \u003C120 ms, and QTc is listed as \u003C450 ms (with a further note of \u003C460 ms). PQ >200 ms indicates AV block, and QRS >120 ms suggests a wide-complex pattern.",{"name":115,"@type":106,"acceptedAnswer":116},"Which findings require urgent action or immediate escalation?",{"text":117,"@type":109},"The guide states that ventricular fibrillation (chaotic ECG/no QRS complexes) and suspected acute myocardial infarction require immediate defibrillation or cardiologist consultation. It also advises always consulting a cardiologist for wide complex tachycardias due to potential risk of sudden death.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},571867,1792086180,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":50,"category_name":51,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":47,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":9},962084928432,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Before you start   \nCheck name, date, time, paperspeed (25 mm/sec), scale (10 mm/mV) .  \nContinue with the 7+2 step-plan.  \nStep 1: Rhythm  \nSinus rhythm(SR) (60-100/min): every P wave is followed by a QRS Narrow QRS tachycardias (QRS\u003C120ms; >100/min) are always supraventricular tachycardias (SVT):  \nSinustachycardia: sinusrhythm  \n> 100/min. Eg. Fever / Psych. stress / Cardiomyopathy Atrial fibrillation (AFIB): irregular  \n• Permanent = chronic.  \n• Persisting = recurring after chemical / electrical cardioversion  \n• Paroxysmal = comes and goes spontaneously: SR  AFIB  SR Atrial flutter: flutter waves on baseline. Often regular 300 / min with a 2:1, 3:1 or  \n4:1 block.  \nAVNRT: AV nodal re-entry tachycardia. Regular, 180-250 / min. P in QRS complex  \n(resulting in RsR’ in V1), often young  \npatients and paroxysmal. Valsalva / carotid massage /adenosine can terminate episode.  \nWide complex tachycardias (QRS>120ms): possible risk of sudden death, always consult with cardiologist.  \nVentricular tachycardia. Arguments for VT (Brugada criteria): fusion  \n(sudden narrow beat), absence of RS precordialy, RS > 100ms, AV dissociation, atypical LBBB. Typically in older patient with previous MI. Unconscious?  proceed to immediate defibrillation.  \nSVT with aberrancy. Typical in younger patient. How was the QRS duration / shape on a previous non-tachycardic ECG?  \nVentricular fibrillation = no QRS-complexes, but chaotic ECG-pattern, like ‘noise’  mechanical cardiac arrest  resuscitate. If patient is conscious it probably is noise.  \nBradycardia (\u003C60/min). Consider stop / reduce beta-blocker / digoxin / Caantagonist. Asymptomatic sinusbradycardia with a normal blood pressure in general doesn’t require treatment.  \n• 1st degree AV-block: prolonged PQ-interval (> 200ms)  \n• 2nd degree AV-block type I (Wenkebach): PQ interval increases until 1 QRS complex is blocked. Good prognosis.  \n• 2nd degree AV-block type II (Mobitz): PQ interval is normal, but not every P wave is followed by QRS. Requires pacemaker.  \n• 3rd degree AV-block = complete block. AV dissociation: no relationship between P waves and QRS. Requires pacemaker.  \n• Ventriculair escape rhythm: wide complex rhythm \u003C 40/min;  \ndangerous. Consult cardiologist. Ischemia? Severe electrolyte shift?  \n Step 2: Heart rate   \nCount the number of large grids between two QRS complexes: 1 box inbetween = 300/min, 2=150/min-100-75-60-50-40. Or use methods at the bottom of this page.  \nStep 3: Conduction intervals (PQ, QRS, QT)  \nNormal: PQ \u003C200ms (5 small squares), QRS \u003C 120ms (3 squares), QTc \u003C 450 ms,  \u003C 460 ms, preferably measured in lead II or lead V5 .  \nPQ > 200ms = AV block (above)  \n\n| QTc=\u003Cbr>| QT\u003Cbr>RR(in sec) |\n| --- | --- |\n\nPQ \u003C 120ms + delta-wave = Wolff-Parkinson-White syndrome (WPW), risk of a circus movement tachycardias (= AVRT: AV re-entry tachycardia)  \nQRS > 120ms = wide QRS complex, check V1:  \n• Left Bundle Branch Block (LBBB)  \nLatest activity towards the left, away from V1, so QRS ends negatively in V1.  \nNew LBBB? Consider ischemia.  \n• Right Bundle Branch Block (RBBB)  \nRsR’ (rabbit ear) latest activity rightwards,(on average) positive in V1  \n• Intraventricular conduction delay=  \nif it’s not LBBB nor RBBB  \nQTc > 450ms: consider: hypokalemia, post myocardial infarction, long QT syndrome, medication (full list on[torsades.org](torsades.org)). Risk of torsade de pointes deteriorating  \n\n| Maximal QTc per given heart rate: what QT value at what heart rate results in a QTc of 450ms? |  |\n| --- | --- |\n| 50/min: | QT 493ms |\n| 60/min: | QT 450ms |\n| 70/min: | QT 417ms |\n| 80/min: | QT 390ms |\n| 90/min: | QT 367ms |\n| 100/min: | QT 349ms |\n\ninto ventricular fibrillation (risk increases especially >500ms).  \nStep 4: Heart axis  \nHeart axis: vector of the average electrical activity. Normal between –30˚ and +90˚. Expecially axis deviation compared to previous ECG is relevant.  \nNormal hart axis: QRS positive in II and AVF  \nLeft axis: AVF and II negative. Eg. left anteri","cbCairNKZLHTjBJ1","https://ap.wps.com/l/cbCairNKZLHTjBJ1","pdf",446526,"English","# Step 1: Rhythm\n## Sinus rhythm and supraventricular tachycardias\n## Atrial fibrillation and atrial flutter\n## AVNRT and AV blocks\n## Wide complex tachycardias and ventricular fibrillation\n## Bradycardia\n# Step 2: Heart rate\n# Step 3: Conduction intervals (PQ, QRS, QT)\n# Step 4: Heart axis\n# Step 5: P wave morphology\n# Step 6: QRS morphology\n# Step 7: ST morphology\n# Step +1: Compare with previous ECG\n# Step +2: Conclusion","[{\"question\":\"What is the “7+2 step-plan” used for in this guide?\",\"answer\":\"It provides a structured method to interpret an ECG by sequentially evaluating rhythm, heart rate, conduction intervals, heart axis, P-wave morphology, QRS morphology, and ST morphology, then comparing with the previous ECG and making a one-sentence conclusion.\"},{\"question\":\"What thresholds define normal conduction intervals (PQ, QRS, QTc) in the document?\",\"answer\":\"Normal PQ is \\u003c200 ms, normal QRS is \\u003c120 ms, and QTc is listed as \\u003c450 ms (with a further note of \\u003c460 ms). PQ \\u003e200 ms indicates AV block, and QRS \\u003e120 ms suggests a wide-complex pattern.\"},{\"question\":\"Which findings require urgent action or immediate escalation?\",\"answer\":\"The guide states that ventricular fibrillation (chaotic ECG/no QRS complexes) and suspected acute myocardial infarction require immediate defibrillation or cardiologist consultation. It also advises always consulting a cardiologist for wide complex tachycardias due to potential risk of sudden death.\"}]","ECGpedia - 7+2 step-plan for ECG interpretation - quick guide | PDF",1791924132]