PROGRAM STUDY ILMU KEPERAWATAN (PSIK): ECG LEARNING CENTER

ECG Image Index

The following ECG categories contain hundreds of ECGs that range from the sublime to the ridiculous, from simplicity to complexity, and from boring to fascinating. Many of the ECG rhythm strips come from the collection of the late Dr. Alan Lindsay, master teacher of electrocardiography. Most of the 12- and 6-lead ECGs were recorded at LDS Hospital in Salt Lake City, Utah. Marquette Electronics has also given permission to use ECG rhythms and diagrams from their educational posters. Each of the ECGs has an interpretation and many have additional explanations that help explain the diagnosis. Feedback is encouraged using the feedback form provided with this website.

ECG Categories

1. Diagrams & Pictures

ecg_496.gif--Diagram: Digitalis Effect on Rhythm and Conduction
ecg_517.gif--WPW Diagram
ecg_533.gif--ECG Intervals and Waves
ecg_703.gif--Conceptual Framework: Arrhythmias and Conduction Abnormalities
ecg_ccs.gif--Cardiac Conduction System Diagram - Marquette
ecg_compens.gif--Compensatory vs. Non-compensatory Pauses - Marquette
ecg_components.gif--ECG Components Diagram - Marquette
ecg_conduct.gif--RV vs LV PVC's - Marquette
ecg_em_events.gif--Electrical and Mechanical Events Diagram - Marquette
ecg_evol.gif--Stages of Acute Q-Wave MI - Marquette
ecg_lead_wire.gif--Pacemaker Lead Wire Placement Diagram - Marquette
ecg_lindsay.gif--Alan E. Lindsay, MD: A Teacher of Substance and Style
ecg_outline38.gif--All About Premature Beats
ecg_outline39.gif--The Three Fates Of PAC's: 1. Normal Conduction; 2. Aberrant Conduction; 3.Non-conduction
ecg_outline42.gif--Diagram: AV Nodal Reentrant Tachycardia
ecg_outline43.gif--Diagram: Type I vs Type II 2nd Degreee AV Block
ecg_outline12.gif--Diagram: Frontal Plane Leads
ecg_st.gif--ST Segment Diagram - Marquette
ecg_torso.gif--Frontal and Horizontal Plane Lead Diagram

2. Frontal Plane QRS Axis Examples

ecg_559.gif--QRS Axis = +90 degrees
ecg_560.gif--QRS Axis = -30 degrees
ecg_561.gif--QRS Axis = 0 degrees
ecg_562.gif--Left Axis Deviation: QRS Axis = -60 degrees
ecg_563.gif--QRS Axis = +60 degrees
ecg_564.gif--QRS Axis = +30 degrees
ecg_565.gif--Left Axis Deviation: QRS Axis = -45 degrees
ecg_566.gif--Right Axis Deviation: QRS Axis =+130 degrees
ecg_6lead001.gif--Frontal Plane QRS Axis = +90 degrees
ecg_6lead002.gif--Frontal Plane QRS Axis = +75degrees
ecg_6lead003.gif--Frontal Plane QRS Axis = +50 degrees
ecg_6lead004.gif--Frontal Plane QRS Axis = +150 degrees (RAD)
ecg_6lead005.gif--Frontal Plane QRS Axis = 90 degrees
ecg_6lead006.gif--Frontal Plane QRS Axis = +30 degrees
ecg_6lead007.gif--Frontal Plane QRS Axis = +15 degrees
ecg_6lead008.gif--Frontal Plane QRS Axis = 0 degrees
ecg_6lead009.gif--Frontal Plane QRS Axis = -15 degrees
ecg_6lead010.gif--Frontal Plane QRS Axis = -45 degrees
ecg_6lead011.gif--Frontal Plane QRS Axis = -45 degrees
ecg_6lead012.gif--Frontal Plane QRS Axis = -75 degreees
ecg_6lead013.gif--Indeterminate Frontal Plane QRS Axis
ecg_6lead015.gif--Right Axis Deviation
ecg_6lead017.gif--Left Axis Deviation

3. Sinus, Atrial, Junctional Rhythms

ecg_12lead005.gif--Normal ECG
ecg_446.gif--Wandering Atrial Pacemaker
ecg_accelerate.gif--Accelerated Junctional Rhythm - Marquette
ecg_arrest.gif--Sinus Pause or Arrest - Marquette
ecg_arrhythmia.gif--Marked Sinus Arrhythmia - Marquette
ecg_brady.gif--Sinus Bradycardia - Marquette
ecg_junctional.gif--Junctional Escape Rhythm
ecg_normal.gif--Normal Sinus Rhythm - Marquette
ecg_sinus_brady.gif--Sinus Bradycardia
ecg_tachy.gif--SinusTachycardia - Marquette
ecg_wander.gif--Wandering Atrial Pacemaker - Marquette

4. PACs, PJCs, and PVCs

ecg_0226_mod.gif--PAC's with RBBB Aberrant Conduction
ecg_0226_mod2.gif--What are those funny looking beats????
ecg_0228_mod.gif--Long QT Mischief
ecg_0229_mod.gif--Long QT Mischief
ecg_0268_mod.gif--Atrial Parasystole
ecg_0273_mod.gif--Ventricular Parasystole
ecg_0274_mod.gif--Ventricular Fusion
ecg_0277_mod.gif--PVC With Venticular Echo
ecg_0286_mod.gif--Nonconducted PACs and Junctional Escapes
ecg_0315_mod.gif-Nonconducted And Conducted PAC's
ecg_401.gif--PAC and PVC: Complete vs. Incomplete Pause
ecg_402.gif--Identification of PVC's and PAC's
ecg_403.gif--Not All Sore Thumbs Are Ventricular In Origin
ecg_404.gif--Nonconducted PAC's: An Unusual Bigeminy
ecg_410.gif--An Interpolated PAC
ecg_414.gif--PAC's With RBBB Aberration
ecg_415.gif--The Three Fates Of PAC's
ecg_418.gif--A Nonconducted PAC Causes An Unexpected Pause
ecg_420.gif--Nonconducted PAC's Slowing The Heart Rate
ecg_441.gif--Atrial Parasystole
ecg_450.gif--Atrial Parasystole
ecg_457.gif--Nonconducted and Aberrantly Conducted PAC's
ecg_463.gif--Sore Thumbs
ecg_485.gif--Junctional Parasystole and Pseudo-AV Block
ecg_508.gif--Premature Junctional Complexes With Retrograde P Waves
ecg_aberrant.gif--PAC's With and Without Aberrant Conduction - Marquette
ecg_bigem_pvs.gif--Ventricular Bigeminy - Marquette
ecg_bigeminy.gif--Atrial Bigeminy - Marquette
ecg_contraction.gif--Nonconducted PAC -Marquette
ecg_cou_pvc.gif--PVC Couplet - Marquette
ecg_inter_pvc.gif--Interpolated PVCs - Marquette
ecg_isolated.gif--Isolated PAC - Marquette
ecg_multi.gif--Multifocal PVC's - Marquette
ecg_paired.gif--PAC Couplet - Marquette
ecg_quad_pvc.gif--PVC's - Marquette
ecg_ront.gif--PVC with R-on-T - Marquette
ecg_tri_pvc.gif--PVC Triplet - Marquette
ecg_trigem_pvc.gif--PVCs - Marquette
ecg_unifocal.gif--Unifocal PVCs - Marquette
ecg_v_fusion.gif--Ventricular Fusion Beat - Marquette

5. Atrial Fibrillation, Flutter and SVT's

ecg_12lead008.gif--Atrial Flutter With 2:1 AV Conduction
ecg_12lead008z.gif--Atrial Flutter With 2:1 Conduction: Leads II, III, V1
ecg_12lead009.gif--Atrial Flutter With 3:2 AV Conduction
ecg_12lead009z.gif--Atrial Flutter with 3:2 Conduction Ratio: Frontal Plane Leads
ecg_12lead010.gif--Atrial Flutter With 2:1 AV Conduction
ecg_12lead010z.gif--Atrial Flutter With 2:1 AV Conduction: Lead V1
ecg_12lead011.gif--Atrial Flutter With 2:1 AV Conduction
ecg_12lead011z.gif--Atrial Flutter With 2:1 AV Conduction: Leads II, III, V1
ecg_12lead051.gif--LBBB and Atrial Flutter with 2:1 AV Block
ecg_12lead059.gif--Multifocal Atrial Tachycardia (MAT)
ecg_12lead069.gif--Atrial Fibrillation in Patient with WPW Syndrome
ecg_407.gif--A PAC Initiates Paroxsymal Atrial Fibrillation
ecg_428.gif--Massage Parlor Games
ecg_477.gif--Atrial Flutter With Variable AV Block And Rate-Dependent LBBB
ecg_478.gif--Atrial Flutter With 2:1 and 4:1 Conduction and Rate Dependent LBBB
ecg_487.gif--Atrial tachycardia With 3:2 AV Block
ecg_491.gif--Atrial Tachycardia With 3:2 and 2:1 AV Block
ecg_493.gif--Digitalis Intoxication: Junctional Tachycardia With and Without AV Block493
ecg_494.gif--Digitalis Intoxication: Junctional Tachycardia With and Without Exit Block
ecg_495.gif--Atrial Tachycardia With Exit Block and AV Block
ecg_498.gif--A Very Subtle Atrial Tachycardia With 2:1 Block
ecg_500.gif--Junctional Tachycardia With Exit Block: A Manifestation of Digitalis Intoxication
ecg_505.gif--Atrial Tachycardia With 2:1 AV Block: A Manifestation of Digitalis Intoxication
ecg_6lead014.gif--Atrial Flutter with 2:1 AV block
ecg_6lead016.gif--Atrial Flutter with 2:1 AV Block
ecg_atrial_fib.gif--Atrial Fibrillation With Moderate Ventricular Response - Marquette
ecg_atrial_flutter.gif--Atrial Flutter With Variable AV Block - Marquette ecg_atrial_tachy.gif--Atrial Tachycardia - Marquette

6. Ventricular Rhythms and Tachycardias

ecg_0263_mod.gif--Ventricular Parasystole
ecg_0325_mod.gif--Accelerated Ventricular Rhythm With Retrograde Atrial Capture and Echo Beats
ecg_0331_mod.gif--Ventricular Tachycardia With Retrograde Wenckebach
ecg_12lead057.gif--Left Ventricular Tachycardia
ecg_12lead058.gif--Ventricular Tachycardia
ecg_12lead063.gif--Right Ventricular Tachycardia
ecg_accel_idio.gif--Accelerated IVR With AV Dissociation - Marquette
ecg_escape.gif--Ventricular Escape Beat - Marquette
ecg_ideo.gif--Idioventricular Escape Rhythm
ecg_v_asyst.gif--Ventricular Asystole - Marquette
ecg_v_fib.gif--Ventricular Fibrillation - Marquette

7. Mischief in the AV Junction (Blocks and Dissociation)

ecg_0233_mod.gif--AV Dissociation by Default
ecg_0236_mod.gif--AV Dissociation by Default
ecg_0238_mod.gif--AV Dissociation by Usurpation
ecg_0246_mod.gif--Isochronic Ventricular Rhythm
ecg_0280_mod.gif--1st Degree AV Block
ecg_0285_mod.gif--2nd Degree AV Block, Type I
ecg_0287_mod.gif--2nd Degree AV Block, Type I, with Junctional Escapes
ecg_0291_mod.gif--LBBB and 2nd degree AV Block, Mobitz Type II
ecg_0293_mod.gif--Trifascicular Block: RBBB, LAFB, and Mobitz II 2nd Degree AV Block
ecg_0294_mod.gif--RBBB plus Mobitz II 2nd Degree AV Block
ecg_0295_mod.gif--Mobitz II 2nd Degree AV Block
ecg_0296_mod.gif--Incomplete AV Dissociation Due To 2nd Degree AV Block
ecg_0298_mod.gif--2nd Degree AV Block, Type I With Escapes and Captures
ecg_0299_mod.gif--3rd Degree AV Block Rx'ed With a Ventricular Pacemaker
ecg_0301_mod.gif--Complete AV Block, Junctional Escape Rhythm, and Ventriculophasic Sinus Arrhythmia
ecg_0305_mod.gif--2nd Degree AV Block, Type I, With Accelerated Junctional Escapes and a Ladder Diagram
ecg_0311_mod.gif--ECG Of The Century: A Most Unusual 1st Degree AV Block
ecg_0312_mod.gif--ECG Of The Century - Part II: Dual AV Pathways
ecg_0315_mod.gif--Nonconducted And Conducted PAC's
ecg_0317_mod.gif--Two Wrongs Sometimes Make A Right
ecg_411.gif--Atrial Echos
ecg_425.gif--Second Degree AV Block, Type I, With 3:2 Conduction Ratio
ecg_480.gif--Second Degree AV Block,Type I, With Bradycardia-dependent RBBB
ecg_506.gif--Supernormal Conduction: 2nd Degree AV Block With Rare Captures; Accelerated Ventricular Rhythm
ecg_507.gif--2nd Degree AV Block With Junctional Escapes And Captures
ecg_first_av.gif--Right Bundle Branch Block
ecg_second_av1.gif--2nd Degree AV Block, Type I (Wenckebach)
ecg_third_av1.gif--Complete AV Block (3rd Degree) with Junctional Rhythm

8. Bundle Branch, Fascicular Blocks, and WPW

ecg_12lead012.gif--Left Anterior Fascicular Block(LAFB)
ecg_12lead012z.gif--LAFB: Frontal Plane Leads
ecg_12lead013.gif--Left Bundle Branch Block (LBBB)
ecg_12lead013z.gif--LBBB: Precordial Leads
ecg_12lead014.gif--RBBB With Primary ST-T Wave Abnormalities
ecg_12lead014z.gif--RBBB with Primary ST-T Abnormalities: Precordial Leads
ecg_12lead015.gif--Bifascicular Block: RBBB + LAFB
ecg_12lead016.gif--Bifascicular Block: RBBB + LAFB
ecg_12lead016z.gif--RBBB: Precordial Leads
ecg_12lead018.gif--WPW Type Preexcitation
ecg_12lead018z.gif--WPW Type Preexcitation: Precordial Leads
ecg_12lead018z.gifAbnormalities
ecg_12lead034.gif--Infero-posterior MI & RBBB
ecg_12lead034z.gif--Infero-posterior MI & RBBB: Frontal Plane Leads + V1
ecg_12lead035.gif--Inferior MI and RBBB
ecg_12lead036.gif--Inferior & Anteroseptal MI + RBBB
ecg_12lead036z.gif--Anteroseptal MI With RBBB: Precordial Leads
ecg_12lead043.gif--Atypical LBBB with Q Waves in Leads I and aVL
ecg_12lead044.gif--Atypical LBBB with Primary T Wave Abnormalities
ecg_12lead046.gif--Infero-posterior MI with RBBB
ecg_12lead047.gif--RBBB + LAFB = Bifascicular block
ecg_12lead049.gif--RBBB + LAFB: Bifascicular Block
ecg_12lead050.gif--Right Bundle Branch Block (RBBB)
ecg_12lead068.gif--WPW and Pseudo-inferior MI
ecg_12lead070.gif--WPW with a Pseudo-inferior MI
ecg_476.gif--Rate-dependent LBBB
ecg_482.gif--Bradycardia-dependent LBBB With Carotid Sinus Massage
ecg_706.gif--Left Anterior Fasicular Block: Frontal Plane Leads
ecg_first_av1.gif--Right Bundle Branch Block
ecg_lbbb.gif--Left Bundle Branch Block - Marquette
ecg_preexcite.gif--WPW Type Preexcitation - Marquette
ecg_rbbb.gif--RBBB - Marquette

9. Artificial Pacemakers

ecg_0327.gif--Ventricular Paced Rhythm With Retrograde Wenckebach
ecg_12lead045.gif--Ventricular Pacemaker Rhythm
ecg_12lead045z.gif--Ventricular Pacemaker Rhythm: V1-3
ecg_12lead053.gif--Ventricular Pacemaker: Demand mode functioning
ecg_12lead065.gif--Atrial Pacemaker Rhythm
ecg_12lead066.gif--AV Sequential Pacing
ecg_12lead067.gif--AV Sequential Pacing
ecg_atrial_pace.gif--Electronic Atrial Pacing - Marquette
ecg_av_pace.gif--AV Sequential Pacemaker - Marquette
ecg_out_fail.gif--Pacemaker Failure to Pace - Marquette
ecg_paced.gif--Pacemaker Fusion Beat - Marquette
ecg_sense_fail.gif--Pacemaker Failure To Sense - Marquette
ecg_spikes.gif--Electronic Ventricular Pacemaker Rhythm - Marquette
ecg_vent_pace.gif--Ventricular Pacing in Atrial Fibrillation - Marquette

10. Myocardial Infarctions

ecg_12lead026.gif--Anteroseptal MI: Fully Evolved
ecg_12lead026z.gif--Anteroseptal MI, Fully Evolved: Precordial Leads
ecg_12lead027.gif--Extensive Anterior/Anterolateral MI: Recent ecg_12lead027z.gif--Extensive Anterior/Anterolateral MI: Precordial Leads
ecg_12lead028.gif--Acute Anterior MI
ecg_12lead029.gif--Infero-posterior MI
ecg_12lead030.gif--Inferior MI: Fully Evolved
ecg_12lead030z.gif--Fully Evolved Inferior MI: Frontal Plane
ecg_12lead031.gif--Acute Inferoposterior MI
ecg_12lead032.gif--Postero-lateral MI: Fully Evolved
ecg_12lead032z.gif--Postero-lateral MI: Precordial Leads
ecg_12lead033.gif--Diffuse Anterolateral T Wave Abnormalities
ecg_12lead034.gif--Infero-posterior MI & RBBB
ecg_12lead034z.gif--Infero-posterior MI & RBBB: Frontal Plane Leads + V1
ecg_12lead035.gif--Inferior MI and RBBB
ecg_12lead036.gif--Inferior & Anteroseptal MI + RBBB
ecg_12lead036z.gif--Anteroseptal MI With RBBB: Precordial Leads
ecg_12lead037.gif--Acute Inferoposterior MI with Right Ventricular MI
ecg_12lead037z.gif--True Posterior MI and Right Ventricular MI
ecg_12lead038.gif--Old Infero-posterior MI
ecg_12lead039.gif--Old Inferior MI
ecg_12lead040.gif--Old Inferior MI, PVCs, and Atrial Fibrillation
ecg_12lead041.gif--Old Inferior MI
ecg_12lead043.gif--Atypical LBBB with Q Waves in Leads I and aVL
ecg_12lead044.gif--Atypical LBBB with Primary T Wave Abnormalities
ecg_12lead046.gif--Infero-posterior MI with RBBB
ecg_12lead055.gif--High Lateral Wall MI (seen in aVL)
ecg_711.gif--Frontal Plane: Accelerated Junctional Rhythm and Inferior MI
ecg_720.gif--Inferoposterior MI
ecg_721.gif--Inferoposterior MI

11. Hypertrophies and Enlargements

ecg_12lead019.gif--Left Atrial Abnormality & 1st degree AV Block
ecg_12lead019z.gif--Left Atrial Abnormality & 1st Degree AV Block: Leads II and V1
ecg_12lead020.gif--Left Atrial Enlargement & Nonspecific ST-T Wave Abnormalities
ecg_12lead020z.gif--Left Atrial Enlargement: Leads II and V1
ecg_12lead021.gif--Right Ventricular Hypertrophy (RVH) & Right Atrial Enlargement (RAE)
ecg_12lead021z.gif--Right Axis Deviation & RAE (P Pulmonale): Leads I, II, III
ecg_12lead022.gif--Right Atrial Enlargement (RAE) & Right Ventricular Hypertrophy (RVH)
ecg_12lead022z.gif--RAE & RVH ecg_12lead023.gif--Voltage Criteria for LVH
ecg_12lead024.gif--LVH with "Strain"
ecg_12lead025.gif--LVH and Many PVCs
ecg_12lead025z.gif--LVH & PVCs: Precordial Leads
ecg_12lead042.gif--LVH: Limb Lead Criteria
ecg_12lead042z.gif--LVH: Limb Lead Criteria
ecg_12lead048.gif--RVH with Right Axis Deviation
ecg_12lead052.gif--LVH: Strain pattern + Left Atrial Enlargement
ecg_12lead054.gif--LVH - Best seen in the frontal plane leads!
ecg_12lead064.gif--Severe RVH
ecg_705.gif--Left Atrial Enlargement

12. ST-T and U Wave Abnormalities and Long QT

ecg_12lead002.gif--Long QT Interval and Giant Negative T Waves
ecg_12lead003.gif--Long QT Interval
ecg_12lead003z.gif--Long QT Interval
ecg_12lead004.gif--Normal Variant: Early Repolarization
ecg_12lead004z.gif--Normal Variant: Early Repolarization
ecg_12lead006.gif--ST Segment Depression
ecg_12lead006z.gif--ST Segment Depression: Precordial Leads
ecg_12lead007.gif--Inferolateral ST Segment Elevation
ecg_12lead007z.gif--ST Segment Elevation: Frontal Plane Leads
ecg_12lead056.gif--Long QT: An ECG Marker For Sudden Cardiac Death
ecg_12lead060.gif--Hyperkalemia and Old Inferior MI
ecg_12lead061.gif--Advanced Hyperkalemia
ecg_486.gif--Giant TU Fusion Waves
ecg_6lead018.gif--Hypothermia: J-waves or Osborne Waves

13. Odds & Ends

ecg_12lead001.gif--Lead Error: V1 & V3 are Transposed
ecg_12lead001z.gif--Lead Error: V1 and V3 are Transposed!
ecg_ac.gif--60 Cycle Artifact - Marquette
ecg_baseline.gif--Wandering Baseline Artifact - Marquette
ecg_calibration.gif--Calibration Signal - Marquette
ecg_tremor.gif--Muscle Tremor Artifact - Marquette