Evaluation of Heart Rhythms



The electrocardiogram (ECG) is synonymous with a cardiac evaluation, just as a chest x-ray is with a pulmonary ­evaluation. The ECG is inexpensive, non-invasive and easy to perform. All hospitals and most offices can perform electrocardiography and because they are so ubiquitous, being able to accurately interpret an ECG is important. The goal of this chapter is to provide a basic understanding of the principles of how to “read” an ECG, why an ECG looks the way it does, and when to order an ECG. Because the readers of this book will likely have quite varied backgrounds and exposures to ECG interpretation, this chapter will begin with more basic principles of what an ECG is and how it is generated. We will then focus on understanding the ECG waveforms and basic rhythm diagnosis. Finally, we will conclude with a discussion of additional ECG tests that can be performed to assess heart rhythm disturbances.


Brugada Syndrome Sick Sinus Syndrome Junctional Rhythm Event Monitor Ventricular Rhythm 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Further Reading

  1. For the beginner – Dubin D. Rapid Interpretation of EKG’s. 6th ed. Tampa: COVER Publishing Company; 2000.Google Scholar
  2. For the intermediate reader – O’Keefe J. The Complete Guide to ECG’s. 3rd ed. Sudbury: Physicians’ Press; 2008.Google Scholar
  3. For the advanced reader – Wagner G. Marriott’s Practical Electro­cardio­graphy. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2001.Google Scholar
  4. For reference – Surawicz B, Knilans T. Chou’s Electrocardiography in Clinical Practice. 6th ed. Philadelphia: Saunders Elsevier; 2008.Google Scholar
  5. For reference – Vereckei et al. New Algorithm Using Only Lead AVR for Differential Diagnosis of Wide QRS Complex Tachycardia. Heart Rhythm. 2008;5:89–98.Google Scholar
  6. For reference – Brugada et al. A New Approach to the Differential Diagnosis of a Regular Tachycardia with a Wide QRS Complex. Circulation. 1991;83:1649–59.Google Scholar
  7. For practice at the intermediate and above level – Marriott HJL. Challenging ECGs. Philadelphia: Hanley & Belfus, Inc.; 2002.Google Scholar
  8. For online practice at all levelswww.ekgstar.com.

Copyright information

© Springer-Verlag London Limited 2012

Authors and Affiliations

  1. 1.Department of Medicine, Division of CardiologyUniversity of Rochester Medical CenterRochesterUSA
  2. 2.Division of Cardiology – ElectrophysiologyUniversity of Rochester Medical CenterRochesterUSA

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