Part I. Heart Rhythm Diagnoses
Class 1. Cardiac pacemakers
- Sinus rhythm
- Low atrial rhythm
- Ectopic atrial rhythm
- Junctional rhythm
- Supraventricular rhythm
- Idioventricular rhythm
Class 2. Wandering pacemaker
- Wandering atrial pacemaker
- Consider wandering atrial pacemaker
Class 3. Heart rate
- Severe bradycardia
- Bradycardia (<60 bpm)
- Normocardia (60-90 bpm)
- Tachycardia (>90 bpm)
- Severe tachycardia
- Tachycardia
- regular rhythm
- irregular rhythm
- HR
- ventricular rate
- atrial rate
Class 4. Fibrillation and flutter
- Atrial fibrillation
- Suggests atrial fibrillation
- Atrial flutter
- Atrial fibrillation with third degree AV block
- Bradycardia
- tachycardia
Class 5. Premature complexes
- Atrial premature complex(es)
- Junctional premature complex(es)
- Supraventricular premature complex(es)
- Left ventricular premature complex(es)
- Right ventricular premature complex(es)
- Ventricular premature complex(es)
- Suggests junctional premature complex(es)
- Suggests supraventricular premature complex(es)
- Suggests left ventricular premature complex(es)
- Suggests right ventricular premature complex(es)
- Suggests ventricular premature complex(es)
- occasional
- frequent
- couplets
- quadrigeminy
- trigeminy
- bigeminy
- episode of quadrigeminy
- episode of trigeminy
- episode of bigeminy
- interpolated
- nonconducted
Class 6. Paroxysmal tachycardia
- Severe tachycardia
- Severe tachycardia, consider atrial flutter
- Atrial fibrillation, consider atrial flutter
- Intermittent
Class 7. Pre-excitation syndrome
- WPW pattern
- Short PR interval
Class 8. Sinoatrial block
- Suggests sinoatrial block, type I
- Sinoatrial block, type II
- Sinoatrial arrest episode
Class 9. AV block
- First-degree AV block
- Second-degree AV block, Mobitz Type 1 (Wenckebach)
- Second-degree AV block, Mobitz Type 2
- AV block, advanced (high-grade)
- Second-degree AV block
- AV block, complete (third-degree)
Class 10. Unidentified arrhythmia
- Unidentified arrhythmia
Class 11. Noise, drift, filter status, sport mode, signal quality, pacemaker spikes
- Bad quality lead
- Bad quality leads
- Pacemaker spikes
- High noise level in leads
- Baseline drift in leads
- Automatic interpretation in Sport mode
- In-depth medical examination is recommended
PART II. QRS shape diagnoses
Class 1. General ECG conclusion
- Normal ECG
- Otherwise normal ECG
- Technical error, consider dextrocardia
- Suggests dextrocardia
- Misplaced limb electrodes. Check electrode’s placement
Class 2. QRS axis
- Normal axis
- Right axis deviation
- Indeterminate axis
- Left axis deviation, consider left anterior fascicular block
- Left axis deviation
- Normal axis
- Right axis deviation, consider right ventricular hypertrophy and left posterior fascicular block
- Right axis deviation
- Right axis deviation, consider right ventricular hypertrophy and left posterior fascicular block
- Right axis deviation
Class 3. Atrial syndrome
- Right atrial enlargement
- Suggests right atrial enlargement
- Left atrial enlargement
- Suggests left atrial enlargement
- Atrial conduction abnormality
Class 4. Intraventricular block
Right bundle branch block
- Complete right bundle branch block
- Incomplete right bundle branch block
- Suggests incomplete right bundle branch block
- rSr’ pattern in V1 or V2
Left bundle branch block
- Complete left bundle branch block
- Incomplete left bundle branch block
- Suggests incomplete left bundle branch block and old anteroseptal myocardial infarction
- Left anterior fascicular block
- Suggests left anterior fascicular block
- Left posterior fascicular block
- Suggests incomplete left bundle branch block
Bifascicular and trifascicular block
- Complete right bundle branch block and left anterior fascicular block
- Complete right bundle branch block and left posterior fascicular block
- Trifascicular block
- Intraventricular block
- Intraventricular conduction delay
Class 5. Myocardial infarction
- Myocardial infarction
- Suggests myocardial infarction
- acute
- of indeterminate age
- old
- anterobasal
- anterolateral
- inferior
- anteroseptal
- anteroapical
- extensive anterior
- anterior and inferior
- inferolateral
- inferoseptal
- inferoаpical
- extensive inferior
- Q wave in leads
- Consider inferobasal myocardial infarction
Class 6. Ventricular hypertrophy
Right ventricular hypertrophy
- Right ventricular hypertrophy, consider right ventricular strain
- Right ventricular hypertrophy
- Right ventricular hypertrophy, consider chronic obstructive pulmonary disease
- Suggests right ventricular hypertrophy with strain
- Suggests right ventricular hypertrophy
- with systolic strain
- with diastolic strain
Left ventricular hypertrophy
- Left ventricular hypertrophy, consider left ventricular strain
- Left ventricular hypertrophy
- Left ventricular hypertrophy with systolic strain
- Left ventricular hypertrophy with diastolic strain
- Suggests left ventricular hypertrophy
- Prevalence of left ventricular electrical activity
Class 7. Other depolarization syndromes
- SI SII SIII pattern, consider right ventricular hypertrophy, pulmonary disease
- SI QIII TIII pattern, consider pulmonary embolism
- Low voltage
- High voltage
- Electrical alternans
Class 8. ST and T changes
- ST deviation
- T-wave change
- ST deviation and/or T-wave change
- T-wave change
- Nonspecific ST deviation
- Nonspecific T-wave change
- Nonspecific ST deviation with T-wave change
- most evident
- major
- moderate
- minor
- possible
Class 9. Other repolarization syndromes
- ST elevation, consider myocardial infarction, pericarditis, early repolarization
- ST elevation, consider pericarditis, early repolarization
- Suggests ST elevation, consider myocardial infarction, pericarditis, early repolarization
- Suggests ST elevation, consider pericarditis, early repolarization
- Suggests early repolarization
- Tall T-waves in V1-V4, consider inferobasal ST-T changes, hyperkalemia
- ST elevation in V1-V4, consider enhanced vagal tone, hyperkalemia, inferobasal ST-T changes
- Nonspecific T-wave changes T(V1) > T(V6)
- Consider digitalis effect
- Juvenile T waves
- Short QT interval
- Prolonged QT interval
- Suggests short QT interval
- Suggests prolonged QT interval
- Consider Brugada syndrome