Basics & Fundamentals
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Premature Junctional Complexes (PJCs)
Key Points Origin: PJCs originate from ectopic foci near the AV junction, leading to premature impulses. ECG Characteristics: P Waves: May be absent or retrograde (inverted), appearing before, during, or…
Premature Ventricular Complexes (PVCs)
Key Points Origin and Characteristics: PVCs originate from ectopic ventricular foci, resulting in wide QRS complexes (>120 ms) with abnormal morphology, including discordant ST segments and T wave abnormalities. Types…
Premature Atrial Complexes (PACs)
Key Points Origin and Characteristics: PACs originate from ectopic atrial foci, resulting in abnormal P waves with different morphology and axis compared to sinus P waves. Hidden P Waves: Ectopic…
Premature Complexes (PACs, PJCs, & PVCs)
Key Points Spontaneous Depolarization: Different pacemaker cells in the heart can spontaneously depolarize at varying rates; the SA node is usually the fastest. Ectopic Impulses: Early depolarizations from ectopic foci…
Osborn Wave
Key Points Definition: An Osborn wave is a J wave—a positive deflection at the QRS–ST junction—classically seen in hypothermia (often more prominent as core temp falls). Where you’ll see it:…
Attending Level ECG Curriculum
Competencies: At the attending level, expert emergency and acute care physicians should proficiently interpret STAT ECGs to diagnose a wide range of emergent conditions—particularly those that are rapidly fatal. Mastery…
PGY-3 (Advanced) Resident ECG Curriculum
The Goals: Master rare and complex ECG findings and correlate them with clinical urgency. Integrate ECG data into immediate treatment decisions (e.g., combining with POCUS, vital signs, and physical exam)….
PGY-2 (Intermediate) Resident Curriculum
The Goals: Enhance speed and accuracy in ECG interpretation through repetition and practice. Recognize subtler findings and expand your differential diagnoses. Integrate nuanced ECG changes into clinical decision-making. Mentor junior…
PGY-1 (Foundational Resident) Curriculum
The Goals: Establish a systematic approach, identify common arrhythmias, distinguish normal variants from dangerous abnormalities, and maintain a strong emphasis on clinical correlation. Core Topics Systematic Interpretation Step-by-Step Method: Rate…
Student Level ECG Curriculum
Pre-Licensure / Pre-Residency Designed for Medical Students, Paramedics, Nursing Students, ED Technicians, or anyone else who wants to start learning more about how to use ECGs effectively in clinical settings….
The ECG STAT Curriculum
Why ECG Interpretation Matters Electrocardiograms (ECGs) are a cornerstone of patient evaluation and management in acute care. Rapid, accurate interpretation can mean the difference between timely intervention and missed critical…
Barcelona Criteria
Key Point Challenge in LBBB and RV Pacing: Both left bundle branch block (LBBB) and right ventricular (RV) paced rhythms alter ventricular depolarization and repolarization, making recognition of acute myocardial…
Acquired Long QT Syndrome
Key Points Acquired Long QT Syndrome (LQTS) is the most common form of LQTS, resulting from medications, electrolyte disturbances, or underlying medical conditions. High-risk factors include the use of multiple…
Himalayan T Waves
Key Points Himalayan T waves are a peculiar T wave abnormality characterized by T wave/U wave fusion, resulting in a mountain peak-like appearance on the ECG. This pattern is strongly…
Normal QRS Axis
Key Points Normal Axis Range: –30° to +90° Lead I: QRS complex is positive Lead aVF: QRS complex is positive → This combination confirms a normal QRS axis Frontal plane…
QRS Morphology & Proportionality
Key Points QRS Morphology Reflects Conduction Pathways: The shape and width of the QRS complex help differentiate between normal conduction, conduction delays, and ventricular-origin rhythms. QRS–T Wave Proportionality Signals Repolarization…
Right Bundle Branch Block (RBBB)
Key Points Definition: In RBBB, the right bundle branch of the heart’s electrical conduction system is blocked, preventing direct activation of the right ventricle (RV). As a result, RV activation…
Isoelectric Segment of the ECG
Key Points PR vs. TP Segment: The most accurate isoelectric baseline for assessing the magnitude of ST segment deviation is debated between the PR segment and the TP segment. Challenges…
Paced Rhythms
Key Points Paced Rhythms Overview: Paced rhythms, whether from right ventricular (RV) pacemakers, left ventricular (LV) pacemakers, or dual-chamber pacemakers, produce specific ECG changes due to the altered sequence of…
Atrioventricular Nodal Reentry Tachycardia (AVNRT)
Key Points Definition: AVNRT is a type of paroxysmal supraventricular tachycardia (SVT) caused by a reentry circuit within or around the AV node, leading to a narrow complex regular rhythm….
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