Mr. Brown's Science Labs
Bio-Med Technology
ECG Rhythm Diagnosis
Reading the electrical signals of the human heart

Cardiac Electrical Vocabulary

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Vocabulary Matching

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The Electrical Story of the Heart

Read carefully — the next page builds directly on this passage.

Every heartbeat begins with a tiny electrical pulse. That pulse fires from the sinoatrial (SA) node, a cluster of specialized cells in the upper right atrium. The SA node acts as the heart's natural pacemaker, setting a resting rhythm of about 60 to 100 beats per minute in healthy adults.

The signal spreads across the atria, causing them to contract. This produces the small bump on an ECG known as the P wave. The pulse then pauses briefly at the atrioventricular (AV) node before racing down the bundle of His and the Purkinje fibers into the ventricles. The sharp, tall QRS complex on an ECG marks ventricular contraction — the powerful squeeze that pumps blood to the lungs and body. The rounded T wave that follows shows the ventricles resetting electrically, ready for the next beat.

When this conduction system breaks down, the rhythm becomes abnormal — an arrhythmia. Some arrhythmias are harmless, but others can be deadly. Atrial fibrillation replaces clean P waves with chaotic atrial activity and an irregularly irregular pulse, sharply raising the risk of stroke because blood pools and clots in the quivering atria. Ventricular fibrillation is a true emergency — the ventricles twitch instead of pump, no blood reaches the brain, and death follows within minutes unless an electrical shock from a defibrillator resets the rhythm. By contrast, asystole — a flat line — cannot be shocked; only CPR and medications can give the heart a chance to restart.

Reading an ECG is pattern recognition under pressure. A trained technician can identify a life-threatening rhythm in seconds, page the cardiology team, and give a patient their best chance at survival.

Sentence Practice

Five short tasks based on the reading. Each item is worth 1 point.

Fill in the blanks using the word bank below.
SA nodeQRSventriclesP wave

The sets the heart's resting pace, while the complex marks the contraction of the .

Drag the words into the correct order to build a complete sentence. Tap a word to place it.
Expand the sentence below into a complete, detailed sentence using one of the prompts.

"Atrial fibrillation increases stroke risk."

Why?How?
Drag the words into the correct order to build a complete sentence.
Expand the sentence below into a complete, detailed sentence using one of the prompts.

"Doctors record ECG signals."

When?Where?

ECG Strip Diagnosis

You are the cardiac tech on shift. Identify each rhythm, then complete the patient log below.

STEP 1

Learn the parts of a normal beat

Below is a Normal Sinus Rhythm at about 70 BPM. Every healthy beat has three waves in this exact order: a small P wave, a tall sharp QRS complex, and a rounded T wave. Use this as your reference — anything that looks different is abnormal.

P wave atrial contraction QRS ventricles pump T wave ventricles reset
↑ Normal Sinus Rhythm: regular spacing, clear P–QRS–T pattern, rate ≈ 70 BPM
STEP 2

Estimate the rate

Each strip is 6 seconds long. Count the number of QRS complexes (the tall sharp peaks) and multiply by 10 to get beats per minute.

< 60
Bradycardia
(too slow)
60–100
Normal
(healthy adult)
> 100
Tachycardia
(too fast)

Example: If you count 7 QRS complexes in a 6-second strip → 7 × 10 = 70 BPM (normal).

STEP 3

Use the diagnostic flowchart

Ask these four questions in order. Stop at the first match.

Is the rhythm a flat line or wild chaos with no real beats?
↓ YES
VENTRICULAR FIBRILLATION (V-fib) — emergency, defibrillate now
Are P waves missing AND beat spacing irregularly irregular?
↓ YES
ATRIAL FIBRILLATION (A-fib) — high stroke risk
Is everything regular and looks normal, but rate > 100 BPM?
↓ YES
SINUS TACHYCARDIA
Is everything regular and looks normal, but rate < 60 BPM?
↓ YES
SINUS BRADYCARDIA
Otherwise — regular, 60–100 BPM, all three waves present:
NORMAL SINUS RHYTHM
WORKED EXAMPLE

A practice strip — let's diagnose it together

Suppose you see this strip on your screen:

1. Count complexes: 4 QRS peaks in 6 seconds → 4 × 10 = 40 BPM
2. Check regularity: Spacing between beats is even → regular
3. Check waves: Each beat has a clear P, QRS, and T → morphology normal
4. Apply flowchart: Regular + normal waves + rate under 60 → SINUS BRADYCARDIA
Now you try! Below are 5 patient strips. For each one: count the rate, check regularity, look at the wave shapes, then pick a diagnosis from the dropdown. After you finish all 5, fill in the Patient Rhythm Log at the bottom.

Patient Rhythm Log

Complete every cell — your BPM estimates, your diagnosis, and the treatment priority you would assign. Filling in the table earns up to 4 points toward your final grade.

PatientHeart Rate (BPM)Rhythm DiagnosisTreatment Priority

24-Hour Holter Monitor

This patient wore a portable monitor for one full day. Use the graph to answer the questions.

1. Approximately what time of day did the abnormal cardiac event occur?
2. The patient's heart rate spiked to about 170 BPM during the event. Which rhythm is most consistent with this finding?

Mastery Quiz

5 questions drawn at random from a 20-question bank. You need 60% to demonstrate mastery. Each question is worth 1 point.

Final Grade Report

Your full lab record, ready to print or save as PDF.

Patient Rhythm Log (your entries)

PatientHeart Rate (BPM)Rhythm DiagnosisTreatment Priority

Holter Trend Answers

Quiz Questions & Your Answers

Sentence Practice — Your Responses