152

Level 1

QUIZ SOLUTION

P x x x x
QRS x x x x
T x x x x

ECG 1

This is an easy example, as P waves, QRS complexes, and T waves follow each other in a regular
fashion.

P x x x x x
QRS x x x x
T x x x x

ECG 2

As this is a more difficult example, use the technique of looking for the sharpest wave in order to
identify the QRS complexes (4 QRS complexes can be found in this example). The T wave appears
5–10 mm behind each QRS complex. The remaining 5 waves are not as sharp as the QRS complex,
but are sharper than the T wave and therefore must be P waves.

P x x x x x x x
QRS x x x x x x x x
T x x x x x x x x

ECG 3

It is important to note that the QRS complexes show 3 different morphologies in this example.
However, they can be identified as the sharpest waves. Furthermore, the T waves can be found
5–10 mm after each QRS complex. The P waves are not uniform and most are positive, but the 2nd
and the 4th P waves are negative.

Level 1 Quiz solution

 153

P x x x x x x
QRS x x x
T x x x

ECG 4

What makes this ECG a little bit tricky is the fact that P and QRS amplitudes are almost the same.
However, the QRS complexes have sharper edges than the P waves. Also, P and T waves inter­
fere with one another at some occasions (e.g., the 4th and the 6th P waves). Remember that the P
waves usually occur at very regular intervals. We should therefore be able to predict where the next
P wave should appear (this also applies to examples 1 and 2 above).

Level 1 Quiz solution