12-lead Electrocardiographic Interpretation for Nurse Practitioners

Abstract This article introduces the basic concepts necessary to accurately interpret 12-lead electrocardiograms and a systematic approach to interpretation. The voltage and the direction of the electrical events of the heart are the foundation of the discussion. The translation of these electrical events from the 3-dimensional heart to 2-dimensional electrocardiographic paper via the 12 leads of the electrocardiogram is presented in detail. A systematic approach to comprehensive interpretation including rate, rhythm, intervals, axis, and morphology complete the introduction to this skill. Subtle abnormalities and less common abnormalities are presented.