Q How do you interpret a 12- lead electrocardiogram (ECG)?

A Patricia Hahn, RN,MN, ARNP, replies:

I asked myself that same question several years ago, and that is when I came up with a systematic approach to ECG interpretation, the ABCDE method. The name of this method is a mnemonic for th e interpretation steps: “A” stands for Analyze rhythm; “B” for Bundle branch block; “C” for Chamber enlargement; “D” for Determine axis; and “E” for Evaluate each area for injury, ischemia, and infarction.

Assess the long lead II tracing at the bottom of the ECG. Interpret the rhythm and measure the PR, QRS, and QT intervals. A QRS duration of 0.12 seconds or greater indicates a delay in ventricular conduction. This delay could be due to a ventricular pacemaker, ventricular rhythm, or a bundle branch block. This finding is important because what depolarizes abnormally will repolarize abnormally; that is,...

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