Clinical Resources
Step 1
Is the QRS narrow (<120 ms)?
Step 2
What is the ventricular rate?
Step 3
Is the rhythm regular or irregular?
Step 3b
Are P waves visible and identifiable?
Step 4
Can you identify P waves?
Step 4b
Are pseudo-R' waves present in V1 or pseudo-S waves in inferior leads?
Step 5
What is the RP interval relative to the PR interval?
Step 6 — Short RP
What is the P-wave axis / morphology in inferior leads (II, III, aVF)?
Step 6 — Long RP
What is the P-wave morphology?
Step 7
What is the flutter wave morphology in inferior leads?
Step 7 — Long RP
Is the P-wave morphology identical to sinus, or different (ectopic)?