These guidelines describe the criteria used to annotate ECGs in The ECG Quiz. They ensure consistency, reproducibility, and accurate scoring. You should follow these same rules when entering your diagnoses.
Important
Be sure to read how Differential Diagnoses and Multiple Interpretations are handled in The ECG Quiz.
| Diagnosis | Definition |
|---|---|
| Bradycardia | A rhythm ≤ 60 bpm for ≥ 3 consecutive RR intervals |
| Tachycardia | A rhythm ≥ 100 bpm for ≥ 3 consecutive RR intervals |
| Sinus Arrest | Sinus node inactivity ≥ 3 seconds |
| Ventricular Asystole | Ventricular inactivity ≥ 3 seconds |
| Block Type | Definition |
|---|---|
| First-Degree AV Block | PR interval ≥ 200 ms |
Premature complexes are included only if they are not already accounted for by another rhythm diagnosis.
Include Premature Atrial Complexes (PAC), Premature Junctional Complexes (PJC), and Premature Ventricular Complexes (PVC) when:
Include these diagnoses when there are ≥ 3 consecutive cycles of the repeating pattern.
Sinus Rhythm is a supercategory, not synonymous with Normal Sinus Rhythm.
Only use Sinus Rhythm when one of the specific sinus subcategories cannot be determined.
| Diagnosis | Sinus Rate |
|---|---|
| Marked Sinus Bradycardia | < 40 bpm |
| Sinus Bradycardia | ≥ 40 bpm and < 60 bpm |
| Normal Sinus Rhythm | ≥ 60 bpm and < 100 bpm |
| Sinus Tachycardia | ≥ 100 bpm |
Include these diagnoses when the ECG contains:
Rate-based differentiation:
| Diagnosis | Venticular Rate |
|---|---|
| Multifocal Atrial Tachycardia | ≥ 100 bpm |
| Wandering Atrial Pacemaker | < 100 bpm |
Include junctional rhythms when ≥ 3 consecutive junctional beats occur at the following rates:
| Rhythm | Rate |
|---|---|
| Junctional Bradycardia | < 40 bpm |
| Junctional Rhythm / Junctional Escape Rhythm | ≥ 40 bpm and < 60 bpm |
| Accelerated Junctional Rhythm | ≥ 60 bpm and < 100 bpm |
| Junctional Tachycardia | ≥ 100 bpm |
PJRT is a rare, often incessant orthodromic AV reentrant tachycardia using a slow, concealed accessory pathway. It may occur in children or young adults and can lead to tachycardia-induced cardiomyopathy.
For full PJRT educational content, see the dedicated page if available.
Important
Be sure to read how Differential Diagnoses and Multiple Interpretations are handled in The ECG Quiz.
References will be added soon.