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An ECG (electrocardiogram) records the electrical activity of the heart from different angles to identify and locate pathology.
When learning to interpret ECGs, it is important to understand what a normal ECG looks like. This provides a foundation for recognising ECG abnormalities.
Normal 12-lead ECG
The image below shows a normal 12-lead ECG.
Features of a normal ECG
- Heart rate: 60 – 100 beats per minute
- Rhythm: regular, originating from the sinoatrial node (sinus rhythm)
- Cardiac axis: between -30° and +90°
- P waves: present, and each P wave is followed by a QRS complex
- PR interval: 120-200 ms (3-5 small squares)
- QRS complex: width <0.12 seconds, normal morphology and normal progression in chest leads (R wave amplitude increases from V1 to V6)
- ST segment: flat/isoelectric
- T waves: usually inverted in V1, and inversion in lead III is a normal variant
Want to learn more about ECGs?
Our ECG Case Collection contains over 85 cases to help you recognise common ECG abnormalities. Each case study includes a detailed explanation to help you master complex topics such as Wolff-Parkinson-White and Brugada syndrome.
Our comprehensive guide on how to read an ECG covers how to interpret ECGs using a systematic approach.
We have several other articles relevant to ECGs:
- Understanding an ECG: a guide to understanding the underlying concepts of ECGs
- Cardiac axis explained: a simple guide to the cardiac axis
- How to record a 12-lead ECG: an OSCE guide to recording a 12-lead ECG
- How to document an ECG: a guide to documenting your ECG interpretation in the notes
- Bundle branch block: a guide to left and right bundle branch block
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