About the ECG & Arrhythmias question bank
You are expected to read a 12-lead systematically and to recognise the rhythms that change what happens next in the lab. That means an ordered approach — rate, rhythm, axis, intervals, then morphology — applied fast enough to be useful while a patient is on the table.
This bank drills interpretation and the reasoning that follows it. It is not enough to name complete heart block; you need to know it may need pacing. It is not enough to spot ST elevation in II, III, and aVF; you need to name the artery and anticipate the hypotension that comes with a right-ventricular infarct.
What this bank covers
- A systematic approach to the 12-lead ECG
- Rate, axis, and interval measurement including QT and QTc
- STEMI localisation — which leads, which wall, which artery
- Reciprocal change and the posterior and right-sided ECG
- AV block: first degree, Mobitz I and II, and complete heart block
- Atrial fibrillation, atrial flutter, and the supraventricular tachycardias
- Ventricular tachycardia, VT versus SVT with aberrancy, and ventricular fibrillation
- Bundle branch blocks, hemiblocks, and paced rhythms
How to use it
- Always read in the same order. A fixed sequence is what stops you from anchoring on the first abnormality you see.
- Learn STEMI localisation as a table — leads to wall to artery — and rehearse it until it is reflexive.
- Any wide-complex tachycardia in an unstable patient is ventricular tachycardia until proven otherwise. The exam tests this repeatedly.
Frequently asked questions
Which leads show an inferior STEMI, and which artery is the culprit?
Leads II, III, and aVF. The culprit is the right coronary artery in the large majority of people, because it is dominant in roughly 85%; a dominant left circumflex causes the rest.
How do I distinguish VT from SVT with aberrancy?
Favour VT with AV dissociation, capture or fusion beats, extreme axis, very wide QRS, and a history of structural heart disease. When in doubt, treat as VT — the wide-complex tachycardia cheat sheet below lays out the full decision path.
What QTc is considered prolonged?
Broadly, above 450 ms in men and above 460 ms in women, with above 500 ms marking a substantially raised risk of torsades de pointes. Use the QTc calculator below to work it out from a measured QT and rate.