Editing Electrocardiography (section)

=== A Method for Interpretation ===
Whitbread, consultant nurse and paramedic, suggests ten rules of the normal ECG, deviation from which is likely to indicate pathology.<ref>{{cite journal |last1=Whitbread |first1=Mark |title=Reading a normal ECG |journal=British Journal of Cardiac Nursing |date=January 2006 |volume=1 |issue=1 |pages=32–33 |doi=10.12968/bjca.2006.1.1.20382 }}</ref> These have been added to, creating the 15 rules for 12-lead (and 15- or 18-lead) interpretation.<ref>{{cite journal |last1=Mallinson |first1=Tom |title=Additional rules for reading an electrocardiogram |journal=Journal of Paramedic Practice |date=2 March 2023 |volume=15 |issue=3 |pages=95–97 |doi=10.12968/jpar.2023.15.3.95 }}</ref>

Rule 1: All waves in aVR are negative.

Rule 2: The ST segment (J point) starts on the isoelectric line (except in V1 & V2 where it may be elevated by not greater than 1&nbsp;mm).

Rule 3: The PR interval should be 0.12–0.2 seconds long.

Rule 4: The QRS complex should not exceed 0.11–0.12 seconds.

Rule 5: The QRS and T waves tend to have the same general direction in the limb leads.

Rule 6: The R wave in the precordial (chest) leads grows from V1 to at least V4 where it may or may not decline again.

Rule 7: The QRS is mainly upright in I and II.

Rule 8: The P wave is upright in I II and V2 to V6.

Rule 9: There is no Q wave or only a small q (<0.04 seconds in width) in I, II and V2 to V6.

Rule 10: The T wave is upright in I II and V2 to V6. The end of the T wave should not drop below the isoelectric baseline.

Rule 11: Does the deepest S wave in V1 plus the tallest R wave in V5 or V6 equal >35&nbsp;mm?

Rule 12: Is there an [[Epsilon wave]]?

Rule 13: Is there an J wave?

Rule 14: Is there a [[Wolff–Parkinson–White syndrome|Delta wave]]?

Rule 15: Are there any patterns representing an [[Myocardial infarction|occlusive myocardial infarction]] (OMI)?