Automated Electrocardiographic Diagnoses

Part I. Heart Rhythm Diagnoses

Class 1. Cardiac pacemakers

  • Sinus rhythm
  • Right atrial rhythm
  • Left atrial rhythm
  • Atrial rhythm
  • Low right atrial rhythm
  • Low left atrial rhythm
  • Low atrial rhythm
  • Ectopic atrial rhythm
  • Junctional rhythm
  • Junctional rhythm with aberrant ventricular conduction
  • Supraventricular rhythm
  • Idioventricular rhythm

Class 2. Wandering pacemaker

  • Wandering atrial pacemaker
  • Consider wandering atrial pacemaker

Class 3. Heart rate

  • Severe bradycardia
  • Bradycardia (<60 bpm)
  • Normocardia (60-100 bpm)
  • Tachycardia (>100 bpm)
  • Severe tachycardia
  • Tachycardia
    • regular rhythm
    • irregular rhythm
      • HR
      • Ventricular rate

Class 4. AV Dissociation

  • AV dissociation
    • escape complexes
    • transient
      • isorhythmia

Class 5. Fibrillation and flutter

  • Atrial fibrillation
  • Suggests atrial fibrillation
  • Atrial flutter
  • Atrial flutter with varying conduction
  • Suggests atrial flutter
  • Atrial fibrillation with third degree AV block
    • bradycardia
    • tachycardia
      • AV block or conduction ratio, 4:3
      • AV block or conduction ratio, 3:2
      • AV block or conduction ratio, 4:1
      • AV block or conduction ratio, 3:1
      • AV block or conduction ratio, 2:1

Class 6. Premature complexes

  • Atrial premature complex(es)
  • Junctional premature complex(es)
  • Supraventricular premature complex(es)
  • Left ventricular premature complex(es)
  • Right ventricular premature complex(es)
  • Ventricular premature complex(es)
  • Suggests atrial premature complex(es)
  • Suggests junctional premature complex(es)
  • Suggests ventricular premature complex(es)
  • Suggests left ventricular premature complex(es)
  • Suggests right ventricular premature complex(es)
  • Suggests ventricular premature complex(es)
    • early
    • late
    • interpolated
    • aberrantly conducted
    • nonconducted
      • occasional
      • frequent
      • couplets
        • monomorphic
        • polymorphic
          • bigeminy
          • trigeminy
          • quadrigeminy

Class 7. Paroxysmal tachycardia

  • Paroxysmal tachycardia
  • Paroxysmal tachycardia, consider atrial flutter
  • Atrial fibrillation, consider atrial flutter
    • sinus
    • atrial
    • junctional
    • supraventricular
    • ventricular
      • intermittent

Class 8. Pre-excitation syndrome

  • WPW pattern
  • WPW pattern, type A
  • WPW pattern, type B
  • Consider WPW pattern
  • Short PR interval
  • Consider pre-excitation

Class 9. Sinoatrial block

  • Sinoatrial block, type I
  • Sinoatrial block, type II
  • Sinus arrest or pause
    • conduction 4:3
    • conduction 3:2
    • conduction 4:1
    • conduction 3:1
    • conduction 2:1

Class 10. AV block

  • First-degree AV block
  • Second-degree AV block, Mobitz Type 1 (Wenckebach)
  • Second-degree AV block, Mobitz Type 2
  • AV block, advanced (high-grade)
  • Second-degree AV block
  • AV block, complete (third-degree)

Class 11. Parasystole

  • Parasystole
  • Suggests parasystole

Class 12. Unidentified arrhythmia

  • Unidentified arrhythmia

Class 13. Noise, drift, Filter

  • High noise level in leads
  • Baseline drift
  • Baseline drift in lead
  • Baseline drift in leads
  • Filter is on

PART II. QRS shape diagnoses

Class 1. General ECG conclusion

  • Normal ECG
  • Otherwise normal ECG
  • Abnormal ECG
  • Technical error, consider dextrocardia
  • Suggests dextrocardia
  • Misplaced specified electrodes: R & L

Class 2. QRS axis

  • Normal axis
  • Right axis deviation
  • Right axis deviation, consider right ventricular hypertrophy and left posterior fascicular block
  • Indeterminate axis
  • Left axis deviation, consider left anterior fascicular block
  • Left axis deviation

Class 3. Atrial syndrome

  • Right atrial enlargement
  • Suggests right atrial enlargement
  • Left atrial enlargement
  • Suggests left atrial enlargement
  • Atrial conduction abnormality

Class 4. Intraventricular block

Right bundle branch block
  • Complete right bundle branch block
  • Suggests incomplete right bundle branch block
  • rSr’ pattern in V1 or V2
Left bundle branch block
  • Complete left bundle branch block
  • Incomplete left bundle branch block
  • Suggests incomplete left bundle branch block and old anteroseptal myocardial infarction
  • Left anterior fascicular block
  • Suggests left anterior fascicular block
  • Left posterior fascicular block
Bifascicular and trifascicular block
  • Complete right bundle branch block and left anterior fascicular block
  • Complete right bundle branch block and left posterior fascicular block
  • Trifascicular block
  • Consider trifascicular block
  • Intraventricular block
  • Intraventricular conduction delay

Class 5. Myocardial infarction

  • Myocardial infarction
  • Suggests myocardial infarction
    • anterobasal
    • anterolateral
    • inferior
    • anteroseptal
    • extensive anterior
    • anterior and inferior
    • inferolateral
    • inferoseptal
    • inferoаpical
    • extensive inferior
      • acute
      • of indeterminate age
      • old
  • Abnormal Q wave, consider myocardial infarction, hypertrophic cardiomyopathy, coronary artery anomalies
  • Consider inferobasal myocardial infarction

Class 6. Ventricular hypertrophy

Right ventricular hypertrophy
  • Right ventricular hypertrophy, consider right ventricular strain
  • Right ventricular hypertrophy
  • Right ventricular hypertrophy, consider chronic obstructive pulmonary disease
  • Suggests right ventricular hypertrophy with strain
  • Suggests right ventricular hypertrophy
  • Suggests right ventricular hypertrophy with systolic strain
  • Suggests right ventricular hypertrophy with diastolic strain
Left ventricular hypertrophy
  • Left ventricular hypertrophy, consider left ventricular strain
  • Left ventricular hypertrophy
  • Left ventricular hypertrophy with systolic strain
  • Left ventricular hypertrophy with diastolic strain
  • Suggests left ventricular hypertrophy
  • Left ventricular hypertrophy by voltage criteria

Class 7. Other depolarization syndromes

  • SI SII SIII pattern, consider right ventricular hypertrophy, pulmonary disease
  • SI QIII TIII pattern, consider pulmonary embolism
  • Low voltage
  • High voltage
  • Electrical alternans

Class 8. ST and T changes

  • ST deviation
  • T-wave change
  • ST deviation and/or T-wave change
  • T-wave change
  • Nonspecific ST deviation
  • Nonspecific T-wave change
  • Nonspecific ST deviation with T-wave change
    • most evident
    • major
    • moderate
    • minor
    • possible
      • anterobasal
      • anterolateral
      • inferior
      • anteroseptal
      • anteroapical
      • extensive anterior
      • anterior and inferior
      • inferolateral
      • inferoseptal
      • inferoаpical
      • extensive inferior

Class 9. Other repolarization syndromes

  • ST elevation, consider myocardial infarction, pericarditis, early repolarization
  • ST elevation, consider pericarditis, early repolarization
  • Suggests ST elevation, consider myocardial infarction, pericarditis, early repolarization
  • Suggests ST elevation, consider pericarditis, early repolarization
  • Suggests early repolarization
  • Tall T-waves in V1-V4, consider inferobasal ST-T changes, hyperkalemia
  • ST elevation in V1-V4, consider enhanced vagal tone, hyperkalemia, inferobasal ST-T changes
  • Nonspecific T-wave changes T(V1) > T(V6)
  • Consider digitalis effect
  • Juvenile T waves
  • Short QT interval
  • Prolonged QT interval