Heart Rate Calculation Ecg Paper

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ECG Heart Rate Calculator

Small Square Method (1500 Rule) Large Square Method (300 Rule) 6-Second Method (Irregular Rhythm)

How to Calculate Heart Rate on ECG Paper

Electrocardiogram (ECG) paper is a standardized grid used to measure the electrical activity of the heart. To calculate the Heart Rate (HR) manually, you must identify the R-waves (the sharp peaks) and measure the distance between them (the R-R interval).

Standard ECG Paper Dimensions (at 25mm/s):
• 1 Small Square = 1mm (0.04 seconds)
• 1 Large Square = 5mm (0.20 seconds)
• 5 Large Squares = 1 second

Common Calculation Methods

1. The 1500 Rule (Small Square Method): This is the most accurate method for regular rhythms. Since there are 1,500 small squares in one minute (60 seconds / 0.04), you divide 1500 by the number of small squares between two R waves.

Example: If there are 20 small squares between R waves: 1500 / 20 = 75 BPM.

2. The 300 Rule (Large Square Method): Best for quick estimation. There are 300 large squares in one minute. Divide 300 by the number of large squares between R waves.

Example: If there are 4 large squares between R waves: 300 / 4 = 75 BPM.

3. The 6-Second Method: Essential for irregular rhythms like Atrial Fibrillation. Count the number of QRS complexes within a 6-second strip (30 large squares) and multiply that number by 10.

Understanding the Results

  • Normal Heart Rate: 60 – 100 BPM
  • Bradycardia: Less than 60 BPM
  • Tachycardia: Greater than 100 BPM
function updateLabels() { var method = document.getElementById("calcMethod").value; var squareInputGroup = document.getElementById("squareInputGroup"); var complexCountGroup = document.getElementById("complexCountGroup"); var label = document.getElementById("inputLabel"); if (method === "small") { squareInputGroup.style.display = "block"; complexCountGroup.style.display = "none"; label.innerText = "Number of Small Squares between R-R interval"; } else if (method === "large") { squareInputGroup.style.display = "block"; complexCountGroup.style.display = "none"; label.innerText = "Number of Large Squares between R-R interval"; } else { squareInputGroup.style.display = "none"; complexCountGroup.style.display = "block"; } } function calculateECGHeartRate() { var method = document.getElementById("calcMethod").value; var squareCount = parseFloat(document.getElementById("squareCount").value); var complexCount = parseFloat(document.getElementById("complexCount").value); var resultDisplay = document.getElementById("resultDisplay"); var interpretation = document.getElementById("interpretation"); var resultArea = document.getElementById("hr-result-area"); var bpm = 0; if (method === "small") { if (isNaN(squareCount) || squareCount <= 0) { alert("Please enter a valid number of small squares."); return; } bpm = 1500 / squareCount; } else if (method === "large") { if (isNaN(squareCount) || squareCount <= 0) { alert("Please enter a valid number of large squares."); return; } bpm = 300 / squareCount; } else if (method === "sixSec") { if (isNaN(complexCount) || complexCount <= 0) { alert("Please enter a valid count of QRS complexes."); return; } bpm = complexCount * 10; } var finalBpm = Math.round(bpm); resultDisplay.innerHTML = "Calculated Heart Rate: " + finalBpm + " BPM"; var note = ""; if (finalBpm 100) { note = "Interpretation: Tachycardia (Fast heart rate)"; } else { note = "Interpretation: Normal sinus rhythm range"; } interpretation.innerText = note; resultArea.style.display = "block"; }

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