Understanding ECG and Heart Rate Calculation
An Electrocardiogram (ECG or EKG) is a vital diagnostic tool that records the electrical activity of the heart over a period of time. This electrical activity is translated into waveforms on graph paper, allowing healthcare professionals to assess heart rhythm, rate, and detect various cardiac abnormalities.
How to Calculate Heart Rate from an ECG:
There are several methods to determine heart rate from an ECG tracing, depending on the regularity of the rhythm and the information available on the ECG strip. The most common and accurate methods involve measuring the time between successive R-waves (the peak of the QRS complex), which represent ventricular depolarization.
1. Using the R-R Interval (Most Accurate for Regular Rhythms):
This is the most direct and accurate method for calculating heart rate, especially when the heart rhythm is regular. The R-R interval is the time between two consecutive R-waves. The formula is:
Heart Rate (bpm) = 60 / R-R Interval (seconds)
For example, if the R-R interval is measured to be 0.8 seconds, the heart rate would be 60 / 0.8 = 75 beats per minute (bpm).
2. Using ECG Paper Measurements (When R-R Interval in Seconds is Not Directly Provided):
ECG machines typically print tracings on graph paper with standard grid lines. Each small box usually represents 0.04 seconds, and each large box (composed of 5 small boxes) represents 0.20 seconds. The paper speed is usually 25 mm/sec.
- For Regular Rhythms: Count the number of small boxes between two consecutive R-waves.
Heart Rate (bpm) = 1500 / Number of Small Boxes between R-R intervals
(This formula derives from 60 seconds/minute * 1000 milliseconds/second / (number of boxes * 40 milliseconds/box) = 1500 / number of boxes) - For Irregular Rhythms: A more practical approach is to count the number of QRS complexes within a 6-second strip and multiply by 10.
Heart Rate (bpm) = Number of QRS complexes in a 6-second strip * 10
The calculator above primarily uses the direct R-R interval in seconds for its calculation, assuming this value is precisely measured or known.
Example Calculation:
Let's assume an ECG tracing shows a consistent R-R interval of 0.75 seconds. Using the primary formula:
- R-R Interval = 0.75 seconds
- Heart Rate = 60 / 0.75 = 80 bpm
If, instead, you measured 30 small boxes between R-waves on an ECG strip and the paper speed was 25 mm/sec (meaning each small box is 0.04 sec), you would calculate:
- Number of Small Boxes = 30
- Heart Rate = 1500 / 30 = 50 bpm