Click to jump directly to one of the following categories:     ----------------点击链接直接跳至某一类型：      

--------P波时限80——110ms，形态 I,II 导联直立，aVF直立或倒置；III，aVL，V1，V2倒置或双相。幅度小于2.5mm，在V1导正向偏差小于1.5mm，负向偏差小于1mm。

• Usually isoelectric (flat) but may vary by approximately 1mm above or below.

• Morphology: Upright in I, II, V3-V6. Inverted in aVR and V1. Maybe be upright, flat, or biphasic in other leads.
• Amplitude: Usually <6mm (limb leads) or <10mm (precordial leads)

• Corrected QT interval (QTc) duration: 300-460ms
• To calculate QTc: QTc = QT/sqrt(RR interval)

• Normal P wave morphology and axis              -----------P波形态和P波电轴正常
• Every P wave is followed by a QRS complex, and vice-versa     ----------每个P波后跟一个QRS波，反之亦然
• Atrial rate is 60-100 bpm and regular        --------------------房率60——100 bpm 且规整

• Normal P wave morphology and axis    ---------P波形态和P波电轴正常
• Gradual change in PP interval         ---------------PP间期缓慢变化
• Longest and shortest PP intervals vary by >160ms or 10%   -----------最长和最短PP间期差别大于160ms 或 10%

• Normal P wave 
• Rate <60 bpm

• Normal P wave
• Rate >100 bpm

• Conducted: Abnormal P wave that is premature relative to normal PP interval, and QRS complex is similar in morphology to QRS complex present during sinus rhythm.   -------下传：异常P波相对于正常PP间期提早发生，并且QRS形态与窦性节律QRS形态相似。
• Non-conducted: Premature and abnormal P wave that is not followed by a QRS complex.

未下传：异常P波提早发生并且后面没有跟随QRS波。

• With aberrant intraventricular conduction: Premature P wave followed by a QRS with abnormal morphology.

• P wave axis or morphology different from sinus node  ----------P波电轴或形态与激动起源于窦房结的P波不同
• Three or more beats in succession at a rate of 100-180 bpm (up to 240)  -------三个以上（含三个）连续心拍速率100——180bpm（最高可达240bpm）
• Regular rhythm ------节律规整
• Normal QRS follows each P wave ------每个P波后跟正常QRS波

• Regular rhythm, rate >100 bpm 
• P wave not easily identified        -------------节律规整，心率大于100bpm，P波不容易识别

• Rapid regular atrial undulations at 240-340 per minute  -----------快速规则的心房波动，速率每分钟240——340次
• Typical atrial flutter morphology usually present in the inferior leads II, III, and aVF (”sawtooth” appearance)  -------典型的心房扑动形态常常在下壁导联II，III，aVF出现。（“锯齿形”）
• QRS complex may be normal or aberrant    -------------QRS波群可正常或异常

• P waves absent         ---------P波消失
• Atrial activity is totally irregular, causing random oscillation of the baseline. ------------心房活动完全不规则，导致基线的随机振动
• Ventricular rhythm is irregular.   --------心室节律不规整

• Uniform: A wide QRS complex that is premature relative to the normal RR interval and not preceded by a P wave; morphology of VPC’s is the same.

---------单形：宽大的QRS波相对于正常RR间期提早发生，并且前面无P波；室性期前收缩的形态相同。

• Multiform: VPC’s with >1 morphology    -------多形：室早心拍的形态大于一种

• Succession of 3 or more premature ventricular beats at a rate of >100 per minute.  -------连续三个以上（含三个）室性早搏拍，速率大于100 /min
• RR interval is usually regular but may be slightly irregular at its initiation.  -----------RR间期通常规则，但是在室速发生一开始轻微的不规整

• Rapid, irregular, and chaotic ventricular rhythm with undulating baseline and no distinct QRS complexes.

• In lead V1, biphasic P wave with a large and wide terminal portion (1 box wide and 1 box deep).
• In lead II, a humped P wave with >40ms between the first and second atrial components (humps).

--------在V1导联，P波双相，终末部分大且宽（一个方格宽 和 一个方格深）

--------在II导联，P波呈驼峰状，心房构成的第一部分和第二部分之间相距大于40 ms（ 前半部分代表右心房，后半部分代表左心房）

• Biphasic P wave in lead V1, with the first (positive) component larger than the second (negative), or

--------V1导联P波双相，第一部分（正向的）大于第二部分（负向的），或者

• P wave height larger than 2.5mm in any limb lead        ------------P波高度在任何一个肢体导联大于 2.5 mm，（I,II,III,aVR,aVL,aVF）

• PR interval >200ms (may be as long as 800ms)   ------PR间期 大于200ms （ 可能长达800 ms）
• Each P wave followed by a QRS complex.  ------------每个P波后跟一个QRS波

• Progressive prolongation of the PR interval and shortening of the RR interval until a P wave is blocked (i.e. not followed by a QRS complex)       ---------------PR间期递增性的延长，RR间期缩短直到一个P波阻滞（即后面未跟一个QRS波）

• Regular sinus or atrial rhythm with intermittent nonconducted P waves    -----规则的窦性或房性节律伴随间歇性的未下传P波
• PR intervals in the conducted beats are constant.      --------下传心拍的PR间期不变

• Regular sinus or atrial rhythm with two P waves for each QRS complex (i.e. every otehr P wave is nonconducted)
• Note: Can be Mobitz type I or II 2nd degree AV block.

---------规则的窦性或房性节律，每个QRS波前有两个P波（即 每隔一个P波出现一个未下传P波）

---------注意：可以是Mobitz I 型 或是 Mobitz II 型 2 度房室阻滞

• Atrial and ventricular rhythms are independent of each other.  ----------心房和心室节律彼此独立
• Atrial rate is usually faster than the ventricular rate.      -------------房率一般比室率快

• Prolonged QRS duration (>120 ms)     ----------------QRS 时限延长（ 大于120 ms）
• Broad R waves in leads V5 and V6 that are usually notched or    ----------V5 和V6导联R波宽，常有切迹，或者
• Dominant S wave (either rS or QS) in V1 and/or V2      -------------V1 和/或V2 S波为主（ rS型或QS型）
• Note:     --------注意：
  • LBBB interferes with determination of QRS axis and ECG diagnoses of ventricular hypertrophy and acute MI. 

 ------------左束支阻滞 会干扰 QRS电轴的确定 和 心室肥大和急性心梗的诊断。

• Prolonged QRS duration (>120 ms)      -------------QRS时限延长 （ 大于120 ms ）
• Secondary R wave (R’) in leads V1 and V2, with R’ usually taller than the initial R wave.  -------V1和V2导有R' 波，R' 波常高于起始R波 
• Wide S wave in lead 1   -----------------------导联1  有 宽S 波    ( 到底是那个导联？？)
• Note:  -----------注意：

• RBBB does not interfere with the ECG diagnosis of ventricular hypertrophy of acute MI.  --------右束支阻滞不影响心室肥大和急性心梗的诊断
• In RBBB, mean QRS axis is determined by the initial unblocked 60-80ms of the QRS, and it should be normal unless left fascicular blocks are present.      ----------右束支阻滞心电图，平均QRS电轴通过起始无阻滞的60—80ms的QRS波确定，QRS电轴应该是正常的，除非存在左侧分支阻滞。

• Limb leads only: Amplitude of the entire QRS complex (R+S) <5mm in all limb leads. ---------仅肢体导联：在全部肢体导联整个QRS波幅度（R波+S波）小于 5mm。
• Limb and precordial leads: Amplitude of the entire QRS complex (R+S)<5mm in all limb leads and <10mm in all precordial leads.

    ---------肢体导联和胸前导联：所有肢体导联QRS幅度小于 5 mm 并且 所有胸前导联小于 10 mm。

• Possible causes include: chronic lung disease, pericardial effusion, obesity, pleural effusion, restrictive cardiomyopathies, etc.

 ---------可能的原因包括： 慢性肺疾病，心包积液，肥胖，胸腔积液，限制性心肌病等。

• Mean QRS axis is >-30° ------------平均QRS电轴 大于 -30 度 （-------小于-30度为左偏）
• Possible causes include: LBBB, LVH, inferior wall MI, etc.  --------可能的原因包括：左束支阻滞，左心室肥厚，下壁心肌梗死等。

• Mean QRS axis is >90°  -----------平均QRS电轴 大于90 度
• Possible causes include: RVH, dextrocardia, lead reversal, etc.  ------可能的原因包括：右心室肥厚，右位心，导联接反，等。

• Cornell criteria: R wave in aVL + S wave in V3      --------Cornell 准则：aVL导联的R波 + V3导联的S波，男性大于24mm，女性大于20mm。 （----------Cornell准则 男性电压界限值其他地方定义为28mm, 参见网址 http://www.ecglibrary.com/lvhlah.html 也可以参考《心电图学》郭继鸿主编）
  • >24mm in males
  • >20mm in females.
• Precordial leads: R V5 or V6 + S V1 > 35mm   ----------心前导联：RV5+SV1  或者 RV6+SV1 大于 35mm
• R aVL       ------- aVL导联R波，男性大于11mm，女性大于9mm 
  • > 11mm in males
  • > 9mm in females

• T wave abnormalities (flipped/inverted), usually seen in leads I, aVL, V5, and V6  ----T波异常（翻转/倒置），常见于I，aVL，V5 和V6导联。

• Right axis deviation (mean QRS axis >90&deg) or        --------心电轴右偏（平均QRS电轴大于90度） 或 
• R wave > S wave in lead V1 or                                -------------V1导联 R波大于S波  或
• R wave > 7mm in lead V1                    ---------------------V1导联R波大于7mm

• T wave abnormalities (flipped/inverted) in V1-V3          ---------在V1至V3导联T波异常（翻转/倒置）

• Abnormal Q waves        ------------Q波异常

• Duration >30ms for most leads (>40ms in leads III, aVL, aVF, and V1)     --------大多数导联Q波时限大于30ms（III，aVL，aVF和V1导联大于40ms）
• Indicates necrosis      ------------意味出现坏死

• ST segment elevation (acute myocardial injury)     -------ST段抬高（急性心肌损伤）
  • >1-2mm elevation in two more more contiguous leads  -----在两个以上相邻导联 ST抬高大于1—2 mm
  • Usually upwardly convex       -----------通常上凸       
  • Can last 48 hours to 4 weeks after MI  --------可在心梗发生后持续48 小时到4周
• T wave inversions         ------------T波倒置
  • Indicates ischemia       -----------意味着缺血
  • May persist indefinitely    ---------可能会一直持续下去
• Determining age of infarct from ECG:    -----------从心电图确定梗死的时期：
  • Acute MI: Abnormal Q waves, ST elevation. ------急性心梗：异常Q波，ST抬高 
  • Recent MI: Abnormal Q waves, isoelectric ST segments, inverted T waves.  ------近期心梗：异常Q波，等电位的ST段，T波倒置
  • Old MI: Abnormal Q waves, isoelectric ST segments, normal T waves.  ------陈旧心梗：异常Q波，等电位的ST段，正常T波
• Myocardial infarction vs. ischemia     ----------心梗和缺血的对比
  • Infarction: Abnormal Q waves; ST segment elevation or depression; T waves inverted, normal, or upright.
  • Ischemia: ST segment depression; T wave inversion; Q waves absent.

  -----梗死：异常Q波；ST段抬高或压低；T波倒置，正常或直立   --------缺血：ST段压低；T波倒置；无Q波

   

• Anterolateral infarction, recent or acute   ---------前侧壁心梗，近期或急性
  • ST segment elevation in leads V1-V6           --------------V1—V6导联ST段抬高
  • Abnormal Q waves (occur approximately 1 hour after onset)   -----异常Q波（心梗之后约一小时出现异常Q波）
  Anterior infarction, recent or acute  ------------前壁心梗，近期或急性
  • ST segment elevation in leads V1-V4        ---------V1—V4导联ST段抬高（   -----V1—V4 是前壁导联）
  • Abnormal Q waves (occur approximately 1 hour after onset)     -----异常Q波（心梗之后约一小时出现异常Q波）
  Anteroseptal infarction, recent or acute  ------------- 前间壁心肌梗塞，近期或急性
  • ST segment elevation in leads V1-V3    ---------V1—V3导联ST段抬高
  • Abnormal Q waves (occur approximately 1 hour after onset)    -----异常Q波（心梗之后约一小时出现异常Q波）
  Lateral infarction, recent or acute   -------侧壁心梗， 近期或急性
  • ST segment elevation in leads I and aVL   ---------I 和aVL导联ST段抬高
  • Abnormal Q waves (occur approximately 1 hour after onset)   -----异常Q波（心梗之后约一小时出现异常Q波）
  Inferior infarction, recent or acute   ---------下壁心梗， 近期或急性
  • ST segment elevation in at least two of leads II, III, aVF.   -------II, III, aVF 中至少有两个导联 ST段抬高  （-----II,III,aVF 是下壁导联）
  • Abnormal Q waves (occur approximately 1 hour after onset)    -----异常Q波（心梗之后约一小时出现异常Q波）
  Posterior infarction, recent or acute   --------后壁心梗， 近期或急性   ( 参考下面网址中的心电图 http://www.ecglibrary.com/postlat.html )
  • R wave in V1 and V2 (Q waves from the opposite side)     ---------V1 和V2导联有R波（ 来自反方向的Q波）
  • R wave > S wave             ---------R波高于S波
  • ST segment depression in V1 and V2        --------V1和V2 ST段压低

   

  Anterolateral infarction, age undetermined or old           -------------------前侧壁心梗，时期不确定 或 陈旧型
  • Same as recent/acute, but no ST segment elevation.        --------与近期/急性 相同，但是没有ST段太高
  Anterior infarction, age undetermined or old     --------前壁心梗，时期不确定 或 陈旧型
  • Same as recent/acute, but no ST segment elevation.  --------与近期/急性 相同，但是没有ST段太高
  Anteroseptal infarction, age undetermined or old  --------前间壁心梗，时期不确定 或 陈旧型
  • Same as recent/acute, but no ST segment elevation.   --------与近期/急性 相同，但是没有ST段太高
  Lateral infarction, age undetermined or old --------侧壁心梗，时期不确定 或 陈旧型
  • Same as recent/acute, but no ST segment elevation.   --------与近期/急性 相同，但是没有ST段太高
  Inferior infarction, age undetermined or old  --------下壁心梗，时期不确定 或 陈旧型
  • Same as recent/acute, but no ST segment elevation.    --------与近期/急性 相同，但是没有ST段太高
  Posterior infarction, age undetermined or old  --------后壁心梗，时期不确定 或 陈旧型
  • Same as recent/acute, but no ST segment elevation is characteristic of acute posterior injury.   ----与近期/急性 相同，但是没有ST段太高是急性后壁损伤的特征。

   

  QT interval abnormalities            --------QT 间期异常
  Long QT interval    ----------长QT间期
  • Corrected QT interval (QTc) >420-460ms.    -------QTc 大于420—460ms
  • (QTc = QT divided by the square root of the preceding RR interval)
  Long QT syndrome  --------长QT间期综合症
  • QT interval more than half of the cardiac cycle.   --------QT间期超过心脏周期的一半长
  Clinical disorders         --------临床疾患
  Digitalis effect    ------------洋地黄 效果
  • Sagging ST segment depression with upward concavity (”scooped out” ST)   ----下垂型ST段压低，有向上凹形（“像挖掘出来的”）   （---参见  http://www.ecglibrary.com/dig.html）
  Digitalis toxicity    ---------洋地黄中毒
  • Can cause almost any type of cardiac arrhythmia, except bundle branch blocks.  ------除了束支阻滞外，能引起几乎任何类型的心律失常
  • Typical abnormalities include: atrial and junctional premature beats, atrial fibrillation with complete heart block, 2nd or 3rd degree AV block, supraventricular tachycardia, etc.   -------典型的异常包括：房性和交界性早搏，房颤伴完全心脏传导阻滞，2度或3度房室阻滞，室上性心动过速，等。
  Hyperkalemia  ----------高钾血症
  • Moderate (K⁺ = 5.5-7.5 mEq/L):  ----------中度（钾离子毫克当量浓度 = 5.5—7.5 mEq/L) :
  • Tall, peaked T waves     -----------高大，尖峰型T波
  • Wide, flattened P waves  ----------宽大，扁平的P波
  • QRS widening -----QRS增宽
• Extreme (K⁺ > 7.5 mEq/L):        ----------重度（钾离子毫克当量浓度 大于 7.5 mEq/L）：
  • Disappearance of P waves   ---------P波消失
  • Markedly widened QRS      -----------显著的QRS增宽
  Hypokalemia ------------低钾血症
  • Prominent U waves      ---------U波突出
  • Flattened T waves    ---------扁平 T波
  • ST segment depression  ---------ST段压低
  Hypercalcemia  ---------高钙血症
  • QT shortening     -----------QT 间期缩短
  Hypocalcemia  ---------------- 低钙血症
  • Prolonged QT segment    ---------QT段延长
  Sick sinus syndrome (SSS)    ----------病态窦房结综合症
  • Can include one or more of the following:       ----------可以包含下面一个或多个特征：
  • Marked sinus bradycardia                   -------------显著窦性心动过缓
  • Bradycardia alternating with tachycardia     -----------心动过缓与心动过速交替出现
  • Atrial fibrillation  -------------房颤
  • Others…          --------其他特征