ECG Guru - Instructor Resources

A gathering place for instructors of ECG and cardiac topics.


Subscribe to me on YouTube

All Blogs

Want Some Tips On Teaching Axis Determination? (Click Here For Full Text)

Sat, 09/12/2015 - 18:28 -- Dawn

Teaching Axis Determination


Frontal plane axis determination often strikes fear into the hearts of new ECG students and ECG instructors.  Instructors may struggle to make the topic relevant for their students, and students struggle to decipher all the complex “methods” that are offered for frontal plane axis determination.  

The “best” way to teach axis is to use the method that works for you.  First, YOU, as the instructor, need to understand the topic well.  There are many ways to approach the calculation of the frontal plane axis. Some methods are more suitable for some students than others.  You should keep in mind the student’s prior level of training, and the job that student uses ECG for.  

First, WHAT IS frontal plane axis?Axis is the measurement of the MEAN (or average) of all the electrical waves as they move through the heart muscle.  The ECG machine cannot show us all the tiny currents, so it combines the information from all the depolarization waves, and shows us the mean direction. The P wave has an axis, the QRS has an axis, and the T wave has an axis. 

Basics of ECG Rhythm Diagnosis Videos From Dr. Ken Grauer, M.D.

Tue, 06/23/2015 - 16:19 -- Dawn

Those of you who have followed the ECG Guru for a while are very familiar with the work of Dr. Ken Grauer, M.D.  He is a generous contributer to the ECG Guru website, and functions as our official Consulting Expert.  He has published many books and e-publications which are (in our opinion) some of the BEST ECG references available, and he has worked hard to keep them low priced to make them available to all of us.  He also offers seemingly endless ECG knowledge and insights for FREE, via this website, his own website, and social media.

Dr. Ken Grauer has recently been producing ECG instructional videos.  The latest is a three-part series (Videos 10, 11,  and 12), which tackle the topic of the BASICS OF ECG RHYTHM INTERPRETATION.  These videos cover the basics for those who are just beginning their ECG training, as well as for those who want a refresher.  More advanced concepts are included along the way to keep the interest of those who are already experienced.  There are also excellent examples of how to teach the basics for those of you who are instructors.  It is presumed that the viewer of the videos has a beginning background in health care sciences, and in anatomy and physiology.  To facilitate navigating through this 3-part (2 hour) video series, Dr. Grauer has made a LINKED CONTENTS that takes you to the precise place in the video for each given content area.  There you will also find links to Dr. Grauer's other publications and free resources.

Are You New to Laddergrams?

Fri, 02/20/2015 - 22:34 -- Dawn

A laddergram is a diagram of conduction through the heart, presented in a minimum of three tiers, one for the atria, one for the AV junction, and one for the ventricles.  Laddergrams are very useful for presenting and testing your theory of a dysrhythmia.  Instructors often use them to illustrate complex dysrhythmia mechanisms.  

If you don't yet have experience in using laddergrams, go to this LINK to find a short PowerPoint presentation that will give you the basics to get started.  Be careful - it can be a bit addicting to construct laddergrams, like working a puzzle.  If you want to use laddergrams to teach your students, this PowerPoint presentation can help you introduce them to the concept.  

Our thanks to Jason Roediger, ECG Guru and dysrhythmia expert, for the laddergram depicted here, and the many LADDERGRAMS featured in his blog posts on this site  to see the discussion accompanying this ECG, go to this LINK  (Warning: this is an ECG Challenge, which is advanced material)  

 “For another step-by-step review from Dr. Ken Grauer on How to Draw a Laddergram - Please check out Dr. Ken Grauer’s ECG Blog #69 - GO TO -


ECG TEACHING VIDEOS - An Important Tool For Teachers and Students Alike

Thu, 09/11/2014 - 23:40 -- Dawn

If you are a teacher, watching a masterful teacher present your topic can help you develop your style, and increase your own knowledge of your subject.  We don't all have the opportunity to attend live classes by the real ECG Gurus of the world, but many of them are now making FREE video lectures available to all of us. Even if you are not an instructor, for many of us, hearing and seeing the presentation is a more effective way to learn than just reading.    

ECG videos are plentiful on the Web.  That being said, we want to be careful who we learn from.  Anyone can publish anything now.  Fortunately, there are some really good teachers out there making videos.  The ECG Guru website would like to recommend two in particular:

Dr. Ken Grauer, MD, is a consulting expert for this website.  Most of you are aware of his website and his excellent print and e-pub publications.  But, he has recently begun making ECG instructional videos, and they are excellent!  Each video is presented in a methodical, organized way, with clear illustrations.  There is something for everyone, from the beginner to the advanced ECG user, including instructors.  To see Dr. Grauer's bio, go to this LINK.  Follow this link to watch his ECG videos.

Dr. Amal Mattu, MD, FACEP, is also well-known to regular readers of the ECG Guru website.  He is an Emergency physician and faculty member at the University of Maryland.  He presents an ECG Video of the Week every week, and they are outstanding!  You will love his conversational style, and his markup illustrations as he progresses through each week's case.  His focus is very clinical and practical, and he manages to be very entertaining as well.  If you are an instructor, you will learn a lot about teaching style from Dr. Mattu.  For his bio, go to this LINK.  Follow this link to his ECG Videos. 


jer5150's picture

Jason's Blog: ECG Challenge for the months of July and August, 2014.

This is an ECG I performed a couple of years ago on an asymptomatic 83-year old man as an outpatient procedure. 

The computer interpreted this as:  "Marked sinus bradycardia [with] Frequent Premature ventricular complexes".  IS THE COMPUTER CORRECT?  Is there more than one plausible interpretation?  What is the differential diagnosis?

jer5150's picture

Jason's Blog: ECG Challenge for the month of June, 2014.

This is an ECG I performed on a 65-year old man about 5 years ago.  He mentioned something to me about his past medical history before we got started but, in truth, I would have recognized it had he not told me beforehand.  What did he tell me and what does this ECG reveal? 

jer5150's picture

Jason's Blog: ECG Challenge for the month of May, 2014.

Patient data:  54-year old man who recently underwent a major cardiac procedure.  At first glance, this ECG may not appear to be particularly unique but a closer inspection reveals something unusual going on here. 

HINT:  The telling clue can be found in lead II but you'll have to use calipers and think "outside-the-box".  3 days after this ECG, the patient reverted back to sinus rhythm but continued to display this one finding.  Good luck! 

Spoiler alert!!!
Only click on these 2 links if you want the answer given to you.
Link 1
Link 2

Glossary of ECG Terms by Dr. Ken Grauer

Fri, 04/25/2014 - 17:20 -- Dawn
Dr. Grauer will continually expand and update his ECG terms glossary, so follow this link to view it in the latest version:  Glossary of ECG Terms.

This Glossary of ECG Terms is intended to accompany Dr. Grauer's newest publication, "A 1st Book on ECGs-2014".   It is not meant to be a complete glossary of all ECG terms, but is very good for helping your students navigate the early lessons.  They will  find Dr. Grauer's book very helpful, also.