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This website revised:
May, 2009
This is an educational web site by Dr. Dale Dubin (Dale Dubin, M.D.), which includes important EKG (ECG) information about EKG tracings, 12 lead EKG's, and cardiac monitors. All web sites offer free PDF downloads.

To order Rapid Interpretation of EKG's, scroll to the bottom of the page.

For physicians, practical understanding of the routine twelve lead EKG and the display on cardiac monitors, provides an invaluable, diagnostic skill.

During the last century, medicine has come to recognize the enormous value of the standard twelve lead EKG. Few tests have provided the range of diagnostic utility and accuracy in determining the patient's medical progress.

Now every physician is expected to possess a reasonable level of expertise and skill in electrocardiography. National and state medical board exams test for competence in electrocardiography, as do most specialty boards; this is essential medical knowledge for all physicians.

In emergencies, the EKG is our mainstay for evaluating minute-to-minute changes in vital cardiac function during life-and-death crises. One cannot predict where and when spontaneous emergencies will arise. Regardless of the medical or social circumstances at hand, physicians are expected to exercise their special knowledge in these critical situations when a person's life is in jeopardy.

Cardiac monitors displaying the heart's electrical messages are standard equipment in critical care and emergency areas. But cardiac monitors are also utilized throughout hospitals. You are expected to understand and interpret this information at any instant. Your essential knowledge will serve your patients and the medical community well. Don't be intimidated… understanding is easy!

Physicians can effortlessly gain a crystal-clear understanding the heart's electrical messages with one simplified book, Rapid Interpretation of EKG's, the most popular and most referenced EKG (ECG) text in the world. The new, updated 6th edition in full color is now available.

This classic text, the international best-seller for over thirty-five (35!) years, is now updated with every printing (updated May, 2007), making it the most current text available. It stresses understanding rather than memorizing, so it instills in you a lifetime of practical knowledge… and the confidence you need for optimal, professional patient care.

This web site presents general information to physicians about electrocardiography, as both paper tracings and cardiac monitor displays. The presentations on "Memory Images" and "Interactive Learning" provide entertaining information that empowers you with very useful, easily learned, medical knowledge. See how fast you learn! Take pride in your new knowledge; put it to use immediately. And it is quite easy to acquire and comprehend, as you will soon see.

The section, "Life Preserver", demonstrates some EKG signs that may be present in apparently normal persons, yet the presence of these simple signs forebodes dangerous medical problems or even sudden death. By merely being attentive and observing these signs, you can then refer one of these patients for proper preventative treatment to become a "Life Preserver." By observation alone, you can save a meaningful life.

The presentation, "Monitor Warnings", uses the most advanced web site technology to portray accurate, animated reproductions of cardiac monitor warning signs in real time, just like the cardiac monitor displays that you see in person. Brief, practical interpretations are provided and carefully explained. Your computer screen should accurately display these cardiac monitor warning signs. All physicians need to know these signs in order to deliver responsible, lifesaving care.

For physicians already experienced with electrocardiography and cardiac monitors, we present "Tricky Tracings". And for physicians and physicians in training who want to learn more about identifying these common imposters once the correct answers are posted, we will provide reference page numbers for in-depth understanding (to avoid future pitfalls).

We also provide (free!) a simplified, step-by-step reference for interpretation of 12-lead EKG's, the classic Personal Quick Reference Sheets ("Reference Sheets"), previously available only by purchasing the book. This reference describes the standard methodology for interpreting EKG's. It also contains snips of example tracings… with brief explanations of each. This valuable quick review is yours to print out or quickly download as a PDF file. It's your free gift to keep for daily reference or for your personal library.

This site is both entertaining and vitally practical for professional patient care. The download speed depends on your computer. If you've read the information so far, everything should be ready. But if your computer requires more time, please be patient, for in the next few minutes you can easily acquire a wealth of useful information. Get a cup of coffee, relax, and enjoy the show as you absorb some practical knowledge.

The EKG (ECG), developed in 1901, persists as medicine's most important diagnostic tool, and it is surprisingly easy to understand and master.

Now standardized worldwide, the EKG provides critical diagnostic information to physicians and health-care professionals everywhere.

*Updated and revised
May, 2007

One book, Rapid Interpretation of EKG's, has made understanding the heart's electrical messages very easy.

  • Simplified comprehension that lasts a lifetime!

  • The international best seller for over 35 years!

  • Now updated with each printing*

  • Printed in 46 languages!

  • The new, updated 6th edition is currently available.

Every page of Rapid Interpretation of EKG's is illustrated:

  • each page has a large illustration of a simplified concept.

  • illustrated concepts are a permanent memory tool.


From Rapid Interpretation of EKG's copyright © 2017 COVER Publishing Co. Inc.


From Rapid Interpretation of EKG's copyright © 2017 COVER Publishing Co. Inc.

Simplified illustrations (with a caption explaining the concept) associate EKG and physiology for rapid comprehension through:

  • image association

  • memorable analogies

  • light and entertaining examples



From Rapid Interpretation of EKG's copyright © 2017 COVER Publishing Co. Inc.


Torsades de Pointes is a rapid ventricular rhythm caused by low potassium, medications (those that block potassium channels), or congenital abnormalities (e.g., Long QT Syndrome) that lengthen the QT interval. The rate is a variable 250 to 350 per minute, in brief episodes.



From Rapid Interpretation of EKG's copyright © 2017 COVER Publishing Co. Inc.

Follow the illustration closely. If the QRS is positive in lead I and also positive in AVF, the Vector points downward and to the patient's left. This is the normal axis range; the area that is both yellow and blue (yellow plus blue equals green.)


The printed text on each page is trimmed down to a few concise sentences that:

  • reinforce both the illustrated concept and its caption explanation.

  • approach the concept from various viewpoints.

Place your cursor in the blank to reveal the missing word.


From Rapid Interpretation of EKG's copyright © 2017 COVER Publishing Co. Inc.

The entire ventricular conduction system consists of rapidly conducting Purkinje fibers. The terminal filaments of the Purkinje fibers depolarize the ventricular myocardium, initiating ventricular contraction while inscribing a QRS complex on EKG.

NOTE: Remember that the entire ventricular conduction system, i.e., the His Bundle through the terminal filaments, is composed of Purkinje fibers.

Depolarization of the ventricular myocytes (myocardial cells) produces a complex on the electrocardiogram and initiates contraction of the ventricles.

NOTE: The QRS complex actually represents the beginning of ventricular contraction. The physical event of ventricular contraction actually lasts longer than the QRS complex, but we will still consider the QRS complex as generally representing the occurrence of ventricular contraction. So the QRS complex is an electrocardiographic recording of ventricular depolarization, which causes ventricular contraction. Still with me?




In each text sentence, a missing key word is required:

  • keeping conceptual information in focus.

  • maintaining the reader's personal satisfaction of achievement.

  • instilling permanent knowledge - a secure basis for diagnostic judgement.



From Rapid Interpretation of EKG's copyright © 2017 COVER Publishing Co. Inc.

A Premature Atrial Beat (PAB) originates suddenly in an irritable (see previous page) atrial automaticity focus, and it produces an abnormal P' wave earlier than expected. On EKG, a P' is atrial depolarization by a focus.

A Premature Atrial Beat (PAB) originates in an irritable atrial automaticity focus that spontaneously fires a depolarization stimulus earlier than the normal wave on EKG.

But because an atrial focus is the origin of this premature atrial depolarization (not the SA Node), the stimulus produces a premature and unusually shaped P' wave* that does not look like a normal Sinus-generated P .

NOTE: On EKG a PAB records as a P'. The P' may be difficult to detect when it's hiding on the peak of a T wave; the giveaway is a too-tall T wave - taller than the other T waves in the same lead.



Conceptual associations are linked so:

  • understanding proceeds effortlessly, for smooth learning continuity.

  • this continuity of linked images provides a seamless flow of comprehension.



From Rapid Interpretation of EKG's copyright © 2017 COVER Publishing Co. Inc.

With Right Ventricular Hypertrophy, the large R wave of V1 gets progressively smaller from V2 to V3 to V4 etc.

When Right Ventricular Hypertrophy is present, there is a large R wave in lead that becomes progressively smaller in chest leads V2, V3, and V4, as the leads move farther away from the hypertrophied right ventrical.

The progressive decrease in the height of the wave is gradual, proceeding from the right chest leads to the left chest leads.



Learning is easy, and visual imagery lasts a lifetime:

  • each visual concept relates to cardiac function.

  • mental images associated with cardiac physiology become an indelible resource (unlike the temporary nature of memorized patterns), because…

This method of programmed instruction may not suit every scientific discipline, but the 35-year success of this text is its own best endorsement. This is the best way for you to learn electrocardiography.




Knowledge of electrocardiography can be yours for a lifetime if you understand it. Rapid Interpretation of EKG's will make it happen.



For over 35 years (!) Rapid Interpretation of EKG's has been the global best seller. It is updated with every printing (updated May, 2007):

  • the preferred text for entertaining, easy reading.

  • an established medical classic known for lasting comprehension.

  • the most used, most referenced, and most current of all EKG texts.

  • number one in the United States and world-wide (published in 42 languages), since first published.

  • updated with each printing*, to keep it the most current EKG text.

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GREAT NEWS... for U.K. and European readers!
Dubin's Rapid Interpretation of EKG's (in English)
is available in your country...
Call: +44 (0) 1524 68765 or Fax: +44 (0) 1524 63232
Email: [email protected]

* Rapid Interpretation of EKG's
revised and updated May, 2007
To order:
Rapid Interpretation of EKG's
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North America & International
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+1 (800) 345-6425

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understanding provides lasting knowledge...


it assures confidence in emergency and stressful situations.
(Memorizing won't!) 
Take pride in your new knowledge!


Essential Information for Physicians

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