GENERAL EKG TECHNICIAN CERTIFICATION
General EKG Technician Certification Exam Prep
EKG Technician Exam Coming Up?
Make the time you have left count. Review high-value EKG concepts including cardiac conduction, lead placement, waves and intervals, heart-rate calculations, common rhythms, artifacts, and patient preparation.
Last-minute review for common EKG and ECG technician certification topics.
Short on Time? Start Here.
Not every topic deserves the same amount of attention when your exam is close. Focus first on concepts that connect directly to performing, evaluating, and understanding an EKG.
Lead Placement
Know where the electrodes go and how incorrect placement can affect the tracing.
Waves & Intervals
Recognize the P wave, PR interval, QRS complex, ST segment, T wave, and other basic tracing components.
Heart Rate
Know the common ways to calculate heart rate from EKG paper.
Rhythms
Practice identifying defining characteristics of common sinus, atrial, junctional, ventricular, and conduction rhythms.
Artifacts
Learn to recognize common tracing problems and their likely causes.
Patient Preparation
Review identification, positioning, skin preparation, electrode application, safety, and accurate recording.
Know the Electrical Pathway
SA Node
AV Node
Bundle of His
Right & Left Bundle Branches
Purkinje Fibers
Understand how the heart’s electrical impulse travels and connect that pathway to what appears on the EKG tracing.
Know Your EKG Paper
Horizontal measurement = time
Vertical measurement = voltage
Small boxes
Large boxes
Standard paper speed
Standard calibration
Using boxes to measure waves and intervals
Know What You’re Looking At
P wave
Represents atrial depolarization; the first small upward deflection before the QRS.
PR interval
Time for the impulse to travel from the SA node to the ventricles; normal is 0.12-0.20s.
QRS complex
Represents ventricular depolarization; signifies the main contraction phase of the heart.
ST segment
The flat line between QRS and T wave; elevation or depression can indicate ischemia.
T wave
Represents ventricular repolarization; the recovery phase before the next heartbeat.
QT interval
Total time for ventricular depolarization and repolarization; varies with heart rate.
Review these tracing components carefully. On the EKG exam, you will likely be asked to identify these waves and explain their clinical significance.
12-Lead Placement: Know This Cold
A standard 12-lead EKG uses 10 electrodes to produce 12 leads.
- V1: 4th intercostal space, right sternal border
- V2: 4th intercostal space, left sternal border
- V3: Midway between V2 and V4
- V4: 5th intercostal space, midclavicular line
- V5: Level with V4, anterior axillary line
- V6: Level with V4, midaxillary line
- Limb Electrodes: Right/Left Arms and Right/Left Legs
COMMON TEST TRAP
Electrodes and leads are not the same thing. A standard 12-lead EKG uses 10 electrodes.
Calculate the Rate
300 Method
Divide 300 by the number of large boxes between R waves.
Best for regular rhythms and quick estimations.
1500 Method
Divide 1500 by the number of small boxes between R waves.
Most accurate method for precise regular rhythm calculation.
6-Second Method
Count QRS complexes in a 6-second strip and multiply by 10.
Essential for irregular rhythms and atrial fibrillation.
Sometimes the Problem Isn’t the Heart
Many exam questions test whether you can spot technical problems on the tracing before assuming a cardiac issue.
Wandering baseline
A drifting tracing that doesn't stay on the center line. Often caused by oily skin, lotion, or loose electrode contact.
Somatic or muscle artifact
Jagged, irregular spikes on the baseline. Commonly caused by patient movement, shivering, anxiety, or Parkinson's tremors.
Electrical interference
Thick, consistent fuzzy baseline (60-cycle interference). Caused by nearby electronic devices, cell phones, or power cords.
Loose electrodes
Discontinuous or missing leads. Likely due to dried gel, diaphoresis (sweating), or chest hair requiring prep.
Incorrect lead placement
Negative P waves in Lead II or abnormal R-wave progression. Caused by switching limb leads or anatomical errors.
Recognize the pattern
Consider likely cause
Correct the problem
Obtain quality tracing
A Good Tracing Starts Before You Press Record
1. Identify the patient
2. Explain the procedure
3. Protect privacy
4. Position the patient appropriately
5. Prepare the skin
6. Place electrodes correctly
7. Reduce movement and interference
8. Acquire the tracing
9. Check tracing quality
10. Document and report according to procedure
Quick Reminder
- Hand hygiene
- Infection prevention
- Patient dignity
- Communication
- Privacy
- Scope of practice
- Accurate patient identification
Don’t Confuse the Monitoring Methods
RESTING 12-LEAD EKG
A short recording providing multiple electrical views of the heart.
HOLTER MONITOR
Continuous ambulatory monitoring over an extended period.
EVENT MONITOR
Used to capture intermittent events over a longer monitoring period.
TELEMETRY
Ongoing cardiac monitoring, commonly in a healthcare setting.
STRESS TEST
Evaluates cardiac activity while patient workload is increased under appropriate supervision.
Take the Cram Sheet With You
Review the highest-value EKG technician concepts in one downloadable study guide. Use it tonight, then come back to the final memory page for a fast review before your exam.
Learn One Concept at a Time
Readyward’s short EKG lessons break difficult concepts into quick explanations you can review when time is limited.
V1–V6 lead placement
10 electrodes vs. 12 leads
EKG paper
300 method
1500 method
P wave vs. QRS complex
Atrial fibrillation vs. atrial flutter
PAC vs. PVC
Ventricular tachycardia vs. ventricular fibrillation
Wandering baseline
Somatic artifact
Electrical interference
If the Exam Is Tomorrow
1
Memorize lead placement and key measurements.
2
Practice rate calculations until the process feels automatic.
3
Compare similar rhythms side by side instead of studying them separately.
4
Finish with artifacts, patient preparation, and common procedural mistakes.
You may not have time to relearn everything. Use the time you have to strengthen the concepts most likely to help you recognize the right answer.
Readyward provides independent educational study materials and is not affiliated with or endorsed by any certification organization. Exam content, requirements, terminology, and procedures may vary by certification provider and can change over time. Always verify current requirements with the organization administering your exam. Readyward content is for educational purposes and is not medical advice or a substitute for professional training or clinical protocols.