12-Lead ECG Course

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ECG Course Level: Intermediate to Advanced.  The Online 12-Lead ECG Course’s only prerequisite is a fundamental knowledge of the anatomy and physiology of the heart. The goal of the course is to teach the student to Analyze Not Memorize.  This comprehensive ECG course covers topics from the normal pattern, STEMI, nonSTEMI, Bundle Branch Blocks, LAFB, LVH, WPW and ultimately to analyze changes associated with the changes of  the  acute MI/Ischemia.

This is a step-by-step, self-paced course that is a hybrid of online material and written material.  The 12-lead ECG Course is designed to be taken at the convenience of the participant’s schedule as a home-study, self-paced course. When your schedule requires a break, an online bookmark will bring you back to your last page. At this point you can continue or you are allowed to review the material previously covered. You cannot skip any material but must cover each new Module in order.

Each registration includes a suggested syllabus to assist in completion of the course.  There are 10 online Modules in this course. Homework Sets and Quizzes are scattered throughout the online portion. The questions are multiple choice, fill-in-the-blank and matching and are immediately graded online. The student must pass with a minimum 80% score or review and retest. A score of 80% is required to proceed to the next module. The student may review all previous material as much as he/she wishes but will not be allowed to skip ahead.

This Online 12-Lead ECG Course is written for the broad audience of:

  • Physicians & Medical Students
  • Midlevel Practitioners & Students
  • Nurses & Nursing Students
  • EMS Personnel
  • Monitor Techs
  • Exercise Physiologists
  • Respiratory Therapists
  • Medical Chart Reviewers (including insurance)
  • Paralegal Forensics
  • Nurse Anesthetists & Nurse Anesthetist Students

Each Online Module will include one or more of the following:

Topics Covered

A detailed outline of contents of the module.

Student Assignment

Assigned reading from the textbook and workbook (offline).

Diagrams and 12-Lead ECG Tracings

A series of diagrams and tracings with special comments regarding the topic. The ECG Tracings will represent examples of all the classic patterns you will encounter in your practice of medicine. They are carefully labeled to show the salient features of each pattern.

Homework & Quiz Sets (graded online with immediate feedback)

  • 15 Practice Tracing Sets of 5 each (total of 75 Tracings) multiple choice matching.
  • 7 homework sets consisting of a total of 80 fill-in-the blank or true/false questions with interactive answers.
  • 3 quizzes consisting of a total of 30 samples of tracings with interactive answers.

The Final Exam of 100 questions, in a similar format to all previous quizzes, is graded online for immediate feedback.  The final can be taken up to three times to achieve a minimum passing score of 80%.

Upon completion, a certificate will be available to the student to download and print for presentation to his/her medical board, hospital or organization for CME or CE credit. This course is an online course but also include materials to keep after the online portion is complete. You are not required to test at a distant center unless you are required to do so by your university or hospital.


When you register for the online 12-lead ECG course, all written materials will be mailed to you using the shipping of your choice.  Standard Free Shipping will be received within 7-10 business days via Media USPS or 3-4 business days by Priority USPS.  These time estimates do not include weekends or holidays.  Please note that shipping times may not apply to orders from Alaska, Hawaii or Canadian orders which may take longer to process and ship.  At this time, ECGcourse.com does not provide any international shipping/order processing except to Canada. We apologize for any inconvenience. All order information is cross-referenced and verified before being processed. All rights reserved.

You may register online credit card through our secured payment portal or pay via check or money order. Please note that for all orders paid via check/money order, your materials will not be sent until payment has been received. Make checks payable to “ECGcourse.com, LLC” and mail to 36 Augustus Road, Fayetteville, WV 25840.


There is a 30-day money back guarantee (minus a $25.00 restocking fee) for the 12-lead ECG Interpretation Course.  Priority and Express mail fees cannot be refunded.  Returns must meet the following conditions:

  1. Materials must be in new condition with no marks, pen, pencil, spills, tears, bends or any signs of use
  2. The online portion of the course has not been more than 25% completed

To begin a return, please contact us at info@ecgcourse.com and include the title of your original purchased course.  Once the materials have been received and have been shown to be in excellent and new condition, the refund will be issued back to the card used for original purchase. Materials which are in used condition with any of the above issues (marks, pen, pencil, spills, tears, bends and any signs of use) will not be accepted for return. Any such items will be returned to the customer and the refund will be reduced by the retail cost of the used item. Checks will be issued for check/money order purchase and only to the individual or corporation making the original purchase. Please allow 3-4 weeks for the entire refund to take place – from initial shipping from the customer to credit back to the customer’s card.

Time Requirement

Time investment will depend on the student’s background and previous knowledge of electrocardiography.  The estimated online time requirement is 30 clock hours online. The course is designed to be taken at the convenience of the student’s schedule.  In order to receive credit, the student must read the text, workbook, complete all homework, quizzes, and the comprehensive examination.

Note: If you are taking this online ECG course through one of our Partners, (see EDUCATION PARTNERS), the Final Exam may be retaken as per the guidelines of your Institution, i.e. if your submitted Final Exam score is less than a specified pass rate (non-partners passing is 75%), then you may retake the Exam at your convenience and resubmit. The number of allowable retakes and passing score will be specified by your school or institution.

INTERNATIONAL Shipping: Please note, ECGcourse.com does not provide international services, except to Canada. No other exceptions made.  All rights reserved.

Online 12-lead ECG Course Outline

  1. Electrical System of the Heart
    1. Anatomy
    2. Concept of Automaticity
    3. Components of the P-QRS-T Complex
    4. Intervals and their Normal Range: PR Interval, QRS Duration, QT Interval
  2. Attachment of the Leads
    1. Limb Leads and Einthoven’s Triangle
    2. Precordial Leads
  3. Vector Concepts
    1. Frontal Plane
    2. Transverse Plane
  4. Predicting the waveshape of the Normal 12-Lead ECG
    1. Polarity of deflection on the ECG
    2. Depolarization sequence and direction of the normal heart
    3. Leads associated with areas of the heartd
    4. Parameters defining the normal 12-Lead ECG
    5. Development of the predicted waveshape of the normal 12-Lead ECG
    6. R-wave progression and the transition zone
  5. Characteristic of the T-wave
    1. Asymmetrical wave
    2. HyperAcute T-wave
    3. Inversion vs. upright
  6. Characteristic of the ST-segment
    1. ST-segment baseline
    2. ST-segment elevation: (1). concave down, (2). concave up
    3. ST-segment depression
  7. ECG changes of ischemia
  8. ECG changes of injury (acute myocardial infarction)
  9. Concept of Reciprocity
  10. ECG changes of old infarction
  11. Locating the STEMI
    1. Associated Leads with specified area of heart: (1). Inferior, (2). Septal, (3). Anterior, (4). Lateral, (5). High Lateral
    2. Location of Reciprocal Leads
    3. Right ventricular infarction
    4. Posterior infarction
  12. Development of the Patterns of the Following Aberrant Conduction
    1. RBBB
    2. LBBB
    3. Left Anterior Fascicular Block (LAFB)
    4. Bifascicular Block
    5. Preexcitation Syndrome (WPW)
    6. Left Posterior Fascicular Block (LPFB)
    7. Primary and Secondary T-wave changes of RBBB and LBBB
  13. Hexaxial System
    1. Definition of Axis of Frontal Plane
    2. Categories: (1). Normal Axis, (2). Right axis deviation, (3). Left axis deviation, (4). Severe right axis deviation
    3. Calculation of axis (examples)
    4. Rapid method to recognize axis more negative than -30 degrees
  14. Concept of Hypertrophy
  15. Criteria of LVH
  16. Waveshape Distortion Due to LVH (STEMI Mimic)
    1. ST-T changes of repolarization (strain)
    2. Precordial Q-waves and ST-segment elevation (pseudoinfarction patterns)
  17. Concept of Sensitivity and Specificity
  18. Hypertrophy Criteria Related to Age of the Patient
  19. Systematic approach to 12-Lead Analysis
    1. Mnemonic with utilization of the acronym H-E-A-R-T to apply to every ECG
    2. Example tracings interpreted with use of acronym and “Stanley’s Heart Rule”
  20. Putting it all in perspective
    1. The LVH pattern and its associated ST-T changes and Q-waves
    2. The LBBB pattern and its associated ST-T changes and Q-waves. Emphasis on the hazard (virtual impossibility) of diagnosis of the acute MI
    3. ECG changes of ventricular aneurysm
  21. Revisiting ST-segment Elevation
  22. Revisiting ST-segment Depression
  23. Revisiting T-wave Inversion
  24. Revisiting Q-waves
  25. Important Truisms: One-liners frequently misunderstood by the practitioner

CMEs and CEs

Continuing Education

The 12-lead ECG Course has been accredited for 30 hours of Continuing Education by the following organizations*:

  • CME Category I endorsed by the AMA (Physicians Recognition Award)

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Prairie/HSHS, Prairie Education and Research Cooperative and ECGcourse.com, LLC.  Prairie/HSHS is accredited by the ACCME to provide continuing medical education for physicians.  Prairie/HSHS designates this educational activity for a maximum of 30 hours AMA PRA Category I Credits™.

  • CE for Nurses endorsed by the WV Board of Examiners for Registered Professional Nurses

    This activity has been approved by the West Virginia Board of Examiners for Registered Professional Nurses(Provider Number WV2006-0505) for 30 CEs. Because regulations vary with each state nursing board, we recommend that the practitioner check with his/her individual state nursing board to ensure that credit granted upon completion of the course will be honored.

*Please note that for customers requiring credit by reciprocity for any organization not listed above, it is the sole responsibility of the customer to check with their continuing education governing body to ensure that the above course credit is accepted by that governing body. It is advised that this be checked before online registration is completed.

Education Certificates

Upon completion of the Online 12-lead ECG Course you will be prompted to download and print your certificate of 30 hours continuing education according to your registration as CME Cat I or CE.

This course is a distance learning course and you are not required to test at a distant center. Your testing is ongoing and is strictly online (unless you are required to test differently by your university or hospital).

Written Materials Supplied with the Online 12-Lead ECG Course

  1. Textbook – 200 page text in B&W and color

    A refinement of Dr. Stanley’s lecture notes from years of teaching this subject.
    *Included in this course or can be purchased separately through The Book Store.

  2. Workbook – 145 page supplement to the Textbook

    It includes 9 practice worksheets and a 19-page, interim workshop exam. Particularly beneficial to the independent student. *Included in this course or can be purchased separately through The Book Store.

  3. Tracing Manual

    Over 200 tracings pulled from Dr. Stanley’s 30+ years of emergency practice. *Included in the online course only and cannot be purchased through The Book Store.

  4. Heart Rule – 2.5″ x 10″ laminated guide to carry for quick reference and measurements

    A handy reminder to keep in your pocket for ready reference and measurements.
    *Included in this course or can be purchased separately through The Book Store.

Shipping of Materials

Written materials will be received via USPS. The shipping fee is included in the cost of the registration fee if Free shipping option is selected. **Please note that for orders, including those to Canada, there may be a brokerage COD fee due on delivery. This fee is not covered by ECGcourse.com and will not be refunded to the customer should it be incurred. **We are unable to process international orders, except to Canada. All order information is cross-referenced and verified before being processed. All rights reserved.