The heart rate can be determined by one of three methods:

• Method 1: Rapid Heart Rate Calculation - Count Large Boxes
• This method does not give exact rates, but is close enough for rapid rate calculation in regular rhythms.
• Method 2: Precise Heart Rate Calculation - Count Small Boxes
• This is the most accurate way to measure a regular rhythm.
• Method 3: Heart Rate in a 6-Second ECG Rhythm Strip
• This is the best method for measuring the heart rate in irregular rhythms.

Once the heart rate method is determined, include the following:

• Any pauses or extra beats such as premature atrial contractions (PACs), premature junctional contractions (PJCs), or premature ventricular contractions (PVCs) should be counted in the rate and written as such. Example: 80 beats per minute (bpm) counting PVCs.
• Include the heart rate (or bpm) of the underlying rhythm, if there is one, as the second rate. Example: 80 bpm (counting PVCs), 100 bpm in underlying rhythm.