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this is part 4 from my cardiac dysrhythmia book and this part begins about page 34 and in this section I want to talk about the graph paper because in order to be able to interpret ECG rhythms you have to understand what the graph paper represents Im also going to talk very briefly about paper speed with your cardiac monitor so if we look at the graph paper first of all with cardiac rhythm interpretation so specifically interpreting heart rhythms not looking at 12 lead ECGs but heart rhythms everything that we analyze is really on in reference to time so heart rate calculation is a time reference PR interval is a time reference QRS duration QT intervals all those things are time related and time is measured on the horizontal plane on on the graph paper as opposed to a 12-lead ECG where were looking at things on the vertical axis so for example SD changes above the baseline below the baseline those are vertical changes but for rhythm interpretation were interested in a time referenc