Double speed 50 mm/sec

Double speed is a non-standard setting where the ECG waves will appear twice as wide as normal. This is because the ECG is recorded at twice the normal ‘paper speed’. At this setting, the calibration signal at the start of the trace will be 10 small squares wide instead of the usual 5 squares.

It has been said that this setting can help to visualise difficult P waves, but all it really does is stretch out the same trace without adding any new information. Using this setting can also create confusion because none of the normal methods for calculating rate, segments or intervals will apply. A better solution to uncover difficult P waves might be to record a full 12 lead ECG (because P waves might be more clearly seen in other leads), or consider recording a Lewis Lead.

See also: Rate

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In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Double speed 50 mm/sec Normal Axis Normal rate Limb leads ECG of the Week CC-BY-NC-SA
ECG of the Week – 19th November 2018 – Interpretation

This ECG is from a man in his 30s who presented with dyspnoea and chest tightness.

This ECG shows a normal ECG recorded with a non-standard calibration of 50 mm/sec, making the trace look twice as slow as it really was.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Double speed 50 mm/sec Hyperacute T waves Chest leads Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Hyperacute T-waves and Concordant ST Elevation seen in PVCs only

This ECG is from a man in his 50s who had chest pain. His only risk factor for ischemia was hypertension.

This ECG shows bigeminy with PVCs showing concordant ST elevation in V2 and hyperacute T waves in V4-6.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Double speed 50 mm/sec Hyperacute T waves ST elevation in a PVC Limb leads Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Hyperacute T-waves and Concordant ST Elevation seen in PVCs only
In the ECGquest archives, this ECG has been tagged with: - Chest pain Double speed 50 mm/sec Hyperacute T waves Inferior ST depression Acute Anterior MI 12-Lead Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
A 65 year old with chest pain, ECG recorded at 50 mm/sec

This ECG is from a man in his 60s who presented with sudden central chest pressure with nausea. He had a history of previous infarction 15 years ago. This was his initial prehospital ECG.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Double speed 50 mm/sec Anterior ST elevation Hyperacute T waves Inferior ST depression Acute Anterior MI 12-Lead Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
A 65 year old with chest pain, ECG recorded at 50 mm/sec

This ECG is from a man in his 60s who presented with sudden central chest pressure with nausea. He had a history of previous infarction 15 years ago. This was his second ECG, taken 35 min after the first.