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    Lec7 Sem2 CVSWK3 20140920 PDF

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    Aprina Rosyadah
    This document provides an overview of electrocardiograms (ECGs) including: - The basic principle is that ECG waves are generated by the propagating depolarization and repolarization of the heart muscles. - The key components of an ECG are the P wave from atrial depolarization, the QRS complex from ventricular depolarization, and the T wave from ventricular repolarization. - A standard 12-lead ECG system measures electrical activity from both the limb leads and precordial chest leads to evaluate the heart's condition.

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    Lec7 Sem2 CVSWK3 20140920 PDF

    Uploaded by

    Aprina Rosyadah
    42 views12 pages
    This document provides an overview of electrocardiograms (ECGs) including: - The basic principle is that ECG waves are generated by the propagating depolarization and repolarization of the heart muscles. - The key components of an ECG are the P wave from atrial depolarization, the QRS complex from ventricular depolarization, and the T wave from ventricular repolarization. - A standard 12-lead ECG system measures electrical activity from both the limb leads and precordial chest leads to evaluate the heart's condition.

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    This document provides an overview of electrocardiograms (ECGs) including: - The basic principle is that ECG waves are generated by the propagating depolarization and repolarization of the heart muscles. - The key components of an ECG are the P wave from atrial depolarization, the QRS complex from ventricular depolarization, and the T wave from ventricular repolarization. - A standard 12-lead ECG system measures electrical activity from both the limb leads and precordial chest leads to evaluate the heart's condition.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    42 views12 pages

    Lec7 Sem2 CVSWK3 20140920 PDF

    Uploaded by

    Aprina Rosyadah
    This document provides an overview of electrocardiograms (ECGs) including: - The basic principle is that ECG waves are generated by the propagating depolarization and repolarization of the heart muscles. - The key components of an ECG are the P wave from atrial depolarization, the QRS complex from ventricular depolarization, and the T wave from ventricular repolarization. - A standard 12-lead ECG system measures electrical activity from both the limb leads and precordial chest leads to evaluate the heart's condition.

    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    of 12

    ELECTRO CARDIOGRAM ECG

    BASIC PRINCIPLE

    LEARNING OBJECTIVES
    At the end of the lecture the student should be able to know
    About ECG
    Basic principle in generation of ECG waves
    About ECG paper and its calibration
    About different leads and their arrangement
    About different components of ECG

    ELECTROCARDIOGRAM ECG
    Graph of electrical activity of heart

    Gold standard for diagnosis of cardiac arrhythmias

    Helps detect electrolyte disturbances (hyper- &


    hypokalemia)

    Allows for detection of conduction abnormalities

    Screening tool for ischemic heart disease during stress


    tests

    Helpful with non-cardiac diseases (e.g. pulmonary embolism or


    hypothermia

    PROPAGATING ACTIVATION WAVEFRONT


    At rest, cells have a negative transmembrane
    voltage surrounding media is positive
    When cells depolarize, they switch to a positive
    transmembrane voltage surrounding media
    becomes negative
    This leads to a propagating electric vector
    (pointing from negative to positive)

    PROPAGATING ACTIVATION WAVEFRONT

    BASIC PRINCIPLE OF ECG RECORDING

    Wave of depolarization traveling towards a positive


    electrode causes an upward deflection on the ECG

    Wave of depolarization traveling away from a


    positive electrode causes a downward deflection on
    the ECG.

    COMPONENT OF ECG
    WAVES
    P atrial depolarization
    QRS complex ventricular depolarization
    T ventricular repolarization
    SEGMENTstraight line between waves
    S-T segment
    end of ventricular depolarization to start of vent.
    Repolariztion
    INTERVAL---wave+segment
    P-R interval
    Q-T interval

    RECORDING ECG
    ECG PAPER
    Recorded on a calibrated graph paper
    Smallest divisions are 1mm square in both X and Y axis
    Runs at a paper speed of 25 mm/sec
    X axis represent time
    Y axis represents voltage
    On Y axis 1 mm=0.1 mV
    On X axis 1mm =0.04 sec

    VERTICAL AXIS
    1 small square = 0.1 mV
    10 small square =10 mV
    1 big square = 5 small square = 0.5 mV
    2 big square = 10 smallsquare= 1 mV
    ECG PAPER HORIZONTAL AXIS
    1 inch = 1 second
    Each inch is divided by dark black lines into 5 big square
    Each big square= 1/5=0.2 sec

    Each big square is further divided into 5 small square


    1 small square = 0.2/5= 0.04 sec
    1smallsquare = 0.04 sec =1mm
    1 second =25 smallsquare
    60second =1min =25 X 60=1500 small square =300 big square

    ECG PAPER CALIBRATION

    ECG LEADS SYSTEM


    Lead
    two electrodes which are placed on body surface and connected to
    ECG machine for measuring the potential fluctuations between two
    points
    Standard ECG has 12 lead system
    6 limb leads

    6 chest leads
    Another classification is
    Bipolar leads---- standard limb leads
    Unipolar leads---- augmented limb leads, chest leads

    BIPOLAR LIMB LEADS


    1 positive 1 neagtive elecrode
    Right arm always negative
    Left leg always positive
    L1 between LA(+) and RA(-)
    L2 between LF(+) and RA(-)
    L3 between LF(+) and LA(-)

    UNIPOLAR LEADS
    1 positive electrode
    1negative reference point
    Summation of 2 negative leads
    Augmented unipolar limb leads
    aVL,aVF, aVR
    Verticalplane
    Precordialchest leads
    V1-V6

    horizontalplane

    AUGMENTED LIMB LEADS


    aVR
    from Right Arm Positive
    Other 2limbs negative
    aVL
    from Left Arm Positive
    RA and LF negative
    aVF
    from Left Foot Positive
    RA and LA negative

    PRECORDIAL (CHEST) LEAD


    POSITION
    V1

    Fourth ICS, right sternal border

    V2

    Fourth ICS, left sternal border

    V3

    Equidistant between V2 and V4

    V4

    Fifth ICS, left Mid clavicular Line

    V5

    Fifth ICS Left anterior axillary line

    V6

    Fifth ICS Left mid axillary line

    ECG INFORMATIONIN DIFFERENT LEADS


    The 12 leads allow tracing of electric vector in all three
    planes of interest

    SUMMARY OF LEADS

    Bipolar

    Limb Leads

    Precordial Leads

    I, II, III

    (standard limb leads)


    Unipolar

    aVR, aVL, aVF (augmented limb leads)

    V1-V6

    ANATOMIC GROUPS

    P WAVE
    Depolarization of both atria;
    First upward deflection

    Duration less than 0.1 sec

    Followed by QRS complex


    Shape and duration of P may indicate atrial
    enlargement

    PR INTERVAL

    From onset of P wave to onset of QRS

    Normal duration = 0.12-2.0 sec (120-200 ms) (3-4 horizontal boxes)

    Represents atria to ventricular conduction time (through His bundle)

    Prolonged PR interval may indicate a 1st degree heart block

    QRS COMPLEX

    Represents ventricular depolarization

    Larger than P wave because of greater muscle mass


    of ventricles

    Normal duration = 0.08-0.12 seconds

    Composed of Q, R ,and S wave


    Q wave
    negative deflection after P wave
    Depolarization of septum
    Not always seen
    R wave
    First positive wave after Q or P
    S wave
    Negative
    J POINT
    Point where QRS complex returns to isoelectric line
    Beginning of ST segment

    ST SEGMENT
    Early repolarization of ventricles
    From Jpoint to onset of T wave

    T WAVE:

    Represents repolarization or recovery of ventricles

    Interval from beginning of QRS to apex of T is referred to


    as the absolute refractory period

    QT INTERVAL

    Measured from beginning of QRS to the end of the T


    wave

    Normal QT is usually about 0.40 sec

    QT interval varies based on heart rate

    EVENTS IN FORMATION OF ECG WAVES

    THANK YOU

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