1) An electrocardiogram (ECG) is a recording of the electrical activity of the heart over time via electrodes placed on the skin.
2) The ECG was discovered by Dutch physiologist Willem Einthoven, who is considered the father of the ECG.
3) An ECG is useful for diagnosing conditions like abnormal heart rhythms, heart attacks, and coronary artery disease.
1) An electrocardiogram (ECG) is a recording of the electrical activity of the heart over time via electrodes placed on the skin.
2) The ECG was discovered by Dutch physiologist Willem Einthoven, who is considered the father of the ECG.
3) An ECG is useful for diagnosing conditions like abnormal heart rhythms, heart attacks, and coronary artery disease.
1) An electrocardiogram (ECG) is a recording of the electrical activity of the heart over time via electrodes placed on the skin.
2) The ECG was discovered by Dutch physiologist Willem Einthoven, who is considered the father of the ECG.
3) An ECG is useful for diagnosing conditions like abnormal heart rhythms, heart attacks, and coronary artery disease.
1) An electrocardiogram (ECG) is a recording of the electrical activity of the heart over time via electrodes placed on the skin.
2) The ECG was discovered by Dutch physiologist Willem Einthoven, who is considered the father of the ECG.
3) An ECG is useful for diagnosing conditions like abnormal heart rhythms, heart attacks, and coronary artery disease.
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Electrocardiogram (ECG)
SURESH BABU EMANDI M.Pharm
Vikas Institute of Pharmaceutical Sciences
Near Air Port, Rajahmundry, Andhrapradesh-533102. Electrocardiography Electrocardiography is the technique by which electrical activities of the heart are studied. The spread of excitation through myocardium produces local electrical potential. This low-intensity current flows through the body, which acts as a volume conductor. • This current can be picked up from surface of the body by using suitable electrodes and recorded in the form of electrocardiogram. • This technique was discovered by Dutch physiologist, Einthoven Willem, who is considered the father of electrocardiogram (ECG). Electrocardiograph Electrocardiogram • Electrocardiogram (ECG or EKG from electrocardiogram in Dutch) is the record or graphical registration • of electrical activities of the heart, which occur prior to the onset of mechanical activities. • It is the summed electrical activity of all cardiac muscle fibers recorded from surface of the body. Uses of ECG • Electrocardiogram is useful in determining and diagnosing the following: 1. Heart rate 2. Heart rhythm 3. Abnormal electrical conduction 4. Poor blood flow to heart muscle (ischemia) 5. Heart attack 6. Coronary artery disease 7. Hypertrophy of heart chambers. ELECTROCARDIOGRAPHIC GRID • The paper that is used for recording ECG is called ECG paper. • ECG machine amplifies the electrical signals produced from the heart and records these signals on a moving ECG paper. • Electrocardiographic grid refers to the markings (lines) on ECG paper. • ECG paper has horizontal and vertical lines at regular intervals of 1 mm. • Every 5th line (5 mm) is thickened. Duration • Time duration of different ECG waves is plotted horizontally on X-axis. • On X-axis • 1 mm = 0.04 second • 5 mm = 0.20 second Amplitude • amplitudeof ECG waves is plotted vertically on Y-axis. On Y-axis 1 mm = 0.1 mV 5 mm = 0.5 mV Speed of the paper • Movement of paper through the machine can be adjusted by two speeds, 25 mm/second and 50 mm/ second. • Usually, speed of the paper during recording is fixed at 25 mm/second. • If heart rate is very high, speed of the paper is changed to 50 mm/second. ECG leads ECG is recorded by placing series of electrodes on the surface of the body. These electrodes are called ECG leads and are connected to the ECG machine. Electrodes are fixed on the limbs. Usually, right arm, left arm and left leg are chosen. Heart is said to be in the center of an imaginary equilateral triangle drawn by connecting the roots of these three limbs. This triangle is called Einthoven triangle. • ECG is recorded in 12 leads, which are generally classified into two categories. • I. Bipolar leads • II. Unipolar leads. BIPOLAR LIMB LEADS • Bipolar limb leads are otherwise known as standard limb leads. Two limbs are connected to obtain these leads and both the electrodes are active recording electrodes, i.e. one electrode is positive and the other one is negative. • Standard limb leads are of three types: Limb lead I Limb lead II UNIPOLAR LEADS • Here, one electrode is active electrode and the other one is an indifferent electrode. Active electrode is positive and the indifferent electrode is serving as a composite negative electrode. Unipolar leads are of two types: 1. Unipolar limb leads 2. Unipolar chest leads. Waves of normal ECG • Normal ECG consists of waves, complexes, intervals and segments. Waves of ECG recorded by limb lead II are considered as the typical waves. Normal electrocardiogram has the following waves, namely P, Q, R, S and T. • Einthoven had named the waves of ECG starting from the middle • of the English alphabets (P) instead of starting from the beginning (A). Major Complexes in ECG 1. ‘P’ wave, the atrial complex 2. ‘QRS’ complex, the initial ventricular complex 3. ‘T’ wave, the final ventricular complex Waves of normal ECG ‘P’ WAVE • ‘P’ wave is a positive wave and the first wave in ECG. It is also called atrial complex. Cause • ‘P’ wave is produced due to the depolarization of atrial musculature. • Depolarization spreads from SA node to all parts of atrial musculature. • Atrial repolarization is not recorded as a separate wave in ECG because it merges with ventricular repolarization (QRS complex). • Duration Normal duration of ‘P’ wave is 0.1 second. Amplitude Normal amplitude of ‘P’ wave is 0.1 to 0.12 QRS’ COMPLEX ‘ ‘QRS’ complex is also called the initial ventricular complex. ‘Q’ wave is a small negative wave. It is continued as the tall ‘R’ wave, which is a positive wave. ‘R’ wave is followed by a small negative wave, the ‘S’ wave. Cause ‘QRS’ complex is due to depolarization of ventricular musculature. ‘Q’ wave is due to the depolarization of basal portion of interventricular septum. ‘R’ wave is due to the depolarization of apical portion of interventricular septum and apical portion of ventricular muscle. ‘S’ wave is due to the depolarization of basal portion of ventricular muscle near the atrioventricular ring. Duration Normal duration of ‘QRS’ complex is between 0.08 and 0.10 second. Amplitude Amplitude of ‘Q’ wave = 0.1 to 0.2 mV. Amplitude of ‘R’ wave = 1 mV. ‘T’ WAVE ‘T’ wave is the final ventricular complex and is a positive wave. Cause ‘T’ wave is due to the repolarization of ventricular musculature. Duration Normal duration of ‘T’ wave is 0.2 second. Amplitude Normal amplitude of ‘T’ wave is 0.3 mV. THANK U