Ecg or Electro Cardiogram and Electrocardiograph

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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

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