ECG ( ELECTRO CARDIO GRAPH) USE , INTRODUCTION, lead , ECG waves

All about ECG

1. Doon Ayurvedic medical college and hospital
[ Saharanpur ]
Guide by – Dr. Anu Bhardwaj
{ B. A. M. S. , M.D. Ayu. }
Perform by – Rajdeep Singh
{ Batch – 2023-24 }

2. Introduction –
–Electrocardiograph .
-Electrocardiograph is the instrument
(machine) by which electrical activities of
the heart are recorded .
-Discovered - Einthouen Leuwenhock .
-Function - Measure heart electric
activity .
-Principle-Galvenometer .

3. 2. USE –
-Diagnosis of chest pain .
-Diagnosis the breathlessness .
-Dignosis of cardiac problems
.

4. 3. Lead - Leads Total 12
-Two type of leads
-Chest lead -6
-Limb lead- Biplolar-3,
-Armented lead -3

5. Chest lead –
V1 -Right Side in 4
th intercostal Space.
V2 - Left Side in 4
thintercostal Space.
V3 -Between V2 and V3 .
V4 -Left Mid clavicular line in 5th
Intercostal Space.
V5.-
Medially axillary line in 5th
IntercostalSapce.
V6. -Laterally axillary line in 5
th
Intercostal Space.

7. Limb lead-
(a) Bipolar limb lead
Lead I -
Lead II-
Between the right arm and left arm
Between the right arm and left leg.
Lead III - Between left arm and left leg.

8. (b)Unipolar limb lead-
Avr - Right arm avl -Left arm avf - Left foot
(av, -Armented voltage foot)

9. ECG waves –
P wave-
T Wave-
Atrium /Articular Depolarisation .
Ventericular Repolarisation .
QRS Complex - Ventricular Depolarisation .
Interval and Segments –
1. P-Rinterval
3. P-R segment
5. R-R interval
7. P-Pinterval
2. Q-T interval
4. S-T
interval
6. S-T interval

10. Interval- Starting point of wave to ending
point of wave. Interval always big.
eg.PR interval- Starting point ofPwave to
ending point of R wave.
-Segment- Ending point ofwave to starting
point ofwave.
-eg. PR Segment - Ending point ofP wave to
starting point of R wave.
-Cardiac cycle -0.8 sec
-PR interval -0.2 sec
-Systol 0.6 sec
-Diastole 0.2 sec

11. Waves of normal ECG –

13. P-R INTERVAL –
= P-R interval is the interval between
the onset of'P' wave and onset ofQ' wave.
= It's significes the aterial devpolarisation
and conduction impulses through the A-V
nodes.
= Normal duration ofP-R interval -0.18
second (0.12 to 0.20)

14. = Prolonged P-R interval scen in
bradycardia and first degree heart block.
= Shortend P-R interval seen in
tachycardia, WPW syndrome and LGL
syndrome.

15. Q-R interval-
= Q-T interval is the interval between
onset of'Q' wave and onset of T' wave. It
indicats the ventricular depolarisation
and repolarisation.
=It's significes the electrical activity in
venrticles.
=Normal duration ofQ-T interval is
between 0.4 to 0.42 seconds.

16. =In long, Q-T Syndrome, Q-T Interval is
prolonged ie. present in myocardial
infarction, myocardities, hypothyroidism
and hypocalcaemia.
= In shrot Q-T syndrome, Q-T interval is
shortend i. e. present in hypercalcaemia.

17. P-R Segment –
= It is an isoelectric period and the time
interval between end of"P' wave and
beginning of QRS Complex.
= P-R segment indicates the atrial
depolarisation and delay in the
AVjunction.
= Normal duration P-R segment - 0.12 - 0.20
seconds.

18. =Depression ofbareline up to 0.8 mm
accepted as normal.
= Pathological depression ofP-R segment
occurs in pericarditis and artial ischemia.

19. S-T Sgement –
= It is an isoelectric preiod, and the time
interval between end of's' wave and the
onset of't' wave.
= Normal duration of"S-T' segment is 0.05
second.
= Elevation of"S-T' segment occurs in
anterior or inferior myocardial infection
and left bundle branch block.

20. = In athelets 'S-T' segment is usually
elevated.
= Depression of"S-T' segment occurs
in posterior or mycoardial infarction
and hypokalemia.
="S-T Segment is prolonged in
hypocalcemia.

21. R-R interval –
= The time interval between two
consecutive 'R' waves is R-R interval.
= Normal duration of R-R interval is 0.8
second.
= Measurement of R-R interval helps in
calculation of heart rate and heart rate
Variability .

23. Heart rate -
Regular rhythm = 300/ Laege box between
R-R interval .
Rate = 300 / 4
= 75 bpm
Irregular rhythm =
[ No. of R waves in 6 sec ][ 10 ]

24. Animation