Ecg report normal sinus rhythm with variants of qrs complex.pptx

Ecg

1. PERPETUAL HELP MEDICAL CENTER – BIÑAN DEPARTMENT OF INTERNAL MEDICINE 1 Anna Katrina F. Manzano, M.D. 1 st year resident ECG HOUR The Normal Electrocardiogram February 12, 2024

2. DEPARTMENT OF INTERNAL MEDICINE OBJECTIVES At the end of the lecture, the participants will be able to: Recognize a normal sinus rhythm ECG tracing Identify the QRS axis 3. Be familiar with the common variants of normal ECG 2

3. The waves and intervals of a normal electrocardiogram QTc = QT / √ RR Women: 460msec Men: 450msec

4. NORMAL SINUS RHYTHM

5. NORMAL SINUS RHYTHM

6. CARDIAC ELECTRICAL CONDUCTING SYSTEM Electrical conduction is said to be antegrade (or forward) if it is directed from the higher pacemaker sites going downwards. Electrical conduction is said to be retrograde (or backwards) if it is directed from lower pacemaker sites going upwards.

7. CARDIAC ELECTRICAL CONDUCTING SYSTEM The SA-node is the primary pacemaker, the usual powerhouse, the primary area where electrical impulses are generated. AV-node (junction1) is the “gate-keeper”, the area where many very fast electrical impulses from the SA-node are selectively filtered & slowed down. His-bundle (junction2) receives the filtered impulses from the AV-node and carries them down almost simultaneously to both bundle branches. The right bundle branch (RBB) carries impulses to the right side of the heart. The left bundle branch (LBB) carries the impulses to the left side of the heart. It further divides into a thin left anterior fascicle & a thick left posterior fascicle.

8. CARDIAC ELECTRICAL CONDUCTING SYSTEM Depolarizing (P or QRS-) wavefront that moves towards the exploring electrode will produce an upright deflection. Depolarizing (P or QRS-) wavefront that moves away from the exploring electrode will produce an inverted deflection. Depolarizing (P or QRS-) wavefront that moves neutrally in relation to the exploring electrode will produce either isoelectric or biphasic deflection.

9. MEAN FRONTAL ELECTRICAL AXIS

10. MEAN FRONTAL ELECTRICAL AXIS

11. MEAN FRONTAL ELECTRICAL AXIS

12. MEAN FRONTAL ELECTRICAL AXIS

13. MEAN FRONTAL ELECTRICAL AXIS

14. MEAN FRONTAL ELECTRICAL AXIS

15. Normal Variants

16. Normal Variants

17. Normal Variants

18. Normal Variants

19. Normal Variants

20. THANK YOU