ECG: ELECTROCARDIOGRAPHY

DEPARTMENTAL LAB IV- BIOMEDICAL ENGINEERING

COURSE INSTRUCTOR: Prof. Puneet Arora

MADE BY: Anish Gupta (071218)

WHAT IS ECG?
 A diagnostic tool that measures and records the electrical activity of heart, over time, captured and externally recorded by skin electrodes.  The ECG works by detecting and amplifying the tiny electrical changes on the skin that are caused when the heart muscle "depolarizes" during each heart beat.

HOW ECG IS PERFORMED?

 Firstly, you lie down. The caretaker will clean several areas on your arms, legs, and chest, and then attach small patches called electrodes to the areas.  The patches are connected by wires to a machine that turns the heart's electrical signals into wavy lines.  Any movement, including muscle tremors such as shivering, can alter the results. So it is important to be relaxed and relatively warm during an ECG recording.

HEART CONDUCTION SYSTEM

WAVEFORMS AND INTERVALS

 P wave caused by atrial depolarizatio n  QRS complex caused by ventricular depolarizatio n  T wave results from ventricular repolarizatio

E.C.G. LEADS
Leads are electrodes which measure the difference in electrical potential between either: 1. Two different points on the body (bipolar leads) 2. One point on the body and a virtual reference point with zero electrical potential, located in the center of the heart (unipolar leads)

E.C.G. LEADS
The standard E.C.G. has 12 leads:

3 Standard Limb Leads 3 Augmented Limb Leads 6 Precordial Leads

The axis of a particular lead represents the viewpoint from which it looks at the heart.

STANDARD LIMB LEADS (BIPOLAR)

The three bipolar limb leads form an equilateral triangle (with the heart at the center) that is called EINTHOVEN'S

 If the three limbs of Einthoven's triangle are broken apart, collapsed, and superimposed over the heart, then the positive electrode for lead I is said to be at zero degrees relative to the heart.  This new construction of the electrical axis is called the AXIAL REFERENCE

SYSTEM.

For a heart with a normal ECG and a mean electrical axis of +60, the standard limb leads will appear as follows:

AUGMENTED LIMB LEADS (UNIP

 The positive electrodes for augmented leads are located on the left arm (aVL), the right arm (aVR), and the left leg (aVF).  The three augmented leads, along with the three standard bipolar limb leads, are depicted as shown to the right using the axial reference

Augmented Limb Leads

All Limb Leads

 These leads record electrical activity along a single plane, termed the frontal plane relative to the heart.  For a heart with a normal ECG and mean electrical axis of +60, the augmented leads will appear as shown below:

PRECORDIAL LEADS (UNIPOL

 This configuration places six positive electrodes on the surface of the chest over different regions of the heart in order to record electrical activity in a plane perpendicular to the frontal plane.
Leads Ventricular Region

V1-V2

anteroseptal

V3-V4

anteroapical

V5-V6

anterolateral

These six leads are named V1 V6.

 Because initial ventricular depolarization is from left to right across the septum, there is an initial R-wave in V1 followed by an Swave as the anterior and lateral walls of the left ventricle depolarize.  Leads V2-V4 are intermediate owing to their electrode placement.

 Tracings from leads V5 and V6 are almost opposite in polarity from V1 because they are viewing opposite sides of the heart.  Leads V5 and V6 show a large net positive QRS because these leads overlie the anterolateral wall of the left ventricle, which has a large muscle mass undergoing depolarization.