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    Basics of ECG

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    Nachiket Vijay Potdar
    The document provides an overview of basics of electrocardiography (ECG) including: 1) It describes the normal impulse conduction pathway through the heart and explains how this relates to the components of the ECG (P wave, QRS complex, T wave). 2) It outlines the steps for analyzing cardiac rhythm on an ECG - calculating the heart rate, determining regularity, assessing P waves, and measuring the PR interval and QRS duration. 3) It provides an example of normal sinus rhythm on ECG and explains that this rhythm results from the normal conduction of the electrical impulse through the heart's pacemaking and conduction system.

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    Basics of ECG

    Uploaded by

    Nachiket Vijay Potdar
    87 views32 pages
    The document provides an overview of basics of electrocardiography (ECG) including: 1) It describes the normal impulse conduction pathway through the heart and explains how this relates to the components of the ECG (P wave, QRS complex, T wave). 2) It outlines the steps for analyzing cardiac rhythm on an ECG - calculating the heart rate, determining regularity, assessing P waves, and measuring the PR interval and QRS duration. 3) It provides an example of normal sinus rhythm on ECG and explains that this rhythm results from the normal conduction of the electrical impulse through the heart's pacemaking and conduction system.

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    Basics of ECG.ppt

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    The document provides an overview of basics of electrocardiography (ECG) including: 1) It describes the normal impulse conduction pathway through the heart and explains how this relates to the components of the ECG (P wave, QRS complex, T wave). 2) It outlines the steps for analyzing cardiac rhythm on an ECG - calculating the heart rate, determining regularity, assessing P waves, and measuring the PR interval and QRS duration. 3) It provides an example of normal sinus rhythm on ECG and explains that this rhythm results from the normal conduction of the electrical impulse through the heart's pacemaking and conduction system.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    87 views32 pages

    Basics of ECG

    Uploaded by

    Nachiket Vijay Potdar
    The document provides an overview of basics of electrocardiography (ECG) including: 1) It describes the normal impulse conduction pathway through the heart and explains how this relates to the components of the ECG (P wave, QRS complex, T wave). 2) It outlines the steps for analyzing cardiac rhythm on an ECG - calculating the heart rate, determining regularity, assessing P waves, and measuring the PR interval and QRS duration. 3) It provides an example of normal sinus rhythm on ECG and explains that this rhythm results from the normal conduction of the electrical impulse through the heart's pacemaking and conduction system.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 32

    BASICS OF ECG

    Chapter Objectives
    • To recognize the normal rhythm of the heart -
    “Normal Sinus Rhythm.”

    • To recognize the 13 most common rhythm


    disturbances.

    • To recognize an acute myocardial infarction on a


    12-lead ECG.
    Normal Impulse Conduction

    Sinoatrial node

    AV node

    Bundle of His

    Bundle Branches

    Purkinje fibers
    Impulse Conduction & the ECG

    Sinoatrial node

    AV node

    Bundle of His

    Bundle Branches

    Purkinje fibers
    Cardiac Action Potential
    Smooth Muscle Contraction
    The “PQRST”

    • P wave - Atrial
    depolarization

    • QRS - Ventricular
    depolarization

    • T wave - Ventricular
    repolarization
    The PR Interval

    Atrial depolarization
    +
    delay in AV junction
    (AV node/Bundle of His)

    (delay allows time for the


    atria to contract before
    the ventricles contract)
    Pacemakers of the Heart

    • SA Node - Dominant pacemaker with an intrinsic


    rate of 60 - 100 beats/minute.

    • AV Node - Back-up pacemaker with an intrinsic


    rate of 40 - 60 beats/minute.

    • Ventricular cells - Back-up pacemaker with an


    intrinsic rate of 20 - 45 bpm.
    Brief Cardiac Anatomy
    Inferior Surface of the Heart
    Limb Leads of ECG
    The ECG Paper
    • Horizontally
    – One small box - 0.04 s
    – One large box - 0.20 s
    • Vertically
    – One large box – 1 mm
    The ECG Paper (cont)

    3 3
    sec sec
    • Every 3 seconds (15 large boxes) is marked by a
    vertical line.
    • This helps when calculating the heart rate.

    NOTE: the strips used for this slide and the following
    slides are not marked but all are 6 seconds long.
    ECG Rhythm Interpretation

    How to Analyze a Rhythm


    Chapter Objective
    • To recognize the normal rhythm of the heart -
    “Normal Sinus Rhythm.”
    Rhythm Analysis

    • Step 1: Calculate rate.


    • Step 2: Determine regularity.
    • Step 3: Assess the P waves.
    • Step 4: Determine PR interval.
    • Step 5: Determine QRS duration.
    Step 1: Calculate Rate

    3 3
    • Option 1 sec sec
    – Count the # of R waves in a 6 second rhythm strip,
    then multiply by 10.
    – Reminder: all rhythm strips in the Modules are 6
    seconds in length.

    Interpretation?

    9 x 10 = 90 bpm
    Step 1: Calculate Rate

    R
    wave

    • Option 2
    – Find a R wave that lands on a bold line.
    – Count the # of large boxes to the next R wave. If the
    second R wave is 1 large box away the rate is 300, 2
    boxes - 150, 3 boxes - 100, 4 boxes - 75, etc. (cont)
    Step 1: Calculate Rate

    3 1 1
    0 5 0 7 6 5
    0 0 0 5 0 0

    • Option 2 (cont)
    – Memorize the sequence:
    300 - 150 - 100 - 75 - 60 - 50

    Interpretation? Approx. 1 box less than


    100 = 95 bpm
    Step 2: Determine regularity

    R R

    • Look at the R-R distances (using a caliper or


    markings on a pen or paper).
    • Regular (are they equidistant apart)? Occasionally
    irregular? Regularly irregular? Irregularly
    irregular?
    Interpretation? Regular
    Step 3: Assess the P waves

    • Are there P waves?


    • Do the P waves all look alike?
    • Do the P waves occur at a regular rate?
    • Is there one P wave before each QRS?
    Interpretation? Normal P waves with 1 P
    wave for every QRS
    Step 4: Determine PR interval

    • Normal: 0.12 - 0.20 seconds.


    (3 - 5 boxes)

    Interpretation? 0.12 seconds


    Step 5: QRS duration

    • Normal: 0.04 - 0.12 seconds.


    (1 - 3 boxes)

    Interpretation? 0.08 seconds


    Rhythm Summary

    • Rate 90-95 bpm


    • Regularity regular
    • P waves normal
    • PR interval 0.12 s
    • QRS duration 0.08 s
    Interpretation? Normal Sinus Rhythm
    Normal Sinus Rhythm (NSR)

    • Etiology: the electrical impulse is formed in the


    SA node and conducted normally.

    • This is the normal rhythm of the heart; other


    rhythms that do not conduct via the typical
    pathway are called arrhythmias.
    NSR Parameters

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