Umyu Ecg Workshop
Umyu Ecg Workshop
Umyu Ecg Workshop
& INTERPRETATION
Meaning of ECG
Uses of ECG & its Principle
Conducting System of the Heart
ECG LEADS
ECG Waves & Intervals
Calculation of Voltages & Time Interval Durations
Rhythm Interpretation and Heart rate Estimation
Summary
Learning Outcomes
At the end of the presentation, Participants are expected to be able to:
Diagnosis of Diseases
Monitoring & Evaluation of Treatment
Fitness Check up
Research Purposes
Bundle of His
Polarized
0 mV Na+
-90 mV
Na+
K +
K+ Single myocardial cell during resting phase (between beats)
Bundle of His
Depolarization
Na+
+ 5 mV
K + Na+
K+
Bundle of His
Repolarization
0 mV
-90 mV
K Na
+ +
K+
Bundle of His
Mechanism of Auto-rhythmicity
Leakage of Na+
Einthoven's Law states that I + (−II) + III = 0. It is written this way (instead of I − II + III = 0)
because Einthoven reversed the polarity of lead II because he liked to view upright QRS
complexes. The equation can also be written I + III = II.
Limb Leads
Lead I Lead II Lead III
─ RA LA + ─ RA LA RA LA ─
RL LL RL LL + RL LL +
+ RA LA RA LA + RA ─ LA
─ ─
RL LL RL LL RL LL
+
Bipolar Limb Leads
Lead I = voltage between LA - RA
Bipolar Limb Leads
Lead II = voltage between RA - LL
Bipolar Limb Leads
Lead III = voltage between LA - LL
Precordial Mid-clavicular line
Anterior axillary line
Leads Angle of Louis Mid-axillary line
Atrial
Repolarization
TP wave
Ventricular
Depolarization QRS
complex
P wave
Atrial
Depolarization
Atrial
Repolarization
TP wave
Ventricular
Depolarization QRS
complex
QRS
T Ventricular
P
Repolarization T wave
ECG waveforms & time intervals
R Positive wave of the QRS complex
PR ST segment
segment
Considered
T
isoelectric
line
P
U
V
+
-
+
V
-
V
V
+
Lead II = R-wave: positive deflection
aVR = R-wave: negative deflection in normal
conditions
ECG LEADS Cont’d
Interpretation: Calculation of Wave
Voltages & Interval Durations
Standard 12-Lead ECG
II
Voltage
Amplitude
1 mm 5 mm 1mm = 0.1mv
UCSF
Exercise
Estimate the Voltages of P-wave, QRS Complex and T-wave in this Strip
P Wave = 0.1mv
QRS = 0.7mv
T Wave = 0.2mv
Standard 12-Lead ECG
Time
0.20 sec
0.04 sec
40 ms 200 ms
UCSF
Time Interval Estimation
EXERCISE
Alternatively
Divide 1500 by the number of small squares between R – R interval
Or divide 300 by the number of big squares between R – R interval
Heart Rate Estimation
HR = 60/0.8 = 75b/min
Estimation of Heart rate Cont’d
Estimation of Heart rate Cont’d
Estimation of Heart Rate in irregular Rhythm
???
???
???
Features of Abnormal Myocardial Blood
Supply on ECG
ST segment elevation
Features of Abnormal Myocardial Blood Supply on
ECG
ECG Workshop
Session 1
Thank You Very Much for Your Participation
biwaziri.pys@buk.edu.ng
@WAZIRI-BI
@Bashwaz Waziri
@wazbash80