Resting ecg
This presentation is the property of its rightful owner.
Sponsored Links
1 / 27

Resting ECG PowerPoint PPT Presentation


  • 252 Views
  • Uploaded on
  • Presentation posted in: General

Resting ECG. An overview. Electrocardiogram (ECG). Graphic recording of the electrical activity (impulses) generated by the heart Placement of electrodes on the body will allow for detection of these impulses. ECG.

Download Presentation

Resting ECG

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Resting ecg

Resting ECG

An overview


Electrocardiogram ecg

Electrocardiogram (ECG)

  • Graphic recording of the electrical activity (impulses) generated by the heart

  • Placement of electrodes on the body will allow for detection of these impulses


Resting ecg

ECG

  • Generally standard procedure to monitor and record the ECG during a graded exercise test (GXT)


Resting ecg

ECG

  • Equipment

    • adhesive silver-silver chloride electrodes with electrolyte gel or paste

    • electrical wires

    • amplifier

    • monitor

    • recording apparatus

    • computer to program the treadmill


Twelve views of the heart

Twelve views of the heart

  • Lead - two or more electrodes placed on the body in designated anatomical locations

  • 1. Standard Limb Leads (3)

  • 2. Augmented Limb Leads (3)

  • 3. Chest Leads (6)

  • Use 10 electrodes


Anatomical locations of leads

Anatomical Locations of Leads

  • Right Arm (RA) - right shoulder below the clavicle but above the border of pectoralis

  • Left Arm (LA) - left shoulder below the clavicle but above the border of pectoralis (in deltoid fossa)


Anatomical locations

Anatomical Locations

  • Right Leg (RL) - halfway between the costal margin (ribs) and the iliac crest (hip bone)

  • Left Leg (LL) - halfway between the costal margin and the iliac crest


Anatomical locations1

Anatomical Locations

  • V1 – right of sternum

  • V2 – left of sternum

  • V3 - midway between positions for V2 and V4

  • V4 - left midclavicular line


Anatomical locations2

Anatomical Locations

  • V5 - Horizontal level of V4 at left anterior axillary line

  • V6 – horizontal level of V4 at left midaxillary line


Standard limb leads

Standard Limb Leads

  • Lead 1 - *Left Arm (LA) - Right Arm (RA) angle 0

  • Lead 2 - *Left Leg (LL) - Right Arm (RA) angle 60

  • Lead 3 - *Left Leg (LL) - Left Arm (LA) angle 120

    • * indicates positive electrode


Augmented limb leads

Augmented Limb Leads

  • Augmented – need to amplify the voltage to get a tracing of the same magnitude as Leads 1,2,3


Augmented

Augmented

  • aVR - Augmented Voltage Right Arm

    • *RA and (LA-LL) angle -150

  • aVL - Augmented Voltage Left Arm

    • *LA and (RA-LL) angle -30

  • aVF - Augmented Voltage Left Foot

    • *LL and (RA-LA) angle +90


Leads

Leads

  • II, III, and AVF - inferior lead

    • view of inferior surface of heart

  • I and AVL - left lateral leads

    • view of left lateral wall of heart

  • AVR - loner


Structures of the heart

Structures of the Heart

  • SA Node

  • Atria

  • AV Node

  • Common Bundle

  • Right and Left Bundle Branches

  • Purkinje fibers

  • Ventricles


Electrical events

Electrical Events

  • 1. Sinus Node in the atrium

  • 2. Depolarization left, inferior, and anterior through right atrium

  • 3. Spreads through left atrium

  • 4. AV node and Bundle of His

  • 5. Left and Right Bundle Branches


Electrical events1

Electrical Events

  • 6. Impulse crosses the intraventricular septum from left to right

  • 7. Depolarization of ventricles simultaneously


Ecg waverforms

ECG Waverforms

  • P - atrial depolarization

  • PR interval - an interval encompasses at least one wave plus the connecting line

    • time from start of P wave to beginning of QRS

    • time for depolarization of the atria to beginning of ventricular depolarization


Waves

Waves

  • QRS - ventricular depolarization

    • first deflection down is Q

    • first deflection up is R

    • first downward deflection following an upward deflection is S


Waves1

Waves

  • ST segment - a straight line connecting two waves

    • ventricular isoelectric period

    • time from end of ventricular depolarization to the start of ventricular repolarization

  • T wave - ventricular repolarization


Depolarization

Depolarization

  • Positive deflection - a wave of depolarization moving toward a positive electrode

  • Negative deflection - a wave of depolarization moving away from a positive electrode

  • biphasic - wave moving perpendicularly to the positive electrode (positive deflection precedes negative)


Repolarization

Repolarization

  • Positive deflection - a wave of repolarization moving away from a positive electrode

  • Negative deflection - a wave of repolarization moving toward a positive electrode

  • biphasic - wave moving perpendicularly to the positive electrode (negative deflection precedes positive)


Resting ecg

PHASES OF THE RESTING ECG


Leads and the p wave

Leads and the P wave

  • Atrial Depol wave moving toward leads I, AVL, II, and AVF  positive deflection

  • Lead III biphasic

  • Lead AVR  negative deflection


Normal ecg responses to exercise

Normal ECG Responses to Exercise

  • Minor and significant changes in P-wave

  • Superimposition of the P and T waves of successive beats

  • Increases in Q wave amplitude

  • Slight decreases in R wave amplitude

  • Increases in T wave amplitude


Normal responses

Normal Responses

  • Minimal shortening of the QRS duration

  • Depression of the J point

  • Rate-related shortening of the QT interval


Time and voltage

Time and Voltage

  • Duration - seconds

  • Amplitude - millivolts

  • Configuration - shape and appearance


Ekg paper

EKG Paper

  • Light Lines (small squares)- 1mm x 1mm

  • Dark Lines (large squares) - 5mm x 5mm

  • Small square - .04 s and/or .1 mV

  • Large Square - .2 s and/or .5 mV


  • Login