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ECG Basics

ECG Basics. Anatomy of the Heart. Sinus Node (SA node) – the primary pacemaker of the heart; Atrioventricular Node (AV node) – slows and transmits electrical signal from atria to ventricles. Bundle of His – rapidly sends electrical signal through ventricles

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ECG Basics

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  1. ECG Basics

  2. Anatomy of the Heart Sinus Node (SA node) – the primary pacemaker of the heart; Atrioventricular Node (AV node) – slows and transmits electrical signal from atria to ventricles. Bundle of His – rapidly sends electrical signal through ventricles Right and Left Bundle branches – carry fast electrical signals through the ventricles Bundle Branches (bundles of Purkinje fibers)

  3. Where is the Rate Determined? SAnode – pacemaker of the heart; rate of 60- 100 bpm if SA node fails, then the Atrial foci will pace the heart; rate of 60-80 bpm If the Atrial foci fail, then the AV node (Junctional foci) will pace the heart, send electrical activity up through the atria and down through the ventricles; rate of 40-60 bpm If the Junctional foci fail, then the Purkinje fibers (ventricular foci) will pace; rate of 20-40 bpm

  4. Breaking Down an EKG – What It All Means

  5. P wave – Atrial Depolarization (atrial contraction) < 0.11 seconds PR interval – Time from atria to Purkinje fibers 0.12 - 0.20 seconds QRS complex – Ventricular Depolarization (ventricular contraction) First negative deflection – Q wave First Positive deflection – R wave Negative following the R wave – S wave 0.05 – 0.10 seconds ST segment – Ventricle remains depolarized 0.04 seconds T wave – rapid ventricular repolarization QT interval – repolarization Ventricular contraction last from Q wave to end of T wave < 0.42 seconds U wave – Purkinje fibers repolarization -usually present with post-MI patients R-R interval – duration of one heart beat

  6. What else to consider? • What is the heart rate? • Atrial HR – number of P waves • Ventricular HR – number of QRS complexes • Normally – should be equal • Is the rhythm regular or irregular? • Are the R-R interval equally spaced? • Is there a P wave for every QRS? • Yes – sinus rhythm • No – more information needed

  7. It’s all about the paper • Each small square is 1 mm tall by 1 mm wide • Time x amplitude • Between two thick black lines is 0.20 seconds, therefore 5 thick line boxes equal 1 minute. • Can use a 6 second strip to calculate rate and rhythm.

  8. Let’s Practice! • P wave = ________ • PR interval = ________ • QRS interval = _________ • ST segment = ________ • T wave = ________ P wave = 0.10 * PR interval = 0.16 * QRS interval = 0.04 * ST segment = 0.14 * T wave = 0.18

  9. More Practice! • What is the heart rate? • Is this rhythm regular or irregular? • Is there a P wave for every QRS complex? • Is this a sinus rhythm? What is the heart rate? 60 bpm * Is this rhythm regular or irregular? Regular * Is there a P wave for every QRS complex? Yes * Is this a sinus rhythm? Yes

  10. Strip of the Month

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