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ECG Basics. Dr. Taj. Outline. Review of the conduction system ECG waveforms and intervals ECG leads Determining heart rate Determining QRS axis. The Normal Conduction System. What is an ECG?. The electrocardiogram (ECG) is a representation of the electrical events of the cardiac cycle.

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ecg basics

ECG Basics

Dr. Taj

outline
Outline
  • Review of the conduction system
  • ECG waveforms and intervals
  • ECG leads
  • Determining heart rate
  • Determining QRS axis
what is an ecg
What is an ECG?

The electrocardiogram (ECG) is a representation of the electrical events of the cardiac cycle.

Each event has a distinctive waveform, the study of which can lead to greater insight into a patient’s cardiac pathophysiology.

what types of pathology can we identify and study from ecgs
What types of pathology can we identify and study from ECGs?
  • Heart rate
  • Heart Rhythem
  • Myopathies
  • Electrolyte disturbances (i.e. hyperkalemia, hypokalemia)
  • Drug toxicity (i.e. digoxin and drugs which prolong the QT interval)
ecg leads
ECG 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)

ecg leads1
ECG Leads

The standard ECG 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.

precordial leads
Precordial Leads

Adapted from: www.numed.co.uk/electrodepl.html

determining the heart rate
Determining the Heart Rate

Take the number of “smallest boxes moved by the machine per minute” i.e. (1500) , and divide by the number of boxes between adjacent “R”-”R” waves.

rule of 1500
Rule of 1500

Take the number of “smallest boxes moved by the machine per minute” i.e. (1500) , and divide by the number of boxes between adjacent “R”-”R” waves.

what is the heart rate
What is the heart rate?

www.uptodate.com

(1500 / 30) = 50 bpm

what is the heart rate1
What is the heart rate?

www.uptodate.com

(1500 / ~18) = ~ 83 bpm

what is the heart rate2
What is the heart rate?

(1500 / 8) = 187 bpm

the rule of 300
The Rule of 300

It may be easiest to memorize the following table:

rhythm

Rhythm

The rhythm of the heart can be regular or irregular.