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Electrophysiologic backround for ECG evaluation

Electrophysiologic backround for ECG evaluation

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Electrophysiologic backround for ECG evaluation

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  1. Electrophysiologic backround for ECG evaluation Prof. J. Hanáček, MD, PhD

  2. Physiologic ECG curve – its parts

  3. Standard bipolar and augmented unipolar leads

  4. ECG record from standard limb leads

  5. Precordial leads

  6. Scheme of horizontal cut of chest with projection of chest leads and direction of atrial and ventricular depolarisation

  7. Calculation of heart rate from ECG curve

  8. Evaluation of ECG curve • Basicinformation on thepatient –agegender, reasonforrecording ECG, preliminaryDg • Technicalparametersof ECG curve – speedofrecording, sensitivityofrecording device 3) Date and timeof ECG recording

  9. Calculation of heart rate

  10. Electric axis of a heart

  11. Factors which influence electric axis of hart

  12. How to create electric axis of a heart – lead I

  13. How to create electric axis of a heart – lead I and aVF

  14. Left axis deviation

  15. Right axis deviation

  16. Description QRS complex deflections

  17. Heart rhythms • Sinusrhythm • Atrialrhythm • Junctionalrhythm (atrio-ventricular) • Ventricularrhythm ● Heartrhythmisnotheart rate, isnotregularityofheartfunction ● Heartrhythmmeanslocalisationofsourceof electricalimpulsforactivationofheart

  18. Sinus rhythm • heartfunctioniccontroled by sinusnodeactivity Characteristicsofsinusrhythm: • Thereshouldbe P wave in front of QRS complex • P waveisnegativ in aVRlead and positive in aVFlead • P waveshouldhavenormalduration and shape

  19. Junctional rhythm • Polarity of P wave is changed • Localisation of P wave is also • changed

  20. Passive ventricular depolarisation – escape beat

  21. Simple guide for ECG evaluation • In ECG curveishidden a lotofimportantinformation usefulforunderstandingheartfunctionunder physiologic and pathologicconditions • To findthisinformationsyoushouldhaveappropriate knowledge and ability to observecarefullythe ECG curve • Forgoodresultof ECG curveevaluationisnecessary to evaluateitsystematically – usingsome type of algorhythm

  22. Characteristicsofpatient – age, gender, dateof ECG recordwas done preliminarydiagnosis, otherinformations on patient 2) To controltechnicalqualityof ECG record, speedof ECG record, sensuitivityofrecording device (inappropriatecontactofelectrodes withthe skin, interferenceofelectricity, other • Evaluationfrequencyof QRS complexes, P waves • Evaluationofheartrhythm • Evaluationofheartaxis • Evaluationofseparatewaves, deflections, segments and intervals • Each abnormality shouldbetakenintoaccont