CARDIAC MUSCLE

SPECIAL CONDUCTING SYSTEM

 CARDIAC CYCLE

POTENTIAL CHANGES TAKING PLACE IN HEART IS

RECORDED AS ECG

GRAPHICAL RECORDING OF SUM OF ELECTRICAL CHANGES

OCCURRING IN HEART DURING CARDIAC CYCLE IS CALLED

ELECTROCARDIOGRAM (ECG)

IT IS DONE WITH THE HELP OF

CALIBRATED LINES (GRAPH LIKE PAPER)

ELECTROCARDIOGRAPH

(INSTRUMENT RECORDING POTENTIALS)

 ECG PAPER

1.0

V
O
L
T 0.02
mV

A
G
E

0.04 0.20
TIME (SECONDS)
CARDIOGRAPH

CALIBRATION
KNOB

SPEED KNOB

LEAD
SELECTION

RECORDER
PEN INK
HEATER
OSCILLOSCOPIC
 ELECTROCARDIOGRAM

LEAD
A SET OF TWO ELECTRODES – LEAD
STIMULATING ELECTRODES
EXPLORING OR RECORDING ELECTRODES

12 LEADS
SIX CHEST LEADS – PRECORDIAL
V1 V2 V3 V4 V5 V6
SIX LIMB LEADS – STANDARD I II III
AUGMENTED aVR aVF aVL
 ELECTROCARDIOGRAM

12 LEADS

UNIPOLAR – A POSITIVE EXPLORING ELECTRODE

COMPARING POTENTIAL TO SOME
ZERO POTENTIAL OR INDIFFERENT PART

CHEST LEADS

AUGMENTED LEADS

BIPOLAR – A POSITIVE EXPLORING ELECTRODE

COMPARING POTENTIAL WITH A
NEGATIVE ELECTRODE

STANDARD LEADS
 ELECTROCARDIOGRAM

12 LEADS – POSITIONING ON BODY

STANDARD BIPOLAR LEADS

LEAD I
Rt ARM – NEGATIVE
Lft ARM – POSITIVE
LEAD II
Rt ARM – NEGATIVE
Lft LEG – POSITIVE
LEAD III
Lft ARM – NEGATIVE
Lft LEG –POSITIVE
 ELECTROCARDIOGRAM

EINTHOVEN’S TRIANGLE

A TRIANGLE FORMED BY JOINING

THREE LEADS WITH HEART AT CENTER

EINTHOVEN’S LAW

POTENTIAL IN

II = I + III

SUM OF POTENTIAL OF ALL LEADS IS ZERO

KEEPING CHARGE OF POTENTIAL IN MIND

 ELECTROCARDIOGRAM

12 LEADS – POSITIONING ON BODY

PRECORDIAL UNIPOLAR CHEST LEADS

NEGATIVE OF ALL LEADS ARE GROUPED TO
A SINGLE POINT WITH ZERO POTENTIAL

V1 – 4th intercostal space on right sternal border

V2 – 4th intercostal space on left sternal border
V3 – In between V2 – V4
V4 – 5th intercostal space left mid clavicular line
V5 – 5th intercostal space anterior axillary line
V6 – 5th intercostal space mid axillary line
 ELECTROCARDIOGRAM

12 LEADS – POSITIONING ON BODY

AUGMENTED UNIPOLAR LIMBS LEADS

NEGATIVE OF ALL LEADS ARE GROUPED TO
A SINGLE POINT WITH ZERO POTENTIAL
THROUGH A RESISTANCE TO AUGMENT THE
POTENTIAL

aVR – RIGHT ARM POSITIVE

aVL – LEFT ARM POSITIVE
aVF – LEFT FOOT POSITIVE
Anatomic Groups
(Septum)
Anatomic Groups
(Anterior Wall)
Anatomic Groups
(Lateral Wall)
Anatomic Groups
(Inferior Wall)
Anatomic Groups
(Summary)
EACH LEAD IS SEEING THE HEART FROM DIFFERENT ANGLES
 VECTOR ANALYSIS OF ELECTROCARDIOGRAM

DEPOLARIZATION & REPOLARIZATION ARE CURRENT

CURRENT IS A VECTOR HAVING MAGNITUDE AND DIRECTION

THREE TYPES OF VECTORS PROVIDE E.C.G RECORDING

INSTANTANEOUS VECTOR
RESULTANT VECTOR
PROJECTED VECTOR
 ELECTROCARDIOGRAM

STANDARD LIMB LEADS

EINTHOVEN
 ELECTROCARDIOGRAM

AUGMENTED LIMB LEADS

 ELECTROCARDIOGRAM

CHEST OR PRECORDIAL LEADS