ECG: Electrocardiography

DEPARTMENTAL LAB IV- BIOMEDICAL

ENGINEERING

COURSE MADE BY:

INSTRUCTOR: Anish Gupta
Prof. Puneet Arora (071218)
 WHAT IS ECG?

 A diagnostic tool that measures and records

the electrical activity of heart, over time,
captured and externally recorded by skin
electrodes.

 The ECG works by detecting and amplifying

the tiny electrical changes on the skin that
are caused when the heart muscle
"depolarizes" during each heart beat.
 HOW ECG IS PERFORMED?
 Firstly, you lie down. The caretaker will clean
several areas on your arms, legs, and chest, and
then attach small patches called electrodes to the
areas.
 The patches are connected by wires to a machine
that turns the heart's electrical signals into wavy
lines.
 Any movement, including muscle tremors such
as shivering, can alter the results. So it is
important to be relaxed and relatively warm
during an ECG recording.
HEART CONDUCTION SYSTEM
WAVEFORMS and INTERVALS
 P wave caused
by atrial
depolarization
 QRS complex
caused by
ventricular
depolarization
 T wave results
from
ventricular
repolarization
 E.C.G. 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)
 E.C.G. LEADS

The standard E.C.G. 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.
 Standard Limb Leads (Bipolar)

The three bipolar limb leads form an equilateral

triangle (with the heart at the center) that is called
Einthoven's triangle.
 If the three limbs of Einthoven's triangle are
broken apart, collapsed, and superimposed over
the heart, then the positive electrode for lead I
is said to be at zero degrees relative to the
heart.
 This new construction of the electrical axis is
called the axial reference system.
For a heart with a normal ECG and a mean
electrical axis of +60º, the standard limb leads will
appear as follows:
 Augmented Limb Leads (Unipolar)
 The positive electrodes for
augmented leads are
located on the left arm
(aVL), the right arm (aVR),
and the left leg (aVF).
 The three augmented leads,
along with the three
standard bipolar limb leads,
are depicted as shown to
the right using the axial
reference system.
Augmented Limb Leads All Limb Leads
 These leads record electrical activity along a
single plane, termed the frontal plane relative
to the heart.
 For a heart with a normal ECG and mean
electrical axis of +60°, the augmented leads
will appear as shown below:
 Precordial Leads (Unipolar)
 This configuration places
Ventricular
six positive electrodes on Leads
Region
the surface of the chest
over different regions of V1-V2 anteroseptal
the heart in order to
record electrical activity V3-V4 anteroapical

in a plane perpendicular
V5-V6 anterolateral
to the frontal plane.
These six
leads are
named V1 -
V6.
 Because initial ventricular depolarization is from
left to right across the septum, there is an initial R-
wave in V1 followed by an S-wave as the anterior
and lateral walls of the left ventricle depolarize.
 Leads V2-V4 are intermediate owing to their
electrode placement.
 Tracings from leads V5 and V6 are almost
opposite in polarity from V1 because they are
viewing opposite sides of the heart.
 Leads V5 and V6 show a large net positive QRS
because these leads overlie the anterolateral wall
of the left ventricle, which has a large muscle mass
undergoing depolarization.