Electrocardioghraphy

ECG/(EKG)
ZTG
PHR 327
Fall 2019
What is ECG?
• Graphic representation of the electrical impulses that the
heart generates during the cardiac cycle.

• Electrodes detect the electrical activity of the heart.

When is it used?
• The ECG is used primarily to identify abnormal heart
rhythms (arrhythmias/dysrhythmias)

• to diagnose
• acute myocardial infarction
• conduction defects
• ventricular hypertrophy

• ECG may be normal, even in the presence of heart disease.

P Wave
• This represents atrial electrical depolarization associated with
atrial contraction.
• If P waves are absent or altered, the cardiac impulse
originates outside the SA (sinoatrial) node.
 PR interval
• Represents time required for the
impulse to travel from the SA node to the
atrioventricular (AV) node

• If this interval is prolonged, a

conduction delay exists in the AV node

• If the PR interval is shortened, the impulse

must have reached the ventricle through a
"shortcut”
• Abnormal extra electrical pathway between
the heart's upper and lower chambers
 QRS complex
• This represents ventricular electrical
depolarization associated with
ventricular contraction.

• This complex consists of an initial downward

(negative) deflection (Q wave), a large
upward (positive) deflection (R wave), and a
small downward deflection (S wave).

• A widened QRS complex indicates abnormal

or prolonged:
• ventricular depolarization time ( e.g., a bundle-
branch block), Wolff-Parkinson-White
syndrome, or pacemaker rhythms.
Bundle Branches
ST segment.
• This represents the period between
the completion of depolarization
and the beginning of repolarization
of the ventricular muscle.

• This segment may be elevated or

depressed in transient muscle
ischemia (e.g., angina) or in muscle
injury (e.g., the early stages of
myocardial infarction).
T wave
• This represents ventricular
repolarization (i.e., return to
the resting state).
 U wave

• This deflection follows

the T wave and is usually
quite small.

• It represents
repolarization of the
Purkinje nerve fibers
within the ventricles
Interfering factors
• Inaccurate placement of the electrodes
• Electrolyte imbalances
• Poor contact between the skin and the electrodes
• Movement or muscle twitching during the test
• Drugs that can affect results include barbirurates, digitalis,
and quinidine.
 Abnormal findings
• Cardiac arrhythmias
• Acute myocardial infarction/ Old myocardial infarction
• Myocardial ischemia
• Conduction defects /Conduction system disease
• Wolff-Parkinson-White syndrome: heart beat rapidly for periods of time
due to an extra electrical conduction pathway in the heart. This
problem with the heart is present at birth (congenital
• Ventricular hypertrophy: ventricle walls enlarge and thicken
• Cor pulmonale: right sided heart failure
• Pulmonary embolus: blood clot blocks a lung artery
• Electrolyte imbalance
• Pericarditis: inflammation of membrane surrounding heart