ECG

Done By :
HUthefah Al-Tarabsheh
Bashar Al-Tarabsheh
Definition
• ECG= ElectroCardioGraphy

ECG: Recording of the electrical impulses that are generated in the

heart
• LEADS :
1- six limb leads ( |,||,|||,aVL, aVF, aVR)
A- Standard bipolar (|,||,|||)
B- augmented unipolar (aVR,aVL , aVF)
2-chest precardial leads (v1,v2,v3,v4,v5,v6)
• Leads are described in EINTHOVEN triangle :
1- lead | > records the difference in voltage between
The left arm and the right arm
2-lead || > records the difference in voltage between
The left leg and right arm
3- lead ||| > records the difference in voltage
between left leg and left arm
4- aVL, aVF , aVR are Composite Leads , computed
using the information from other leads
PLACEMENT OF CHEST LEAD
Relation of
12 leads to
the HEART
OVERVIEW OF PROCEDURE
• GRIP
Great , rapport , introduce , identify , privacy, explain the procedure ,
permission
• Lay the patient down
• Exposure of chest , wrist , ankles
• Clean electrode sites
• Apply the electrodes
• Attach wires
• Turn on the machine
Calibrate to 10 mm/Mv
Rate at 25 mm/s
• Record and print
• Label the tracing
Name , hospital number , date , time , reason for recording
Procedure in Al-Basheer hospital
Normal ECG MORPHOLOGY
• P wave – atrial depolarization
• QRS – ventricular depolarization
• T Wave – repolarization of ventricle
Interpretation of ECG
• Check
Name
Time and Date
Indication
Any previous ECG
• Calibration
• Rate
• Rhythm
• Axis
• Elements of tracing in each lead
Calibration
RYTHEM
• REGULAR OR IRREGULAR ?
• Count the number between 2 R
waves of ist equal this is regular if
it’s not it’s irregular
• PAPER METHOD
Irregular rhythm
RATE
• REGULAR
300/ number of large squares btw 2 R waves
OR
1500/ number of small squares btw 2 R waves
• IRREGULAR
R WAVES IN 30 squares * 10

Normal HR = 60-100
Rythem
• Sinus bradycardia
• Rythem originates in the sinus node
• Rate less than 60 per minute more than 5 squares btw RR
• Sinus tachycardia
• Rythem originates in the sinus node
• Rate of greater than 100 per minute less than 3 squares btw RR
waves
• Sinus arrhythmia

• Sinus arrhythmia refers to a changing sinus node rate with the

respiratory cycle, on inspiration and expiration.

• This is quite common in young, healthy individuals and has no

clinical significance. The heart rate increases with inspiration, due to
the Bainbridge reflex, and decreases with expiration.
AXIS