ELECTROCARDIOGRAPHY

(ECG)

Presented by-
Arnab Kumar Guin, Arkadeep Ghosh, Arijit Acharyya.
B.Pharm , 2nd Year , 3rd Sem ; Roll No. - 117,118,119
 CONTENTS
 Introduction

 History of ECG

 Modern ECG Machine

 Electrodes & Leads

 Understanding ECG waveform

 Electrocardiogram

 Rhythm

 Application of ECG

 Conclusion

 Reference
 What is ECG?
Electrocardiography-
It is a transthoracic interpretation of the
electrical activity of the heart over time
captured and externally recorded by skin
electrodes for diagnostic or research
purposes on human hearts.
 THE HISTORY OF ECG

• 1842 - Italian scientist Carlo Matteucci realizes that electricity is

associated with heart beat.

• 1872 – French scientist Gabriel Lipmann , invented the capillary

electrometer which can measure electricity by utilizing mercury.

• 1895 – William Einthoven , credited for the invention of EKG.

Using the string electrometer EKG , William Einthoven
diagnoses some heart problems.
NOW
Modern ECG machine
has evolved into compact electronic
systems that often include
computerized interpretation of the
electrocardiogram.
Electrodes and Leads:
An electrode is a conductive pad in contact with the body
that makes an electrical circuit with the
electrocardiograph.

A lead is a connector to an electrode. A standard

12-lead ECG happens to need only 10 electrodes.
• Three limb leads
• Three augmented limb leads
• Six precordial leads or chest leads

Three limb leads form “Einthoven’s Triangle.”

 Understanding
ECG Waveform
Positive
- + complex

Depolarisatioon Wave
Negative
- + complex

If a wavefront of depolarization
travels towards the positive
electrode, a positive-going
deflection will result. If the
waveform travels away from
the positive electrode, a
negative going deflection will
be seen.
 PR Interval

PR interval will vary in second degree AV heart block type1(Wenkebach).

PR interval can be altered by changing sympathetic and parasympathetic
tone. Beta blockers can lengthen the PR interval and result in a first
degree AV block.
 QRS Complex

• Junctional tachycardia – Narrow QRS complexes with no visible P waves.

• Atrial flutter – Narrow QRS complexes are associated with regular flutter
waves.
• The most important cause is massive pericardial effusion , in which the
alternating QRS voltage is due to the heart swinging back and forth within a
large fluid–filled pericardium.
 ST Segment

Causes of ST segment elevation Causes of ST segment depression

• Acute myocardial infraction • Myocardial ischaemia/NSTEMI
• Coronary vasospasm(printzmental • Digoxin effect
angia) • Hypokalemia
• Pericarditis • Supraventricular tachycardia
• Benign early repolarization • Ventricular paced rhythm
• Left bundle branch block
• Left ventricular hypertrophy
• Raised intracranial pressure
• Brugada syndrome
Electrocardiogram
RHYTHM
Application of ECG:
• Suspected myocardial infraction(heart attack) or new chest
pain.
• Suspected pulmonary embolism or shortness of breadth.
• Cardiac murmur or structural heart disease.
• Fainting or collapse.
• Cardiac dysrhythmias or palpitations.
• Prolonged effect of drug.
• Hypertrophic cardiomyopathy
• Electrolytes abnormalities such as hyperkalemia.
• Cardiac stress testing.
 Conclusion
From this presentation we get a basic idea about ECG,
condition of heart in various situation, symptoms of various
disease and preventive measure.
 Reference
Textbook of Medical physiology ; By - Guyton & Hall ;
Eleventh edition ; Publisher - Elsevier Saunders ; Page no.
123-156.