Introduction to ECG

Jacktan Josephat Ruhighira

MSc Physiology
 Session Objectives

• At the end of this session everyone should be able to

− Define ECG
− Explain the characteristics of a normal ECG
− Identify duration and voltage on ECG
− Explain the physiological basis of ECG characteristic of different
arrhythmic conditions
− Explain the physiological basis of electroshock defibrillation
Introduction
• The body is a good conductor of the
electrical current
• Electrical current from cardiac impulse
conduction through the heart also
spreads from the into the adjacent
tissues
• A small portion of that current spreads
to the surface of the body and can be
detected by electrodes placed on the
skin
• The recording obtained is called an
electrocardiogram ( ECG or EKG ) and
the recording device is called an
electrocardiograph
Normal ECG
• Is composed of a P wave, a QRS
complex, and a T wave
• P is a depolarization wave caused by
electrical potentials generated when
the atria depolarize before atrial
contraction begins
• The QRS complex is composed of Q, R
and S waves caused by potentials
generated when the ventricles
depolarize and depolarization spread
before ventricular contraction begins
• T is a repolarization wave caused by
potentials generated as the ventricles
recover from the state of depolarization
ECG Time and Voltage
• ECG paper has lines,
horizontal for duration and
vertical for amplitude
• Lines are at regular intervals of
1 mm thickened at every 5 mm
• Each 1 mm represent 0.04 sec
or 0.1 mV
• Segments with zero voltage
are called isoelectric periods
• Can you find the duration of
each wave on the attached
ECG?
 ECG Intervals and Segments
• P-R interval: from onset of P to onset of
Q, signifies the atrial depolarization and
conduction of impulses through AV
node
• Q-T interval: from onset of Q the end of
T, signifies the electrical activity in
ventricles
• S-T segment: an isoelectric period from
end of S wave to the onset of T
• P-Q is also an isoelectric segment
• R-R interval: between two consecutive
‘R’ waves, signifies the duration of one
cardiac cycle
ECG Leads
• Are series of electrodes
placed on the surface of the
body and connected to an
ECG machine
• Heart is said to be in the
center of an imaginary
equilateral triangle drawn by
connecting the leads called
Einthoven triangle
• There limb and chest leads
 References
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Kearns, B. P., & Ganong, W. F. (2016). Ganong's review of medical
physiology. 25th edition. New York: McGraw Hill Education.
• Fox, S. I. and Rompolski K. (2022). Human physiology. 16th
Edition. Boston: McGraw-Hill
• Hall, J. E. (2016). Guyton and Hall textbook of medical
physiology.13th edition. Philadelphia, PA: Elsevier.
• Preston R. R. and Wilson T. E. (2018). 2nd edition. Lippincott
Illustrated Reviews
• Sembulingam K and Sembulingam P (2019). Essentials of medical
physiology. 8th ed. Jaypee Brothers Medical Limited