10.17 - Thompson - EKG Essentials

10.17 - Thompson - EKG Essentials - EKG Essentials Standard...

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EKG Essentials Standard Limb Leads I, II, III Augmented Leads aV L , aV R , aV F 1 Uses of the EKG Heart Rate Conduction in the heart Arrhythmia Direction of the cardiac vector Damage to the heart muscle Provides NO information about pumping or mechanical events in the heart. 2 Normal and Augmented Limb Leads I, II, III, aV R , aV L , aV F 3
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Determinants of Wave Form 1. Conduction Velocity - Determines width (duration) of peaks 2. Mass - Bigger mass produces bigger dipole 3. Vectorial Orientation - At any point (P,QRS,T,etc.) size depends on lead 4. Distance Electrodes from Dipole - Std Leads eliminate this with equilateral triangle 4 Conduction Velocity 1. Magnitude of Action Potential - Nodal cells have a smaller overshoot and a less polarized “resting” potential 2. Rate of rise of the Action Potential - dV/dt - fast response or slow response 5 6 Functional Syncytium
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7 Action Potential Conduction Grant’s Atlas of Anatomy Fig 1.60 Conduction system of the heart, coronal section 8 9 Electrical Conduction
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10 Conduction times SA node AV node Origin of ECG 11 EKG - Cardiac Cycle 12
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ECG reflects Cellular APs J. Clin. Invest. 110 :1075-107 7 (2002). 13 ECG Intervals 14 Determinants of Wave Form • Conduction Velocity –Determines width (duration) of peaks Mass Bigger mass produces bigger dipole • Vectorial Orientation –At any point (P,QRS,T,etc.) size depends on lead • Distance Electrodes from Dipole –Std Leads eliminate this with equilateral triangle 15
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10.17 - Thompson - EKG Essentials - EKG Essentials Standard...

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