Electrocardiography (ECG)
Registration of electrical potentials from the heart also from body surface (the tissues of
the body contain electrolytes – are conductive).
W. Einthoven (1903) – string galvanometer
A three – lead system: Leads I. II. III. – standard - frontal plane ECG – equilateral triangle
Unipolar leads – V – Wilson – potential of one site is 0.
Transverse plane, precordial leads V
1-6 (12)
Augmented unipolar limb leads – aVR, aVL, aVF.
Form of the ECG
Isoelectric line
Waves:
P – atrial depolarization (0.1 – 0.3 mV, 0.1 s)
QRS – ventricular depolarization (atrial repolarization)
Q – initial depolarization (His bundle, branches)
R – activation of major portion of ventricular myocardium
S - late activation of posterobasal portion of the LV mass and the pulmonary conus
T – ventricular repolarization
U – repolarization of the papillary muscles
The duration of the waves, intervals and segments
P – wave
0.1 s
PQ – interval
0.16 s
PQ – segment
0.06 – 0.1 s
QRS complex
0.05 – 0.1 s
QT interval
0.2 – 0.4
QT segment
0.12
T wave
0.16
The voltage of ECG curve
P - 0.1 – 0.3 mV
R - 0.7 - 1.5 mV
T - 0.3 – 0.5 mV
Q, S - -0.3 - -0.5 mV
Intracellular potential 100 mV
Explanation:
1) ECG potential represents an algebraic sum of the action potentials of myocardial fibres
2) loss of voltage during spreading of potential
Special use of ECG
Esophageal leads (e.g. E-30)
Intracardial leads – RA, RV – His bundle electrogram
Monitoring:
– permanent in UIC
- Holter´s monitoring (tape recorder) diagnosis of arrhytmias