Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
WHAT IS ECG?
A diagnostic tool that measures and records the electrical activity of heart, over time, captured and externally recorded by skin electrodes. The ECG works by detecting and amplifying the tiny electrical changes on the skin that are caused when the heart muscle "depolarizes" during each heart beat.
E.C.G. LEADS
Leads are electrodes which measure the difference in electrical potential between either: 1. Two different points on the body (bipolar leads) 2. One point on the body and a virtual reference point with zero electrical potential, located in the center of the heart (unipolar leads)
E.C.G. LEADS
The standard E.C.G. has 12 leads:
The three bipolar limb leads form an equilateral triangle (with the heart at the center) that is called EINTHOVEN'S
If the three limbs of Einthoven's triangle are broken apart, collapsed, and superimposed over the heart, then the positive electrode for lead I is said to be at zero degrees relative to the heart. This new construction of the electrical axis is called the AXIAL REFERENCE
SYSTEM.
For a heart with a normal ECG and a mean electrical axis of +60, the standard limb leads will appear as follows:
These leads record electrical activity along a single plane, termed the frontal plane relative to the heart. For a heart with a normal ECG and mean electrical axis of +60, the augmented leads will appear as shown below:
V1-V2
anteroseptal
V3-V4
anteroapical
V5-V6
anterolateral
Because initial ventricular depolarization is from left to right across the septum, there is an initial R-wave in V1 followed by an Swave as the anterior and lateral walls of the left ventricle depolarize. Leads V2-V4 are intermediate owing to their electrode placement.
Tracings from leads V5 and V6 are almost opposite in polarity from V1 because they are viewing opposite sides of the heart. Leads V5 and V6 show a large net positive QRS because these leads overlie the anterolateral wall of the left ventricle, which has a large muscle mass undergoing depolarization.