ELECTROCARDIOGRAPHY

Electrocardiography (ECG) is recording of electrical changes

occurring during process of depolarization and repolarization

of heart via electrodes placed on body surface

Or Recording of electrical activities of heart from the body

surface through electrodes

Electrocardiograph is an instrument used to take recording

known as elctrocardiogram
Depolarisation and repolarisation generate electrical current

It flows in a circuitous route from depolarized to polarized area

Electric currents can be measured by the electrodes (leads)

Leads are placed on surface of the body surrounding the heart

ECG is recorded as deflection or waves using lead systems

Einthoven (1908) first recorded ECG using bipolar leads

Lead is connection of two points /parts of the body through

electrodes and wires with the electrocardiograph

If the electrical impulse travels towards the positive pole, a

positive (upward) deflection occurs

If the impulse moves towards negative lead the deflection is

negative (downward)
Applications of ECG

1) Measure automaticity:
HR, rhythmicity, pacemaker

2) Measure conductivity
pathway, reentry, block

3) Reveal hypertrophy- Enlargement of a

chamber of heart

4) Reveal ischemic damages

location, size, and progress
 COMMON LEAD SYSTEMS

A) Bipolar limb leads (by Einthoven)

B) Augmented unipolar limb leads

C) Unipolar Chest Leads

 COMMON LEAD SYSTEMS

A) Bipolar limb leads (by Einthoven)

•Lead I: Right arm, (- ve) & Left arm (+ ve)

•Lead II: Right arm (- ve) & Left leg (+ ve)

•Lead III: Left arm (- ve) & Left leg (+ ve)

•The right hind leg is connected to the earth

The triangle formed by the three lead systems with the heart at

the centre is referred to as Einthoven's triangle

B) Augmented unipolar limb leads

It compares electrical activity at the reference limb (right arm,

or left arm or left leg) to the sum of electrical activity at other

two limbs

Unipolar leads permit more precise location of direction of

electrical potential within the myocardium

 Lead aVR: Right arm (+ ve) & Left arm and left leg (- ve)

Lead aVL: Left arm (+ ve) & Right arm and left leg (- ve)

Lead aVF: Left leg (+ve) & Right and left arm (- ve)

Among the augmented unipolar limb leads only aVR shows

inverted deflections when compared to others.

 ECG WAVES

Deflection of normal ECG are referred as P, QRS and T waves

P wave

Positive wave of electrical potentials

Produced during depolarisation of S.A node & atria

It slightly precedes atrial systole and initiates atrial contraction

There is a very brief interval between P wave and atrial systole,

which is due to time lag between electrical and mechanical

events
QRS wave

QRS complex shows spreading depolarization wave through ventricles

Complex of positive and negative deflections

Initiates ventricular systole (depolarization)

QRS wave precedes isovolumetric contraction

T wave

Positive (upward) deflection precede ventricular diastole

Indicates the initiation of ventricular repolarization (relaxation)

No separate wave for atrial relaxation, due to fusion with QRS complex
P wave: atrial depolarization
QRS complex: ventricular depolarization
T wave: ventricular repolarization
 ECG INTERVALS

P-Q or P-R interval

- duration of time between beginning of P wave and QRS wave
- time of excitation wave travel from SA node to purkinje system
- includes short AV nodal delay after atrial contraction
P-R interval indicates atrio-ventricular conduction time
Normally P-R interval is 0.1 sec
Q-T interval

-duration from the beginning of Q wave to end of T wave

-Indicates duration from initiation of ventricular depolarization

to completion of repolarization
S-T interval

-duration between the beginning of S wave and T wave

-ventricles remain depolarized

P-P interval

- time between two successive P waves

-corresponds to time between atrial contractions

-used to calculate number of atrial contractions per minute

R-R interval

-time between two successive R waves

-used to calculate the ventricular rate/ heart rate

AVERAGE HEART RATE PER MINUTE AND ECG INTERVALS

Intervals in seconds
Species Average heart rate
PR QRS QT
Cattle 70 (48 – 84) 0.18 0.09 0.39
Horse 35 (28 - 40) 0.30 0.11 0.52
Swine 100 (70-120) 0.13 0.06 0.32
Sheep/goat 100 (72-120) 0.13 0.04 0.28
Dog 100 (70-120) 0.10 - 0.06
Cat 130(120-140) 0.07 0.04 0.17
 SIGNIFICANCE OF ECG

1. It is a non-invasive method to evaluate cardiac function

2. To diagnose ventricular hypertrophy

3. To evaluate conduction system blocks, myocardial

infarction and drug effects etc

 Disorders of the Cardiac Conduction System ----
Arrhythmias

-refers to abnormal initiation or conduction of electrical

impulses in the heart

- caused by ischemia, fibrosis, inflammation, or drugs

Bradycardia

slow heart rate ( < 60 beats/min)

Tachycardia

fast heart rate ( > 100 beats/min)

Atrial or Ventricular Flutter and Fibrillation

-No coordination in contraction of heart muscle

- Extremely rapid contraction
- Ventricular fibrillation is lethal
Premature contraction

When heart beat is triggered by ectopic pacemakers

(cells other than SA node)
 ECHOCARDIOGRAPHY
A non invasive tool for

- imaging heart & surrounding intrathoracic structures

- to diagnose cardiac diseases to assess cardiac function

Uses

•To evaluate size of cardiac chambers

•To study the thickness and movement of the wall

•To study the structure and movement of the valves

•To detect pericardial and pleural fluid

•To find out congenital cardiac anomalies

•To identify mass lesions within and adjacent to the heart

•To diagnose valvular and myocardial pathology .