 Cone shaped muscular

organ-10cm long.

 Weighs 220gm in
female and 310gm in
males.

 Position-Lies in
thoracic cavity behind
mediastinum and
between the lungs.
1) atrial depolarization
begins
2) atrial depolarization
complete (atria
contracted)
3) ventricles begin to
depolarize at
apex; atria
repolarize (atria
relaxed)
4) ventricular
depolarization
complete
(ventricles
contracted)
5) ventricles begin to
repolarize at apex
6) ventricular
repolarization
complete
(ventricles
relaxed)
 It is a period
of time for
which the
cardiac cells
may unable
to respond,
to a
stimulus.
P wave
 The first deflection of the
cardiac cycle, caused by
depolarization of the atria.
 Smooth and rounded.
 The amplitude shouldn't
exceed 2.5 mm
 Duration shouldn't be greater
than 0.10 second.
 
 The P wave is normally
positive in lead II.
 
 PR interval
 Measured from
the beginning of
the P wave to the
beginning of the
QRS complex.

 The normal
duration is
0.12 to 0.20 sec.
QRS complex
 represents the
conduction from the
bundle of His
throughout the
ventricles
 The QRS complex is
the largest complex.
 The point where the
QRS complex ends is
called the J point.
 The normal QRS
complex duration
0.10 second or less.
 ≥ 0.12 is Abnormal
ST segment
 The ST segment
begins with the end
of the QR8 complex
and ends with the
onset of the T wave.
 The normal ST
segment is flat
(isoelectric).
 The point marking
the end of the QRS
complex and the
beginning of the ST
segment is called the
J point.
T wave
 Represents
ventricular
repoarization.
 Slopes upward
from the ST
segment and
ends when the
waveform
returns to
baseline  
 Amplitude less
than 5 mm.
QT Interval
 The QT interval is
measured from the
beginning of the QRS
complex to the end of the T
wave.
 The normal QT interval
should be less than half the
distance between two
consecutive R waves when
the rhythm is regular.
 The QT interval can be
measured more accurately
if it's corrected for heart
rate (QT rate corrected, or
QTc).
 U wave
 Normal U waves are
small, rounded, and
symmetrical;
positive in lead II.
 Usually less than 2
mm in amplitude
(always smaller than
the preceding T
wave).
 Some causes:
Hypokalemia
Cardiomyopathy
Digitalis, Quinidine,
and Procainamide.
 aVL is placed on the left arm (or
shoulder)
 aVF is placed on the left leg (or
hip)
 aVR is placed on the right arm
(or shoulder)
 V1- 4th intercostal space to the
right of sternum
 V2- 4th intercostal space to the
left of sternum
 V3- halfway between V2 and V4
 V4- 5th intercostal space in the
left mid-clavicular line
 V5- 5th intercostal space in the
left anterior axillary line
 V6- 5th intercostal space in the
left mid axillary line
There are five basic steps to be followed in
analyzing a rhythm strip:
Five basic steps to analyze a rhythm strip:
 Step 1: Determine the regularity (rhythm) of

the R waves
  Step 2: Calculate the heart rate

 Step 3: Identify and examine P waves

 Step 4: Measure the PR interval

 Step 5: Measure the QRS complex

 ECG Workout (Exercises in arrhythmia
Interpretation), Jane Huff, 5th Edition (2006).
  Thelans Critical Care Nursing, Diagnosis and
Management Linda D. Urden 4th Edition (2002).