Main Statements Of

the Einthoven’s Theory

BY: Prakhar Gupta & Dhruv Agrawal
Group: 51-2a
Week: 5
Date: 1April2022
ECG, EKG
 Electrocardiography is the technique by which electrical activities of the heart are
studied.
 The spread of excitation through myocardium produces local electrical potential.
 This low-intensity current flows through the body, which acts as a volume
conductor.
 This current can be picked up from surface of the body by using suitable electrodes
and recorded in the form of electrocardiogram.
 The electrode combination records the difference of potential difference at two sites
on the body. The potential differences are produced due to the electrical activity of
the heart.
 This technique was discovered by Dutch physiologist, Einthoven Willem, who is
considered the father of electrocardiogram (ECG).

 Electrocardiograph is the machine

 Electrocardiogram is the record
 The characteristic shape and
timing of the ECG waves are due
to the spread of wave of
depolarization and repolarization
associated with each heart beat.

USES OF ECG
Electrocardiogram is useful in determining
and diagnosing the following:
1. Heart rate
2. Heart rhythm
3. Abnormal electrical conduction
4. Poor blood flow to heart muscle
(ischemia)
5. Heart attack
6. Coronary artery disease
7. Hypertrophy of heart chambers.
• The ECG is not only
the oldest but, in
fact, over 100 years
after its
introduction,
continues as the
most commonly
used cardiovascular
laboratory
procedure.
What does the
ECG look like?
ECG LEADS
 ECG is recorded by placing series of electrodes on the surface of the body.
 These electrodes are called ECG leads and are connected to the ECG machine(A
Galvanometer)
 Each electrode controls an ink needle that writes on a grid paper. The higher the intensity
of the electric wave, the higher up the needle will move on the paper. The paper moves at
a certain speed beneath the needle, resulting in an ink curve.

Remember
The representation of the electrical activity of the heart is critically dependent on the
position of the electrodes. The same electrical activity will look different on different
electrode combinations
Leads that are routinely used for standard ECG
Total=12 leads
Standard Limb Leads/
3 Bipolar Limb Leads
Willhem Einthoven

3 Augmented Limb Leads E Goldberger

6 Precordial Leads Frank Wison

 BIPOLAR LIMB LEADS/
STANDARD LIMB LEADS
• The electrical connection of two electrodes to a recording instrument and to two
different places on the body, such as the chest and a limb.

• A record is obtained from the combined input of the two electrodes.

• More precisely, Two limbs are connected to obtain these leads and both the electrodes are
active recording electrodes, i.e. one electrode is positive and the other one is negative.

• Standard limb leads are of three types:

1. Limb lead I
2. Limb lead II
3. Limb lead III
Limb Lead I — This axis
goes from shoulder to
shoulder, with the negative
electrode placed on the right
shoulder and the positive
electrode placed on the left
shoulder. This results in a 0
degree angle of orientation.
Limb Lead II — This axis
goes from the right arm to the
left leg, with the negative
electrode on the shoulder and
the positive one on the leg.
This results in a +60 degree
angle of orientation.
Limb Lead III — This axis
goes from the left shoulder
(negative electrode) to the
right or left leg (positive
electrode). This results in a
+120 degree angle of
orientation.
Einthoven’s
Triangle

Einthoven's triangle is an imaginary

formation of three Bipolar limb leads, into
a triangle used in electrocardiography,
formed by the two shoulders and the pubis.
The shape forms an inverted equilateral
triangle with the heart at the center. It is
named after Willem Einthoven, who theorized
its existence.
NOTE
 Electrodes may be placed distally or proximally on the limb without affecting
the recording.

 The right leg electrode acts to reduce interference, and can be placed anywhere
without an effect on the ECG results.

 Each lead measures the electric field created by the heart during
the depolarization and repolarization of myocytes.

 The electric field can be represented as a vector that changes continuously and
can be measured by recording the voltage difference between electrodes.
 Einthoven’s Law Standard Limb Leads

 If the electrical potential difference of any two of the three

bipolar limb leads(standard Leads) are known at any given
instant,then the electric potential difference of third standard
- Limb lead I +
lead can be calculated mathematically by using the Einthoven’s
law.

Li
-

mb
Li
- mb

le
le
 It states that potential differences between the bipolar leads

ad
ad

III
II
measured simultaneously will, at any given moment, have the
values
II = I + III +
+
i.e, the potential of any wave or complex in lead II of ECG is
equal to the sum of potentials in lead I and lead III.

 Einthoven law is the modification of Kirchhoff’s law of

Einthoven’s triangle
voltage(the algebraic sum of voltage rise in a closed circuit is Einthoven’s Law
equal to the algebraic sum of voltage drops.)
Einthoven's triangle can also be used to
identify lead misplacements at time of ECG.
 Einthoven's triangle can be helpful in the identification in incorrect placement of
leads.
 Incorrect placement of leads can lead to error in the recording, which can ultimately
lead to misdiagnosis.

• If the arm electrodes are reversed, lead I changes polarity, causing lead II and
lead III to switch.
• If the right arm electrode is reversed with the leg's electrode, lead II changes
polarity, causing lead I to become lead III, and vice versa.
• Reversal of the left arm and leg causes a change in polarity of lead III and
switching of leads I and II.
 THANK YOU
FOR YOUR
ATTENTION !!