1. ECG 1.BIPOLAR LEADS I II III 2.UNIPOLAR LIMBS LEADS AVR AVL AVF
3.UNIPOLAR CHEST LEADS C1………..C6
4.RECORDING OF THE ECG

6. 6

7. Ground electrode Limb leads Lead I: Right arm to left arm
aVR: right arm
aVL: left arm
Lead II:
Right arm to
left leg
Lead III:
Left arm to
left leg
aVF: left leg
FIGURE 9-13: Electrocardiogram leads. (a) Limb leads. The six limb leads include leads I, II, III, aVR, aVL, and aVF. Leads I, II, and III are bipolar leads because two recording electrodes are used. The tracing records the difference in potential between the two electrodes. For example, lead I records the difference in potential detected at the right arm and left arm. The electrode placed on the right leg serves as a ground and is not a recording electrode. The aVR, aVL, and aVF leads are unipolar leads. Even though two electrodes are used, only the actual potential under one electrode, the exploring electrode, is recorded. The other electrode is set at zero potential and serves as a neutral reference point. For example, the aVR lead records the potential reaching the right arm in comparison to the rest of the body.
Ground electrode
Fig. 9-13a, p. 253

8. 2)Chest leads (precordial leads):8

9. 2 1 6 3 5 4
FIGURE 9-13: Electrocardiogram leads. (b) Chest leads. The six chest leads, V1 through V6, are also unipolar leads. The exploring electrode mainly records the electrical potential of the cardiac musculature immediately beneath the electrode in six different locations surrounding the heart.
Fig. 9-13b, p. 253

10. ECG 1.ECG WAVES P, QRS AND T 2.ECG SEGMENTS PR AND ST
3.ECG INTERVAL PR, QT AND TP

11. R T P P Q S PR ST TP interval
FIGURE 9-14: Electrocardiogram waveforms in lead II. PR ST
TP interval
Fig. 9-14, p. 254

12. The shape of the ECG 12

13. SINGLE VENTRICULAR ACTION POTENTIAL
ENDOCARDIAL FIBER
ATRIAL
FIBER
EPICARDIAL FIBER R
1 mV
ECG T P
Repolarization of ventricles
Q S
Depolarization of ventricles
Depolarization of atria

14. EKG Waves and Intervals
QRS length R T P Q S
Normal: PR interval: sec
QRS length: <0.10 sec
QT interval: sec
Abnormalities in:
QRS – ventricular depolarizaton problems
P-R interval – A/V conduction problems
P-R
interval
Q-T interval

15. EKG Reading 0.2 sec 0.04 sec 1.0 mV Test pulse
HR = 1500/ small boxes between QRS complexes

16. 3)Augmented unipolar limb leads:16

17. Relationship between No. of large squares & HR …..
Heart rate (beat/min)
R-R interval (large squares)
300 1
150 2
100 3 75 4 60 5 50 6 17

18. Times & speed…. Normal duration (s) Range Average intervals 0.12-0.20
0.18
PR interval
0.08
QRS duration
0.40
QT interval …
0.32
ST interval 18

19. R T P P Q S PR ST TP interval
FIGURE 9-14: Electrocardiogram waveforms in lead II. PR ST
TP interval
Fig. 9-14, p. 254