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Instructor Terry Wiseth

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1 Instructor Terry Wiseth
ECG AND HEART FUNCTION ECG AND EXERCISE Instructor Terry Wiseth Click Here to Start Your Lab

2 What Do I Need To Hand In For This Lab?
1) ECG Tracing Data Table At Rest 2) ECG Tracing Data Table After Exercise 3) Labeled Sketch of ECG Tracing At Rest 4) Labeled Sketch of ECG Tracing After Exercise 5) Answers to Questions 1-8 Click Here to Advance to Next Slide

3 ECG Data Table At Rest After Exercise
You can use the links below to print off the data tables, graphs and questions you will need to hand in with this lab. ECG Data Table At Rest After Exercise ECG Tracing Graph Paper (You will want 2 copies of this) Questions 1-8 Click Here to Advance to Next Slide

4 Click on the blackboard to view a larger blackboard.
The electrocardiogram (ECG) can be monitored in the laboratory and gives information on the electrical activity of the atria and ventricles during the cardiac cycle. Monitor mV sec sec sec Time DATA ACQUISITION UNIT Stimulator Outputs Recording Inputs + 1 Start Recording Stop Recording Power - 2 ECG Sensor Click Here to Advance to Next Slide

5 Click Here to Advance to Next Slide
The cardiac cycle consists of a contraction of the atria and then the ventricles, followed by a period of rest. An impulse from the sinoatrial node produces a contraction of the atria and then excites the ventricles via the atrioventricular node. Click Here to Advance to Next Slide

6 Click Here to Advance to Next Slide
The currents produced by these impulses are recorded as the electrocardiogram or ECG, and the various waves can be correlated with the contractions of the atria and ventricles. An ECG is also called an EKG or electrokardiogram. Click Here to Advance to Next Slide

7 Click Here to Advance to Next Slide
We can summarize an ECG tracing in the image below. Each of the waves or spikes on the tracing can be represented with letters to indicate changes in electrical actions within the heart. Click Here to Advance to Next Slide

8 Click Here to Advance to Next Slide
It is easy to monitor a subjects electrocardiogram (ECG) in the lab and determine any changes provoked by exercise. In this lab the intervals between the various components of the ECG are measured from a volunteer at REST and immediately after EXERCISE, when the heart rate is elevated. The results will help to see how changes in physical activity affect heart function. Click Here to Advance to Next Slide

9 Ventricular Contraction
Exercise increases the cardiac output by increasing 1) stroke volume and 2) heart rate. This lab compares the ECG from a volunteer at rest and during recovery from exercise. This is achieved by measuring the P-Q, Q-T and R-R time intervals and the QRS Complex amplitude to see which are affected by exercise. Study the image below to identify the various parts of the ECG tracing. P Q S T R PQ QT Atrial Contraction Ventricular Contraction QRS Complex Amplitude Click on the Image or here to view a printable image Click Here to Advance to Next Slide

10 Click on the Image or here to view a printable image
The PQ Interval represents the atrial contraction. The length in time of the PQ interval can infer the strength of the atrial contraction. The QT Interval represents the contraction and relaxation of the ventricles. The length in time of the QT Interval can infer the strength of the ventricular contraciton. Click on the Image or here to view a printable image P Q S T R PQ QT Atrial Contraction Ventricular Contraction QRS Complex Amplitude Click Here to Advance to Next Slide

11 Click Here to Advance to Next Slide
During exercise there is an increase in the amount of blood circulating around the body. Activation of the sympathetic nervous system increases cardiac output by modifying heart function in two ways: 1) The Stroke Volume Increases 2) The Heart Rate Increases Click Here to Advance to Next Slide

12 1) The Stroke Volume Increases Click Here to Advance to Next Slide
The volume of blood in the heart before contraction increases and the volume of the blood in the heart after contraction decreases. Thus the Stroke Volume (the amount of blood ejected from either ventricle during each cardiac cycle) increases because there is more blood in the ventricles before contraction and less remaining in the ventricles after contraction. Click Here to Advance to Next Slide

13 Click Here to Advance to Next Slide
Comparisons of Stroke Volumes can be inferred by the relative amplitude of the QRS complex of an ECG tracing at rest and after exercise. Amplitude is measured in millivolts (mV) and can be found on the vertical axis of the ECG tracing. A larger amplitude (mV) reading would indicate a more forceful ventricular contraction. A more forceful ventricular contraction causes more blood to be ejected during a cardiac cycle and thus an increased Stroke Volume. Click Here to Advance to Next Slide

14 Click Here to Advance to Next Slide
A measure of Stroke Volume can be inferred by the amplitude of the QRS complex of an ECG tracing. sec mV Time Amplitude Click Here to Advance to Next Slide

15 2) The Heart Rate Increases Click Here to Advance to Next Slide
The number of cardiac cycles (contractions) per minute increases. The heart rate increase is a result of the excess CO2 produced by exercising muscles. sec mV Time AT REST One contraction each second would represent a heart rate of 60 beats per minute Click Here to Advance to Next Slide

16 Click Here to Advance to Next Slide
ECG The image to the left is a tracing of an ECG reading. The spikes can be thought to represent one heart beat. From the tracing given here we can see that there is a spike every second. sec mV Time Spikes Click Here to Advance to Next Slide

17 Click Here to Advance to Next Slide
ECG A spike each second would represent a heart rate of 60 beats per minute. As well, a spike every 0.5 seconds would represent a heart rate of 120 beats per minute. sec mV Time Spikes Click Here to Advance to Next Slide

18 Click Here to Advance to Next Slide
Monitor mV sec sec sec Time DATA ACQUISITION UNIT Stimulator Outputs Recording Inputs + 1 Start Recording Stop Recording Power - 2 ZOOM PRINT ECG Sensor During this experiment you will display an ECG from a volunteer at rest and during recovery from exercise. To Start click the Red power control button to turn on the Data Acquisition Unit. Click Here to Advance to Next Slide

19 Click Here to Advance to Next Slide
Monitor mV Time sec DATA ACQUISITION UNIT Stimulator Outputs Recording Inputs + 1 Start Recording Stop Recording Power - 2 ZOOM PRINT ECG Sensor Click on the Blue lead from the ECG Sensor to plug it into Recording Input #1. The Red, Green and Black sensors on the table are radio telemetry sensors and will relay signals to the ECG Sensor. Click Here to Advance to Next Slide

20 Click Here to Advance to Next Slide
Monitor mV sec Time DATA ACQUISITION UNIT Stimulator Outputs Recording Inputs + 1 Start Recording Stop Recording Power - 2 ZOOM PRINT ECG Sensor Click on the Red electrode to connect it to the left wrist of the volunteer. Next click on the Green and Black electrodes to place them on the right foot and the right wrist respectively. Click Here to Advance to Next Slide

21 You should click on the STOP RECORDING button at this time
mV sec sec sec Time DATA ACQUISITION UNIT Monitor Stimulator Outputs Recording Inputs + 1 Start Recording Stop Recording Power - 2 ZOOM PRINT ECG Sensor Start Recording the ECG waves by clicking on the Green button on the monitor. The ECG tracings will continue for about 40 seconds and will then stop. You should click on the Red button to stop recording. At Rest

22 Ventricular Contraction
P Q S T R PQ QT Atrial Contraction Ventricular Contraction QRS Complex Amplitude Monitor mV Time sec DATA ACQUISITION UNIT Stimulator Outputs Recording Inputs + 1 Start Recording Stop Recording Power - 2 ZOOM PRINT ECG Sensor Click on the blue ZOOM button above to see a larger view of the ECG. Click on the yellow PRINT button view a printable version. Enter your data in the Data Table for At Rest. When you have collected all of the data for the subject at rest Click Here to Go to the Part 2 of the Lab

23 mV sec sec sec Time Monitor Power DATA ACQUISITION UNIT Stimulator Outputs + - Recording Inputs 1 2 ECG Sensor Start Recording Stop Recording ZOOM PRINT We will now have the subject exercise by running in place for a prescribed period of time. Click on the subject above to begin exercising. When the exercise is completed we will monitor the ECG once again. The exercise is now complete. Click Here to go to the next slide to collect data You will be notified what to do next, when the subject has exercised the prescribed time. Please be patient.

24 Ventricular Contraction
P Q S T R PQ QT Atrial Contraction Ventricular Contraction QRS Complex Amplitude You should click on the STOP RECORDING button at this time mV sec sec sec Time DATA ACQUISITION UNIT Monitor Stimulator Outputs Recording Inputs + 1 Start Recording Stop Recording Power - 2 ZOOM PRINT ECG Sensor Start Recording the ECG waves by clicking on the Green button on the monitor. The ECG tracings will continue for about 40 seconds and will then stop. You should click on the Red button to stop recording. After Exercise

25 PERFORM THE FOLLOWING SKETCHES
Sketch an image of the ECG tracing taken from the subject at Rest. Include at least three cycles in your sketch. Label the PQRST landmarks of one of the cycles. ECG TRACING PAPER 2) Sketch an image of the ECG tracing taken from the subject after Exercise. Include at least three cycles in your sketch. Label the PQRST landmarks of one of the cycles. ECG TRACING PAPER Click Here to View a Printable ECG Graph Paper Click Here to Advance to Next Slide

26 Answer The Following Questions
1) Which component of the ECG coincides with contraction of the ventricles? 2) Which component of the ECG coincides with contraction of the atria? 3) What is the heart rate of the subject at rest? 4) What is the heart rate of the subject after exercise? 5) Describe at least two differences between the ECG tracings of the subject at rest and after exercise. 6) Why is the amplitude of the ECG tracing of the subject after exercise higher than when measured at rest? 7) Tachycardia is a term used to indicate a rapid heart rate. Which of the two ECG tracings performed indicate tachycardia? 8) Sinus rhythm is a term used to describe normal heart rate. Which of the two ECG tracings performed indicate sinus rhythm? Click Here to View a Printable Version of the Questions Click Here to Advance to Next Slide

27 Click Here to End the Lab
You have now collected the data you need to finish the lab. Be sure that you include the following in your lab report. You can click on each of the following to link to them. 1) ECG Tracing Data Table At Rest 2) ECG Tracing Data Table After Exercise 3) Labeled Sketch of ECG Tracing At Rest 4) Labeled Sketch of ECG Tracing After Exercise 5) Answers to Questions 1-8 Click Here to End the Lab

28 Time Click to View a Printable Version of blank ECG Tracing Paper
sec Monitor mV 1.0 0.5 1.5 Click to View a Printable Version of blank ECG Tracing Paper Click to View a Printable Version of this Image Click to View ECG Data Table at Rest Click Here to Return to Last Slide Viewed Sketch the ECG tracing above. You can use the red link shown above to print out a blank ECG tracing graph. Using the time measuring bars and the mV scale on the left, find the time intervals for the following: R-R Interval, P-Q Interval, Q-T Interval, Amplitude of QRS Complex.

29 ECG Tracings Data Table at REST
Time seconds Amplitude mV Heart Rate HR = 60 / RR Interval   RR Interval PQ Interval QT Interval QRS Amplitude Click to View a Printable Version of the ECG Data Table at Rest Click Here to Return to Lab After entering the data from the ECG tracing calculate the Heart Rate at REST by using the formula given in the table.

30 Time sec Monitor mV 1.0 0.5 1.5 Click to View a Printable Version of ECG Tracing Paper Click to View a Printable Version of this Image Click to View ECG Data Table After Exercise Click Here to Return to Last Slide Viewed Sketch the ECG tracing above. You can use the link shown above to print out a blank ECG tracing graph. Using the time measuring bars and the mV scale on the left, find the time intervals for the following: R-R Interval, P-Q Interval, Q-T Interval, Amplitude of QRS Complex.

31 ECG Tracings Data Table After Exercise
Time seconds Amplitude mV Heart Rate HR = 60 / RR Interval RR Interval PQ Interval QT Interval QRS Amplitude Click to View a Printable Version of the ECG Data Table After Exercise Click Here to Return to Lab After entering the data from the ECG tracing calculate the Heart Rate after EXERCISE by using the formula given in the table.

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