Electrocardiography A Brief Overview of ECG Interpretation.

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Updated March 2006: D. Tucker, RPh, BCPS

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Presentation transcript:

Electrocardiography A Brief Overview of ECG Interpretation

Normal to Abnormal Only way to understand abnormal is to first look at the “normal”. First: looking at cardiac electrical conduction.

Conduction System Sinoatrial Node Atrioventricular Node Bundle of His Bundle Branches Perkinje Fibres

Conduction System Sinoatrial Node (60-80 bpm) Atrioventricular Node (40-60 bpm) Bundle of His (20-40 bpm) Bundle Branches Purkinje fibres Cardiac Cells

Normal Conduction SA node starts action Accepted by AV node, starts inferior action Passes to bundle of His, down Purkinje fibres Action potential restarts

Cardiac Cell Regular Muscle cells many more Nuclei per cell, whereas cardiac Muscle cells only have one. Much more like smooth muscle, Under involuntary control.

Cardiac Cell

Muscle Cell

Conductivity Contractile and Conductive cells Focused impulse is generated (a pacemaker of any other site) then surrounding tissue will rhythmically contract. Bad when not starting at node.

Normal ECG

Dysrhythmias Look at P Wave Look at QRS complex Look at T Wave Look for U Waves

Rhythm Rate In order to tell what the rate of the heart is from the ECG: Count the # of QRS complexes in a six second strip and multiply by ten.

Dysrhythmias Rate P Waves (present, inverted, absent, retrograde, ratio) PR Interval (5 small squares) QRS (3 small squares) Rhythm (regular/irregular)

Interpret me!

Now me!

Heart Disease #1 killer in Canada

Blocked Coronary Artery depending on the amount of damage, conductive system may be impaired. electrical impulses do not travel across dead tissue.

Defibrillation Reboot the computer

Defibrillation Definition - the application of an external electrical shock to the heart muscle which terminates the electrical activity of the heart. This allows the natural pacemakers of the heart to restore normal rhythm. Time from collapse to defibrillation is critical factor to survival

Ventricular Tachycardia

Ventricular Fibrillation

Non-Shockable Rhythms

12 Lead Normally look at Lead II (over Left shoulder) Sometimes need to look at more aspects of heart Used to diagnose myocardial infarction, other cardiac dysrhythmias Looks at 12 Different aspects of the heart

12 Lead

Questions?