ECG interpretation basics

Size: px
Start display at page:

Download "ECG interpretation basics"

Transcription

1 ECG interpretation basics Michał Walczewski, MD Krzysztof Ozierański, MD

2 Electrical conduction system of the heart

3 Limb leads

4 Precordial leads

5 Precordial leads

6 Precordial leads

7

8

9

10

11 Small square (1 mm) Paper speed 25 mm/s 50 mm/s 0,04 s = 40 ms 0,02 s = 20 ms Big square (5 mm) 0,2 s = 200 ms 0,1 s = 100 ms

12 Patient 1 25 mm/s 0,04 s = 40 ms 0,2 s = 200 ms 50 mm/s 0,02 s = 20 ms 0,1 s = 100 ms

13 What rhythm Regularity Heart rate Axis PR interval QRS width Basic ECG analysis ST segment, T wave, QT interval Relation between atria and ventricles QRS morphology Signs of ischemia

14 What rhythm Regularity Heart rate Axis PR interval QRS width Basic ECG analysis ST segment, T wave, QT interval Relation between atria and ventricles QRS morphology Signs of ischemia

15 Where does the rhythm come from?

16 Different pacemakers different rhythms Sinus rhythm AV node rhythm (junctional) Ventricular rhythm Many others

17 Sinus rhythm Positive P wave: II Negative P wave: avr

18 Sinus rhythm Positive P wave: II Negative P wave: avr

19 Sinus rhythm??? Positive P wave: II Negative P wave: avr

20 Sinus rhythm??? Positive P wave: II Negative P wave: avr

21 Accelerated Junctional Rhythm Sinus rhythm

22 What rhythm Regularity Heart rate Axis PR interval QRS width Basic ECG analysis ST segment, T wave, QT interval Relation between atria and ventricles QRS morphology Signs of ischemia

23 Sinus rhythm??? Positive P wave: I, II Negative P wave: avr

24 Sinus rhythm Atrial fibrillation No P waves, only f wave Irregular

25 What rhythm Regularity Heart rate Axis PR interval QRS width Basic ECG analysis ST segment, T wave, QT interval Relation between atria and ventricles QRS morphology Signs of ischemia

26 Heart Rate 25 mm/s 300 / RR 50 mm/s 600 / RR RR count of big squares between two R waves

27 Heart Rate 25 mm/s 300 / RR HR? 50 mm/s 600 / RR RR count of big squares between two R waves

28 Heart Rate 25 mm/s 300 / RR HR = 300 / 3,5 = 8 50 mm/s 600 / RR RR count of big squares between two R waves

29 Heart Rate 25 mm/s 300 / RR 50 mm/s 600 / RR HR? RR count of big squares between two R waves

30 HR = 600/7,5 = 80 Heart Rate 25 mm/s 300 / RR 50 mm/s 600 / RR RR count of big squares between two R waves

31 Heart Rate (sinus rhytm) <60/min bradycardia normal HR >100 tachycardia

32 Heart Rate

33 Heart Rate

34 What rhythm Regularity Heart rate Axis PR interval QRS width Basic ECG analysis ST segment, T wave, QT interval Relation between atria and ventricles QRS morphology Signs of ischemia

35 Heart axis

36 Heart axis

37 Heart axis

38 What rhythm Regularity Heart rate Axis PR interval QRS width Basic ECG analysis ST segment, T wave, QT interval Relation between atria and ventricles QRS morphology Signs of ischemia

39 PR interval Normal: ms

40 PR interval Normal: ms

41 PR interval Normal: ms???

42 PR interval Normal: ms

43 What rhythm Regularity Heart rate Axis PR interval QRS width Basic ECG analysis ST segment, T wave, QT interval Relation between atria and ventricles QRS morphology Signs of ischemia

44 QRS complex width Normal: ms

45 Normal: ms QRS complex width

46 Normal: ms QRS complex width

47 Wide QRS complex Left/ Right Bundle Branch Block Intraventricular conduction disturbances Ventricular rhythm / excitation Artificial pacemaker (ventricular stimulation) Preexcitation syndrome

48 What rhythm Regularity Heart rate Axis PR interval QRS width Basic ECG analysis ST segment, T wave, QT interval Relation between atria and ventricles QRS morphology Signs of ischemia

49 ST segment, T wave, Q wave

50 ST segment elevation, T wave, Q wave

51 ST segment elevation, pathological Q wave

52 ST segment, T wave, Q wave

53 ST segment depression, Negative T wave

54 What rhythm Regularity Heart rate Axis PR interval QRS width Basic ECG analysis ST segment, T wave, QT interval Relation between atria and ventricles QRS morphology Signs of ischemia

55 Relation between atria and ventricles

56 Relation between atria and ventricles

57 What rhythm Regularity Heart rate Axis Basic ECG analysis PR interval ( ms) QRS width ( ms) ST segment, T wave, QT interval Relation between atria and ventricles QRS morphology Signs of ischemia

58

Family Medicine for English language students of Medical University of Lodz ECG. Jakub Dorożyński

Family Medicine for English language students of Medical University of Lodz ECG. Jakub Dorożyński Family Medicine for English language students of Medical University of Lodz ECG Jakub Dorożyński Parts of an ECG The standard ECG has 12 leads: six of them are considered limb leads because they are placed

More information

Electrocardiography Abnormalities (Arrhythmias) 7. Faisal I. Mohammed, MD, PhD

Electrocardiography Abnormalities (Arrhythmias) 7. Faisal I. Mohammed, MD, PhD Electrocardiography Abnormalities (Arrhythmias) 7 Faisal I. Mohammed, MD, PhD 1 Causes of Cardiac Arrythmias Abnormal rhythmicity of the pacemaker Shift of pacemaker from sinus node Blocks at different

More information

2017 BDKA Review. Regularity Rate P waves PRI QRS Interpretation. Regularity Rate P waves PRI QRS Interpretation 1/1/2017

2017 BDKA Review. Regularity Rate P waves PRI QRS Interpretation. Regularity Rate P waves PRI QRS Interpretation 1/1/2017 1. 2017 BDKA Review 2. 3. 4. Interpretation 5. QT 6. 7. 8. 9. 10. QT 11. 12. 13. 14. 15. 16. 17. 18. QT 19. 20. QT 21. 22. QT 23. 24. Where are pacer spikes? Before the P wave or before the QRS complex?

More information

ECG ABNORMALITIES D R. T AM A R A AL Q U D AH

ECG ABNORMALITIES D R. T AM A R A AL Q U D AH ECG ABNORMALITIES D R. T AM A R A AL Q U D AH When we interpret an ECG we compare it instantaneously with the normal ECG and normal variants stored in our memory; these memories are stored visually in

More information

ABCs of ECGs. Shelby L. Durler

ABCs of ECGs. Shelby L. Durler ABCs of ECGs Shelby L. Durler Objectives Review the A&P of the cardiac conduction system Placement and obtaining 4-lead and 12-lead ECGs Overview of the basics of ECG rhythm interpretation Intrinsic

More information

Appendix D Output Code and Interpretation of Analysis

Appendix D Output Code and Interpretation of Analysis Appendix D Output Code and Interpretation of Analysis 8 Arrhythmia Code No. Description 8002 Marked rhythm irregularity 8110 Sinus rhythm 8102 Sinus arrhythmia 8108 Marked sinus arrhythmia 8120 Sinus tachycardia

More information

Lab Activity 24 EKG. Portland Community College BI 232

Lab Activity 24 EKG. Portland Community College BI 232 Lab Activity 24 EKG Reference: Dubin, Dale. Rapid Interpretation of EKG s. 6 th edition. Tampa: Cover Publishing Company, 2000. Portland Community College BI 232 Graph Paper 1 second equals 25 little boxes

More information

ECG INTERPRETATION MANUAL

ECG INTERPRETATION MANUAL Lancashire & South Cumbria Cardiac Network ECG INTERPRETATION MANUAL THE NORMAL ECG Lancashire And South Cumbria Cardiac Physiologist Training Manual THE NORMAL ECG E.C.G CHECKLIST 1) Name, Paper Speed,

More information

CORONARY ARTERIES HEART

CORONARY ARTERIES HEART CARDIAC/ECG MODULE THE HEART CORONARY ARTERIES FIBRILLATING HEART CORONARY ARTERIES HEART PRACTICE RHYTHMS PRACTICE RHYTHMS ELECTRICAL CONDUCTION SA Node (60 100) Primary pacemaker AV Node (40 60) ***Creates

More information

The Electrocardiogram part II. Dr. Adelina Vlad, MD PhD

The Electrocardiogram part II. Dr. Adelina Vlad, MD PhD The Electrocardiogram part II Dr. Adelina Vlad, MD PhD Basic Interpretation of the ECG 1) Evaluate calibration 2) Calculate rate 3) Determine rhythm 4) Determine QRS axis 5) Measure intervals 6) Analyze

More information

Dr.Binoy Skaria 13/07/15

Dr.Binoy Skaria  13/07/15 Dr.Binoy Skaria binoyskaria@hotmail.com binoy.skaria@heartofengland.nhs.uk 13/07/15 Acknowledgement Medtronic, Google images & Elsevier for slides Natalie Ryan, Events Manager, HEFT- for organising the

More information

This presentation will deal with the basics of ECG description as well as the physiological basics of

This presentation will deal with the basics of ECG description as well as the physiological basics of Snímka 1 Electrocardiography basics This presentation will deal with the basics of ECG description as well as the physiological basics of Snímka 2 Lecture overview 1. Cardiac conduction system functional

More information

Electrocardiography for Healthcare Professionals

Electrocardiography for Healthcare Professionals Electrocardiography for Healthcare Professionals Chapter 7: Junctional Dysrhythmias 2012 The Companies, Inc. All rights reserved. Learning Outcomes 7.1 Describe the various junctional dysrhythmias 7.2

More information

8/20/2012. Learning Outcomes (Cont d)

8/20/2012. Learning Outcomes (Cont d) 1 2 3 4 Electrocardiography for Healthcare Professionals Chapter 7: Junctional Dysrhythmias Learning Outcomes 7.1 Describe the various junctional dysrhythmias 7.2 Identify premature junctional complexes

More information

ECG CONVENTIONS AND INTERVALS

ECG CONVENTIONS AND INTERVALS 1 ECG Waveforms and Intervals ECG waveforms labeled alphabetically P wave== represents atrial depolarization QRS complex=ventricular depolarization ST-T-U complex (ST segment, T wave, and U wave)== V repolarization.

More information

UNDERSTANDING YOUR ECG: A REVIEW

UNDERSTANDING YOUR ECG: A REVIEW UNDERSTANDING YOUR ECG: A REVIEW Health professionals use the electrocardiograph (ECG) rhythm strip to systematically analyse the cardiac rhythm. Before the systematic process of ECG analysis is described

More information

3/26/15 HTEC 91. EKG Sign-in Book. The Cardiac Cycle. Parts of the ECG. Waves. Waves. Review of protocol Review of placement of chest leads (V1, V2)

3/26/15 HTEC 91. EKG Sign-in Book. The Cardiac Cycle. Parts of the ECG. Waves. Waves. Review of protocol Review of placement of chest leads (V1, V2) EKG Sign-in Book HTEC 91 Review of protocol Review of placement of chest leads (V1, V2) Medical Office Diagnostic Tests Week 2 http://www.cvphysiology.com/arrhythmias/a013c.htm The Cardiac Cycle Represents

More information

Paediatric ECG Interpretation

Paediatric ECG Interpretation Paediatric ECG Interpretation Dr Sanj Fernando (thanks to http://lifeinthefastlane.com/ecg-library/paediatric-ecginterpretation/) 3 yo boy complaining of abdominal pain and chest pain Child ECG vs Adult

More information

Step by step approach to EKG rhythm interpretation:

Step by step approach to EKG rhythm interpretation: Sinus Rhythms Normal sinus arrhythmia Small, slow variation of the R-R interval i.e. variation of the normal sinus heart rate with respiration, etc. Sinus Tachycardia Defined as sinus rhythm with a rate

More information

Chapter 2 Practical Approach

Chapter 2 Practical Approach Chapter 2 Practical Approach There are beginners in electrocardiogram (ECG) analysis who are fascinated by a special pattern (e.g., a bundle-branch block or a striking Q wave) and thereby overlook other

More information

ELECTROCARDIOGRAPH. General. Heart Rate. Starship Children s Health Clinical Guideline

ELECTROCARDIOGRAPH. General. Heart Rate. Starship Children s Health Clinical Guideline General Heart Rate QRS Axis T Wave Axis PR Interval according to Heart Rate & Age P Wave Duration and Amplitude QRS Duration according to Age QT Interval R & S voltages according to Lead & Age R/S ratio

More information

ECG. Prepared by: Dr.Fatima Daoud Reference: Guyton and Hall Textbook of Medical Physiology,12 th edition Chapters: 11,12,13

ECG. Prepared by: Dr.Fatima Daoud Reference: Guyton and Hall Textbook of Medical Physiology,12 th edition Chapters: 11,12,13 ECG Prepared by: Dr.Fatima Daoud Reference: Guyton and Hall Textbook of Medical Physiology,12 th edition Chapters: 11,12,13 The Concept When the cardiac impulse passes through the heart, electrical current

More information

EKG Intermediate Tips, tricks, tools

EKG Intermediate Tips, tricks, tools Birmingham Regional Emergency Medical Services System 2018 ALCTE Summer Conference EKG Intermediate Tips, tricks, tools Brian Gober, MAT, ATC, NRP, CSCS Education Services Manager ECC Training Center Coordinator

More information

Proceedings of the World Small Animal Veterinary Association Sydney, Australia 2007

Proceedings of the World Small Animal Veterinary Association Sydney, Australia 2007 Proceedings of the World Small Animal Sydney, Australia 2007 Hosted by: Next WSAVA Congress ECG INTERPRETATION Adrian Boswood MA VetMB DVC DECVIM-CA(Cardiology) MRCVS The Royal Veterinary College, Hawkshead

More information

Diploma in Electrocardiography

Diploma in Electrocardiography The Society for Cardiological Science and Technology Diploma in Electrocardiography The Society makes this award to candidates who can demonstrate the ability to accurately record a resting 12-lead electrocardiogram

More information

Electrocardiography Biomedical Engineering Kaj-Åge Henneberg

Electrocardiography Biomedical Engineering Kaj-Åge Henneberg Electrocardiography 31650 Biomedical Engineering Kaj-Åge Henneberg Electrocardiography Plan Function of cardiovascular system Electrical activation of the heart Recording the ECG Arrhythmia Heart Rate

More information

CRC 431 ECG Basics. Bill Pruitt, MBA, RRT, CPFT, AE-C

CRC 431 ECG Basics. Bill Pruitt, MBA, RRT, CPFT, AE-C CRC 431 ECG Basics Bill Pruitt, MBA, RRT, CPFT, AE-C Resources White s 5 th ed. Ch 6 Electrocardiography Einthoven s Triangle Chest leads and limb leads Egan s 10 th ed. Ch 17 Interpreting the Electrocardiogram

More information

Bundle Branch & Fascicular Blocks. Reading Assignment (p53-58 in Outline )

Bundle Branch & Fascicular Blocks. Reading Assignment (p53-58 in Outline ) Bundle Branch & Fascicular Blocks Reading Assignment (p53-58 in Outline ) Objectives 1. QRS analysis of Right and Left BBB 2. Uncomplicated vs complicated BBB 3. Diagnosis of RBBB with LAFB and LPFB 4.

More information

Full file at

Full file at MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) What electrical event must occur for atrial kick to occur? 1) A) Atrial repolarization B) Ventricular

More information

Relax and Learn At the Farm 2012

Relax and Learn At the Farm 2012 Relax and Learn At the Farm 2012 Session 2: 12 Lead ECG Fundamentals 101 Cynthia Webner DNP, RN, CCNS, CCRN-CMC, CHFN Though for Today Mastery is not something that strikes in an instant, like a thunderbolt,

More information

General Introduction to ECG. Reading Assignment (p2-16 in PDF Outline )

General Introduction to ECG. Reading Assignment (p2-16 in PDF Outline ) General Introduction to ECG Reading Assignment (p2-16 in PDF Outline ) Objectives 1. Practice the 5-step Method 2. Differential Diagnosis: R & L axis deviation 3. Differential Diagnosis: Poor R-wave progression

More information

The Electrocardiogram

The Electrocardiogram The Electrocardiogram Chapters 11 and 13 AUTUMN WEDAN AND NATASHA MCDOUGAL The Normal Electrocardiogram P-wave Generated when the atria depolarizes QRS-Complex Ventricles depolarizing before a contraction

More information

Lecture outline. Electrical properties of the heart. Automaticity. Excitability. Refractoriness. The ABCs of ECGs Back to Basics Part I

Lecture outline. Electrical properties of the heart. Automaticity. Excitability. Refractoriness. The ABCs of ECGs Back to Basics Part I Lecture outline The ABCs of ECGs Back to Basics Part I Meg Sleeper VMD, DACVIM (cardiology) University of Florida Veterinary School Electrical properties of the heart Action potentials Normal intracardiac

More information

TELEMETRY BASICS FOR NURSING STUDENTS

TELEMETRY BASICS FOR NURSING STUDENTS TELEMETRY BASICS FOR NURSING STUDENTS Accuracy of cardiac monitoring is an important component of patient safety in hospitalized patients who meet the criteria for dysrhythmia monitoring. (AACN, 2016,

More information

DR QAZI IMTIAZ RASOOL OBJECTIVES

DR QAZI IMTIAZ RASOOL OBJECTIVES PRACTICAL ELECTROCARDIOGRAPHY DR QAZI IMTIAZ RASOOL OBJECTIVES Recording of electrical events in heart Established electrode pattern results in specific tracing pattern Health of heart i. e. Anatomical

More information

Cardiac Telemetry Self Study: Part One Cardiovascular Review 2017 THINGS TO REMEMBER

Cardiac Telemetry Self Study: Part One Cardiovascular Review 2017 THINGS TO REMEMBER Please review the above anatomy of the heart. THINGS TO REMEMBER There are 3 electrolytes that affect cardiac function o Sodium, Potassium, and Calcium When any of these electrolytes are out of the normal

More information

Please check your answers with correct statements in answer pages after the ECG cases.

Please check your answers with correct statements in answer pages after the ECG cases. ECG Cases ECG Case 1 Springer International Publishing AG, part of Springer Nature 2018 S. Okutucu, A. Oto, Interpreting ECGs in Clinical Practice, In Clinical Practice, https://doi.org/10.1007/978-3-319-90557-0

More information

Basic Dysrhythmia Interpretation

Basic Dysrhythmia Interpretation Basic Dysrhythmia Interpretation Objectives 2 To understand the Basic ECG To understand the meaning of Dysrhythmia To describe the normal heart conduction system. To describe the normal impulse pathways.

More information

Electrocardiography for Healthcare Professionals

Electrocardiography for Healthcare Professionals Electrocardiography for Healthcare Professionals Kathryn A. Booth Thomas O Brien Chapter 10: Pacemaker Rhythms and Bundle Branch Block Learning Outcomes 10.1 Describe the various pacemaker rhythms. 10.2

More information

Electrocardiography for Healthcare Professionals

Electrocardiography for Healthcare Professionals Electrocardiography for Healthcare Professionals Kathryn A. Booth Thomas O Brien Chapter 5: Rhythm Strip Interpretation and Sinus Rhythms Learning Outcomes 5.1 Explain the process of evaluating ECG tracings

More information

ECG Interpretation Made Easy

ECG Interpretation Made Easy ECG Interpretation Made Easy Dr. A Tageldien Abdellah, MSc MD EBSC Lecturer of Cardiology- Hull University Hull York Medical School 2007-2008 ECG Interpretation Made Easy Synopsis Benefits Objectives Process

More information

EKG Abnormalities. Adapted from:

EKG Abnormalities. Adapted from: EKG Abnormalities Adapted from: http://www.bem.fi/book/19/19.htm Some key terms: Arrhythmia-an abnormal rhythm or sequence of events in the EKG Flutter-rapid depolarizations (and therefore contractions)

More information

BEDSIDE ECG INTERPRETATION

BEDSIDE ECG INTERPRETATION BEDSIDE ECG INTERPRETATION Presented by: Ryan Dean, RN, MSN, CCRN, CCNS, CFRN Flight Nurse 2017 Based on presentations originally by Gennifer DePaoli, RN Objectives Hospital policies Electrical conduction

More information

Ekg pra pr c a tice D.HAMMOUDI.MD

Ekg pra pr c a tice D.HAMMOUDI.MD Ekg practice D.HAMMOUDI.MD Anatomy Revisited RCA (Right Coronary Artery) Right ventricle Inferior wall of LV Posterior wall of LV (75%) SA Node (60%) AV Node (>80%) LCA (Left Coronary Artery) Septal wall

More information

Reading Assignment (p1-91 in Outline ) Objectives What s in an ECG?

Reading Assignment (p1-91 in Outline ) Objectives What s in an ECG? Reading Assignment (p1-91 in Outline ) Objectives What s in an ECG? The 5-Step Method ECG #: Mearurements: Rhythm (s): Conduction: Waveform: Interpretation: A= V= PR= QRS= QT= Axis= 1. Compute the 5 basic

More information

Miscellaneous Stuff Keep reading the Outline

Miscellaneous Stuff Keep reading the Outline Miscellaneous Stuff Keep reading the Outline Welcome to the 5-Step Method ECG #: Mearurements: Rhythm (s): Conduction: Waveform: Interpretation: A= V= PR= QRS= QT= Axis= 1. Compute the 5 basic measurements:

More information

HR: 50 bpm (Sinus) PR: 280 ms QRS: 120 ms QT: 490 ms Axis: -70. Sinus bradycardia with one ventricular escape (*)

HR: 50 bpm (Sinus) PR: 280 ms QRS: 120 ms QT: 490 ms Axis: -70. Sinus bradycardia with one ventricular escape (*) 1? HR: 50 bpm (Sinus) PR: 280 ms QRS: 120 ms QT: 490 ms Axis: -70 1 Sinus P waves? 2 sinus cycles The pause (2 sinus cycles) suggests that the sinus fired (?) but did not conduct to the atria (i.e., missing

More information

ECG Interpretation Cat Williams, DVM DACVIM (Cardiology)

ECG Interpretation Cat Williams, DVM DACVIM (Cardiology) ECG Interpretation Cat Williams, DVM DACVIM (Cardiology) Providing the best quality care and service for the patient, the client, and the referring veterinarian. GOAL: Reduce Anxiety about ECGs Back to

More information

The Efficient and Smart Methods for Diagnosis of SVT 대구파티마병원순환기내과정병천

The Efficient and Smart Methods for Diagnosis of SVT 대구파티마병원순환기내과정병천 The Efficient and Smart Methods for Diagnosis of SVT 대구파티마병원순환기내과정병천 Differentiation Supraventricular Origin from Ventricular Origin on ECG. QRS-Complex Width. 1. Narrow QRS-Complex Tachycardia (

More information

ECG Basics Sonia Samtani 7/2017 UCI Resident Lecture Series

ECG Basics Sonia Samtani 7/2017 UCI Resident Lecture Series ECG Basics Sonia Samtani 7/2017 UCI Resident Lecture Series Agenda I. Introduction II.The Conduction System III.ECG Basics IV.Cardiac Emergencies V.Summary The Conduction System Lead Placement avf Precordial

More information

Case-Based Practical ECG Interpretation for the Generalist

Case-Based Practical ECG Interpretation for the Generalist Case-Based Practical ECG Interpretation for the Generalist Paul D. Varosy, MD, FACC, FAHA, FHRS Director of Cardiac Electrophysiology VA Eastern Colorado Health Care System Associate Professor of Medicine

More information

CASE 10. What would the ST segment of this ECG look like? On which leads would you see this ST segment change? What does the T wave represent?

CASE 10. What would the ST segment of this ECG look like? On which leads would you see this ST segment change? What does the T wave represent? CASE 10 A 57-year-old man presents to the emergency center with complaints of chest pain with radiation to the left arm and jaw. He reports feeling anxious, diaphoretic, and short of breath. His past history

More information

5- The normal electrocardiogram (ECG)

5- The normal electrocardiogram (ECG) 5- The (ECG) Introduction Electrocardiography is a process of recording electrical activities of heart muscle at skin surface. The electrical current spreads into the tissues surrounding the heart, a small

More information

10 ECGs No Practitioner Can Afford to Miss. Objectives

10 ECGs No Practitioner Can Afford to Miss. Objectives 10 ECGs No Practitioner Can Afford to Miss Mary L. Dohrmann, MD Professor of Clinical Medicine Division of Cardiovascular Medicine University of Missouri School of Medicine No disclosures Objectives 1.

More information

ECG QUIZ Luc DE ROY Brussels Belgium Disclosure in relation to this topic: none

ECG QUIZ Luc DE ROY Brussels Belgium Disclosure in relation to this topic: none ECG QUIZ Luc DE ROY Brussels Belgium Disclosure in relation to this topic: none TEST EXAMPLE What is the colour of this rectangle? 1. Blue? 2. Red? 3. Purple? 4. Green? 5. Yellow? 6. 1 and 3? 7. Any of

More information

Collin County Community College

Collin County Community College Collin County Community College BIOL. 2402 Anatomy & Physiology WEEK 5 The Heart 1 The Heart Beat and the EKG 2 1 The Heart Beat and the EKG P-wave = Atrial depolarization QRS-wave = Ventricular depolarization

More information

REtrive. REpeat. RElearn Design by. Test-Enhanced Learning based ECG practice E-book

REtrive. REpeat. RElearn Design by. Test-Enhanced Learning based ECG practice E-book Test-Enhanced Learning Test-Enhanced Learning Test-Enhanced Learning Test-Enhanced Learning based ECG practice E-book REtrive REpeat RElearn Design by S I T T I N U N T H A N G J U I P E E R I Y A W A

More information

Understanding the 12-lead ECG, part II

Understanding the 12-lead ECG, part II Bundle-branch blocks Understanding the 12-lead ECG, part II Most common electrocardiogram (ECG) abnormality Appears as a wider than normal S complex Occurs when one of the two bundle branches can t conduct

More information

a lecture series by SWESEMJR

a lecture series by SWESEMJR Electrolyte disturbances Hypokalaemia Decreased extracellular potassium increases excitability in the myocardial cells and consequently the effect of very severe hypokalaemia is ventricular arrhythmia.

More information

EKG Competency for Agency

EKG Competency for Agency EKG Competency for Agency Name: Date: Agency: 1. The upper chambers of the heart are known as the: a. Atria b. Ventricles c. Mitral Valve d. Aortic Valve 2. The lower chambers of the heart are known as

More information

EKG. Danil Hammoudi.MD

EKG. Danil Hammoudi.MD EKG Danil Hammoudi.MD What is an EKG? The electrocardiogram (EKG) is a representation of the electrical events of the cardiac cycle. Each event has a distinctive waveform, the study of which can lead to

More information

Basic EKG Interpretation. Nirja Parikh, PT, DPT

Basic EKG Interpretation. Nirja Parikh, PT, DPT Basic EKG Interpretation Nirja Parikh, PT, DPT Electrocardiogram (EKG) Using surface electrodes record the electrical activity of the heart electrical activity (usually) correlates to mechanical function

More information

ECGs: Everything a finalist needs to know. Dr Amy Coulden As part of the Simply Finals series

ECGs: Everything a finalist needs to know. Dr Amy Coulden As part of the Simply Finals series ECGs: Everything a finalist needs to know Dr Amy Coulden As part of the Simply Finals series Aims and objectives To be able to interpret basic ECG abnormalities To be able to recognise commonly tested

More information

Lab 2. The Intrinsic Cardiac Conduction System. 1/23/2016 MDufilho 1

Lab 2. The Intrinsic Cardiac Conduction System. 1/23/2016 MDufilho 1 Lab 2 he Intrinsic Cardiac Conduction System 1/23/2016 MDufilho 1 Figure 18.13 Intrinsic cardiac conduction system and action potential succession during one heartbeat. Superior vena cava ight atrium 1

More information

Introduction to ECG Gary Martin, M.D.

Introduction to ECG Gary Martin, M.D. Brief review of basic concepts Introduction to ECG Gary Martin, M.D. The electrical activity of the heart is caused by a sequence of rapid ionic movements across cell membranes resulting first in depolarization

More information

HTEC 91. Performing ECGs: Procedure. Normal Sinus Rhythm (NSR) Topic for Today: Sinus Rhythms. Characteristics of NSR. Conduction Pathway

HTEC 91. Performing ECGs: Procedure. Normal Sinus Rhythm (NSR) Topic for Today: Sinus Rhythms. Characteristics of NSR. Conduction Pathway HTEC 91 Medical Office Diagnostic Tests Week 3 Performing ECGs: Procedure o ECG protocol: you may NOT do ECG if you have not signed up! If you are signed up and the room is occupied with people who did

More information

Electrical Conduction

Electrical Conduction Sinoatrial (SA) node Electrical Conduction Sets the pace of the heartbeat at 70 bpm AV node (50 bpm) and Purkinje fibers (25 40 bpm) can act as pacemakers under some conditions Internodal pathway from

More information

ECG Underwriting Puzzler. Presented by: William Rooney, M.D.

ECG Underwriting Puzzler. Presented by: William Rooney, M.D. ECG Underwriting Puzzler Presented by: William Rooney, M.D. Obtaining Best Results from this presentation For best results please do the following: Select Slide Show from the menu option on top Select

More information

TEST BANK FOR ECGS MADE EASY 5TH EDITION BY AEHLERT

TEST BANK FOR ECGS MADE EASY 5TH EDITION BY AEHLERT Link download full: http://testbankair.com/download/test-bank-for-ecgs-made-easy-5thedition-by-aehlert/ TEST BANK FOR ECGS MADE EASY 5TH EDITION BY AEHLERT Chapter 5 TRUE/FALSE 1. The AV junction consists

More information

Cardiac Cycle. Each heartbeat is called a cardiac cycle. First the two atria contract at the same time.

Cardiac Cycle. Each heartbeat is called a cardiac cycle. First the two atria contract at the same time. The Heartbeat Cardiac Cycle Each heartbeat is called a cardiac cycle. First the two atria contract at the same time. Next the two ventricles contract at the same time. Then all the chambers relax. http://www.youtube.com/watch?v=frd3k6lkhws

More information

Myocardial Infarction. Reading Assignment (p66-78 in Outline )

Myocardial Infarction. Reading Assignment (p66-78 in Outline ) Myocardial Infarction Reading Assignment (p66-78 in Outline ) Objectives 1. Why do ST segments go up or down in ischemia? 2. STEMI locations and culprit vessels 3. Why 15-lead ECGs? 4. What s up with avr?

More information

Introduction to Electrocardiography

Introduction to Electrocardiography Introduction to Electrocardiography Class Objectives: Introduction to ECG monitoring Discuss principles of interpretation Identify the components and measurements of the ECG ECG analysis ECG Monitoring

More information

1 st Degree Block Prolonged P-R interval caused by first degree heart block (lead II)

1 st Degree Block Prolonged P-R interval caused by first degree heart block (lead II) AV Heart Blocks 1 st degree A condition of a rhythm, not a true rhythm Need to always state underlying rhythm 2 nd degree Type I - Wenckebach Type II Classic dangerous to the patient Can be variable (periodic)

More information

MICS OF MYOCARDIAL ISCHEMIA AND INFARCTION REVISED FOR LAS VEGAS

MICS OF MYOCARDIAL ISCHEMIA AND INFARCTION REVISED FOR LAS VEGAS ECG MIMICS OF MYOCARDIAL ISCHEMIA AND INFARCTION 102.06.05 Tzong-Luen Wang MD, PhD, JM, FESC, FACC Professor. Medical School, Fu-Jen Catholic University Chief, Emergency Department, Shin-Kong Wu Ho-Su

More information

The ECG in healthy people

The ECG in healthy people The ECG in healthy people The normal cardiac rhythm 3 The heart rate 3 Extrasystoles 7 The P wave 7 The PR interval The QRS complex 3 The ST segment 29 The T wave 33 The QT interval 42 The ECG in athletes

More information

How To Think About Rhythms and Conduction

How To Think About Rhythms and Conduction How To Think About Rhythms and Conduction Frank Yanowitz, MD Professor of Medicine (Cardiology) University of Utah School of Medicine Medical Director, IHC ECG Services Intermountain Healthcare http://ecg.utah.edu

More information

Chad Morsch B.S., ACSM CEP

Chad Morsch B.S., ACSM CEP What Is Cardiac Stress Testing? Chad Morsch B.S., ACSM CEP A Cardiac Stress Test is a test used to measure the heart's ability to respond to external stress in a controlled clinical environment. Cardiac

More information

ECG pre-reading manual. Created for the North West Regional EMET training program

ECG pre-reading manual. Created for the North West Regional EMET training program ECG pre-reading manual Created for the North West Regional EMET training program Author:- Dr Juan Carlos Ascencio-Lane juan.ascencio-lane@ths.tas.gov.au 1 Disclaimer This handbook has been created for

More information

Arrhythmia Study Guide 3 Junctional and Ventricular Rhythms

Arrhythmia Study Guide 3 Junctional and Ventricular Rhythms Arrhythmia Study Guide 3 Junctional and Ventricular Rhythms JUNCTIONAL RHYTHMS The AV Junction (Bundle of His and surrounding cells) only acts as pacemaker of the heart when the SA Node is not firing normally

More information

Hatim Al Lawati. MD, FRCPC, DABIM(CV), FACC

Hatim Al Lawati. MD, FRCPC, DABIM(CV), FACC Hatim Al Lawati. MD, FRCPC, DABIM(CV), FACC Consultant Interventional Cardiology & Structural Heart Disease Department of Medicine Sultan Qaboos University Hospital hatim.al.lawati@gmail.com April 2017

More information

Electrical System Overview Electrocardiograms Action Potentials 12-Lead Positioning Values To Memorize Calculating Rates

Electrical System Overview Electrocardiograms Action Potentials 12-Lead Positioning Values To Memorize Calculating Rates Electrocardiograms Electrical System Overview James Lamberg 2/ 74 Action Potentials 12-Lead Positioning 3/ 74 4/ 74 Values To Memorize Inherent Rates SA: 60 to 100 AV: 40 to 60 Ventricles: 20 to 40 Normal

More information

1/22/2007 Fernald Medical Monitoring Program Sort Code EKG coding

1/22/2007 Fernald Medical Monitoring Program Sort Code EKG coding 1/22/2007 Fernald Medical Monitoring Program Sort Code EKG coding PLEASE NOTE THAT ALL EKG CODES MUST RANGE FROM 500-599 OR FROM 900-999. PLEASE DO NOT ASSIGN NUMBERS OUTSIDE THAT RANGE FOR EKG CODES.

More information

KERN COMMUNITY COLLEGE DISTRICT CERRO COSO COLLEGE HCRS C255 COURSE OUTLINE OF RECORD

KERN COMMUNITY COLLEGE DISTRICT CERRO COSO COLLEGE HCRS C255 COURSE OUTLINE OF RECORD KERN COMMUNITY COLLEGE DISTRICT CERRO COSO COLLEGE HCRS C255 COURSE OUTLINE OF RECORD 1. DISCIPLINE AND COURSE NUMBER: HCRS C255 2. COURSE TITLE: Basic Cardiac Rhythm Interpretation 3. SHORT BANWEB TITLE:

More information

Rate: The atrial and ventricular rates are equal; heart rate is greater than 100 bpm (usually between bpm).

Rate: The atrial and ventricular rates are equal; heart rate is greater than 100 bpm (usually between bpm). Sinus Bradycardia Regularity: The R-R intervals are constant; the rhythm is regular. Rate: The atrial and ventricular rates are equal; heart rate is less than 60 bpm. P wave: There is a uniform P wave

More information

ECG Cases and Questions. Ashish Sadhu, MD, FHRS, FACC Electrophysiology/Cardiology

ECG Cases and Questions. Ashish Sadhu, MD, FHRS, FACC Electrophysiology/Cardiology ECG Cases and Questions Ashish Sadhu, MD, FHRS, FACC Electrophysiology/Cardiology 32 yo female Life Insurance Physical 56 yo male with chest pain Terminology Injury ST elevation Ischemia T wave inversion

More information

Understanding basics of EKG

Understanding basics of EKG Understanding basics of EKG By Alula A.(R III) www.le.ac.uk Topic for discussion Understanding of cellular electrophysiology Basics Rate Rhythm Axis Intervals P wave QRS ST/T wave Abnormal EKGs Understanding

More information

Bradydysrhythmias and Atrioventricular Conduction Blocks

Bradydysrhythmias and Atrioventricular Conduction Blocks Emerg Med Clin N Am 24 (2006) 1 9 Bradydysrhythmias and Atrioventricular Conduction Blocks Jacob W. Ufberg, MD*, Jennifer S. Clark, MD Department of Emergency Medicine, Temple University School of Medicine,

More information

12 LEAD EKG BASICS. By: Steven Jones, NREMT P CLEMC

12 LEAD EKG BASICS. By: Steven Jones, NREMT P CLEMC 12 LEAD EKG BASICS By: Steven Jones, NREMT P CLEMC ECG Review Waves and Intervals P wave: the sequential activation (depolarization) of the right and left atria QRS complex: right and left ventricular

More information

The ABC of Pediatric ECG

The ABC of Pediatric ECG The ABC of Pediatric ECG Mohamed Hamdan, MD, FAAP, FACC Assistant Professor of Pediatrics Columbia University College of Physicians and Surgeons, NY, USA Consultant Pediatric Cardiologist & Co-Director

More information

Supraventricular Arrhythmias. Reading Assignment. Chapter 5 (p17-30)

Supraventricular Arrhythmias. Reading Assignment. Chapter 5 (p17-30) Supraventricular Arrhythmias Reading Assignment Chapter 5 (p17-30) The Supraventricular Rhythms In Our Lives Site of Origin Single Events Slow Rates Intermediate Rates Fast Rates (>100 bpm) Sinus Sinus

More information

Atlantic Health System

Atlantic Health System Atlantic Health System Morristown Medical Center Newton Medical Center Overlook Medical Center Basic Dysrhythmia Course Day 1 1 2 Chapter 1 Anatomy and Physiology Learning Objectives 1) Identify electrophysiology

More information

Interpreting Electrocardiograms (ECG) Physiology Name: Per:

Interpreting Electrocardiograms (ECG) Physiology Name: Per: Interpreting Electrocardiograms (ECG) Physiology Name: Per: Introduction The heart has its own system in place to create nerve impulses and does not actually require the brain to make it beat. This electrical

More information

The ECG Course. Boone County Fire Protection District EMS Education

The ECG Course. Boone County Fire Protection District EMS Education The ECG Course Level I G rated material AV Blocks What Causes AV Block? Long list of bad things that includes ischemia and.. Old age / disease Medications or drugs Electrolyte imbalances Physiologic Blocks

More information

Chapter 16: Arrhythmias and Conduction Disturbances

Chapter 16: Arrhythmias and Conduction Disturbances Complete the following. Chapter 16: Arrhythmias and Conduction Disturbances 1. Cardiac arrhythmias result from abnormal impulse, abnormal impulse, or both mechanisms together. 2. is the ability of certain

More information

If the P wave > 0.12 sec( 3 mm) usually in any lead. Notched P wave usually in lead I,aVl may be lead II Negative terminal portion of P wave in V1, 1

If the P wave > 0.12 sec( 3 mm) usually in any lead. Notched P wave usually in lead I,aVl may be lead II Negative terminal portion of P wave in V1, 1 If the P wave > 0.12 sec( 3 mm) usually in any lead. Notched P wave usually in lead I,aVl may be lead II Negative terminal portion of P wave in V1, 1 mm depth and 3 mm width( most specific) Since Mitral

More information

Birmingham Regional Emergency Medical Services System

Birmingham Regional Emergency Medical Services System Birmingham Regional Emergency Medical Services System 2018 ALCTE Summer Conference EKG Basics Brian Gober, MAT, ATC, NRP, CSCS Education Services Manager ECC Training Center Coordinator Birmingham Regional

More information

Emergency Medical Training Services Emergency Medical Technician Paramedic Program Outlines Outline Topic: WPW Revised: 11/2013

Emergency Medical Training Services Emergency Medical Technician Paramedic Program Outlines Outline Topic: WPW Revised: 11/2013 Emergency Medical Training Services Emergency Medical Technician Paramedic Program Outlines Outline Topic: WPW Revised: 11/2013 Wolff-Parkinson-White syndrome (WPW) is a syndrome of pre-excitation of the

More information

Pennsylvania Academy of Family Physicians Foundation & UPMC 43rd Refresher Course in Family Medicine CME Conference March 10-13, 2016

Pennsylvania Academy of Family Physicians Foundation & UPMC 43rd Refresher Course in Family Medicine CME Conference March 10-13, 2016 Pennsylvania Academy of Family Physicians Foundation & UPMC 43rd Refresher Course in Family Medicine CME Conference March 10-13, 2016 Disclosures: EKG Workshop Louis Mancano, MD Speaker has no disclosures

More information

12 Lead ECG Skills: Building Confidence for Clinical Practice. Presented By: Cynthia Webner, BSN, RN, CCRN-CMC. Karen Marzlin, BSN, RN,CCRN-CMC

12 Lead ECG Skills: Building Confidence for Clinical Practice. Presented By: Cynthia Webner, BSN, RN, CCRN-CMC. Karen Marzlin, BSN, RN,CCRN-CMC 12 Lead ECG Skills: Building Confidence for Clinical Practice NTI 2009 Preconference Session 803 Presented By: Karen Marzlin, BSN, RN,CCRN-CMC 1 12 Lead ECG Fundamentals: The Starting Place for Linking

More information

Electrocardiography Normal 5. Faisal I. Mohammed, MD, PhD

Electrocardiography Normal 5. Faisal I. Mohammed, MD, PhD Electrocardiography Normal 5 Faisal I. Mohammed, MD, PhD 1 Objectives 2 1. Describe the different waves in a normal electrocardiogram. 2. Recall the normal P-R and Q-T interval time of the QRS wave. 3.

More information