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ECG
? Lecture video # 01
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ECG - QRS Complex variants in Limb leads part #01
? Today we are going to talk about what is the normal pattern of QRS complex in Limb leads.
There are 6 limb leads:
- AVR
- AVL
- AVF
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We are going to talk about normal (lead) QRS patterns and their normal variants, not abnormalities.
We try to understand those patterns logically.
X (=) There are 6 Limb leads, 3 are bi-polar and 3 are uni-polar limb lead.
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? Even through there are 6 Limb leads, but at least a good doctor and a good medical student should be familiar with 18 different patterns which are normal patterns.
18 different variants of QRS pattern.
So today we are going to master 18 patterns cause if you recognize the normal pattern clearly, then you can differentiate normal from abnormal.
? Now to understand those patterns logically, we made a format (chart)
First of all, we start with the basics.
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Of all we should know that the QRS complex graphically represents the ventricular stimulation.
Graphically represent the electrical activity in the ventricle during depolarization process when ventricles undergo depolarization.
The ECG pointer is drawing QRS complex.
So what are the electrical activity in the ventricular during the depolarization.
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We have already discussed in detailed in previous lecture. We will do a little review here.
Previously, that when electrical impulse of wave of de-
-Polarization: From the AV node and bundle of his system entre intra ventri-cat first of all (they or it depolarizes / septum)
(inter-ventricular septum) and inter-ventricular septum is depolarized from left to the right.
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So the vector of septal depolarization of ventricle is directed right word and upward and it's a
It is a small vector, so what is this structure representing this vector?
Representing the ventricular septal depolarization which is first electrical event during the ventricular depolarization and this vector is in the frontal plane. This vector is directed right word and slightly upwards. Once septum is completing it's de-polarization, the wave of depolarization enters into major ventricular tissue left ventricular tissue through
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procongial system and you know that the left ventricle is much more thicker than the right ventricle. So when
Waves of depolarization spread through the ventricles. There is left ventricular depolarization and right ventricular depolarization.
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? Septal
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? Major
? Based
150°
I
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II
III
AVR
AVL
AVF
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? Electrical Position of the heart & QRS Complexes in limb leads.
HORIZONTAL
Vertical Elec
Intermediate elec.
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? Electro-cardio-graphy means that electrical activity of the heart is graphically presented.
OR
Graphic presentation of electrical activity of the heart.
To really understand the fundamentally of ECG, you must understand the electrical activity of the heart.
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Let's talk few words of the electrical activity in the myocardial cell.
Let's suppose first the myocardial cell is resting.
If the cell is electrically resting it must have resting membrane potential.
Potential is a electrically voltage difference b/w the inside of the membrane and outside.
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-rance potential is (-90) mv. in a resting cell.
When I say thy myocardial cell has -90 mv resting membrane potential I mean that resting condition of thy myocardial cell has it membrane-inter-nally paralized negative.
Now whatever really happens
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myocardial cell.
Screen shots pics.
? septal
? Major
? Based
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Stimulation
?
RMP? Depolarization ? Repolarization
Action potential
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replea the effect of leach
Note: Ther use of lead Pen-cil instead on Blue-
• Blue Color in Pic
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Next Page
PR seg
ORS
ST seg
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Waves.
Segments
Intervals.
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Waves.
Segments
Intervals.
EKG : Interpretation Part: 4:-)
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? Timings and duration of ECG
? Segments of Intervals
1 Big Sq=S small
5 small sq= 1 Big sq=0.20
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1 Small Sq
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This download link is referred from the post: MBBS Lecture Notes for all subjects (updated for 2021 syllabus) - All universities