Description
Demystifying ECG: Navigating the Cardiac Landscape" serves as a comprehensive exploration into the intricacies of Electrocardiography (ECG), shedding light on its role in deciphering cardiac health. The webinar delves into the fundamentals of ECG, unraveling the meaning behind P, Q, R, S, and T waves and their significance in assessing the heart's electrical activity.
Participants will gain insights into interpreting abnormal ECG findings, understanding how deviations from the norm can signal various cardiac conditions. The webinar elucidates the practical applications of ECG in clinical settings, including its role in diagnosing arrhythmias, ischemic events, and other cardiac abnormalities. Attendees will benefit from clarifications on common misconceptions surrounding ECG interpretation, ensuring a nuanced understanding of its diagnostic capabilities. Real-life case studies will be presented, offering participants the opportunity to apply theoretical knowledge to practical scenarios and enhance their diagnostic skills. The webinar will touch upon emerging trends in ECG technology, exploring how advancements contribute to more accurate diagnoses and improved patient care.
Summary Listen
- ECG, or EKG, records electrical activity of the heart using electrodes placed on the chest and limbs. Different types include resting, stress (treadmill), continuous monitoring, and Holter tests. The 12-lead ECG, comprising limb and chest leads, is most common in hospital settings.
- Heart's electrical activity results from the summation of action potentials in myocytes. Myocytes generate electrical currents through depolarization and repolarization phases, conducted systematically by a specialized conduction system.
- The Sinoatrial (SA) node, the heart's pacemaker, initiates depolarization, spreading to the right and left atria. The Atrioventricular (AV) node, in the right atrium, delays conduction, allowing ventricular filling. Impulses then pass to the bundle of His, dividing into right and left bundles, and finally the Purkinje system for simultaneous ventricular contraction.
- ECG records P waves (atrial depolarization), PR segment (AV node conduction delay), QRS complex (ventricular depolarization), and ST segment (ventricular repolarization). The location of electrodes in the frontal and transverse planes provides a 3D view of the heart's electrical activity.
- Limb leads (I, II, III, aVR, aVL, aVF) provide a frontal view, while chest leads (V1-V6) offer a cross-sectional view. Specific leads are associated with different heart regions like lateral (I, aVL, V5, V6), inferior (II, III, aVF), anterior/septal (V1-V4), and right ventricle (V4R).
- Proper ECG recording requires attention to calibration. ECG paper has a grid, with each small square representing 0.04 seconds (time) and 0.1 millivolts (voltage). The ECG should be recorded at 25 mm/second. The calibration box should be 10 squares high, and limb lead attachment should be correct (aVR negative, Lead I positive).
- Analyzing ECGs involves measuring rate, assessing rhythm, evaluating conduction, describing waveforms, and forming interpretations. Calculating heart rate involves dividing 300 by the number of large squares between R waves. Normal sinus rhythm shows a P wave before each QRS, a PR interval within 0.12-0.20 seconds, and a QRS complex less than 0.12 seconds.
- Pathological Q waves (wider than 0.04 seconds and deeper than 2mm) can indicate old myocardial infarctions. QRS height can indicate ventricular hypertrophy. Right bundle branch block shows RSR pattern (rabbit ear sign) in V1, while left bundle branch block exhibits QS or small r wave in V1 and a monophasic R wave in V6.
- Heart blocks are classified as first-degree (prolonged PR interval), second-degree Mobitz type I (Wenckebach - gradual PR lengthening) and type II (sudden QRS drop), and third-degree (AV dissociation). Atrial fibrillation presents as an irregular rhythm with no P waves and undulation of the baseline. Atrial flutter exhibits a sawtooth pattern of flutter waves.
- ST elevation is a marker for acute myocardial infarction. Ventricular tachycardia is a broad QRS regular tachycardia, and ventricular fibrillation shows no discernible complexes, requiring immediate defibrillation.
Sample Certificate
About the Speakers
Dr. Navjeet Ahluwalia
Head of Cardiology & Intervention Kalra Hospital, Kirti Nagar, New Delhi
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