ACKNOWLEDGEMENT

It is with pleasure that I find myself penny down these lines to express
our sincere thanks to various people to help me along the way in completing this
work.

I am helpful Mrs. Kamlesh Sharma who gave me a chance to go

outside the college for this work. Also thankful to all those who provided me the
possibility to complete this report.

B.Sc- II(med)

13320
 INTRODUCTION
The electrocardiogram is a diagnostic tool that measures and records
the electrical activity of the heart in exquisite detail. Interpretation of these
details allows diagnosis of a wide range of heart conditions. These conditions
can vary from minor to life threatening.

The term was introduced by William Einthoven in 1893 at a meeting of the

Dutch Medical Society. In 1924, Einthoven received the Nobel prize for his life’s
work in developing the ECG.

To fully understand how an ECG reveals useful information about the

condition of your heart requires a basic understanding of the anatomy (i.e. the
structure) and physiology (i.e. the function) of the heart.
BASICS OF ECG.......
ECG Electrodes:-

Skin preparation

Clean with an alcohol wipe if necessary. If the patient are very hairy, shave the
electrode areas.

ECG Standard leads

There are three of these leads, I,II and III.

Lead I:- it is between the right arm and the left arm electrodes, the left arm being
positive.

Lead II:- It is between the right arm and left leg electrodes, the left leg being
positive.

Lead III:- It is between the left arm and left leg electrodes, the left leg again
being positive

Chest electrodes placement

V1:- fourth intercostal space to the right of the sternum.

V2:- fourth intercostal space to the left of the sternum.

V3:- directly between leads V2 and V4.

V4:- fifth intercostals space at midclavicular line.

V5:- level with V4 at left anterior axillary line.

V6:- level with V5 at mid-axillary line.

 WORKING OF ECG......
The ECG works mostly by detecting and amplifying the tiny electrical
changes on the skin that are caused when the heart muscles “depolarises”
during each heart beat. At rest, each heart muscle cells has a charge
across it outerwall or cell membrane. Reducing this charge towards zero is
called depolarisation, which activates the mechanisms in the cell that
cause it to contract. During each heartbeat a healthy heart will have an
orderly progression of a wave of depolarisation that is triggered by the
cells in the sinoatrial node, spread out through the atrium , passes through
intrinsic conduction pathway and then spreads all over the ventricle. This
is detected as tiny rises and falls in the voltage between the two
electrodes placed either side of the heart which is displaced as a wavy line
either on a screen or on a paper. This display indicates the overall rythm of
the heart and weakness in different parts of the heart muscles.

Usually more than two electrodes are used and they can be combined
into a number of pairs ( for example- left arm <LA> , right arm < RA> , left
leg<LL> electrodes from the pairs :- LA+RA, LA+LL, RA+LL).The output
from each pair is known as a lead. Each lead is set to look at the heart
from a different angle.Different types of ECGs can be referred to by the
number of leads that are recorded, for example- 3-lead, 5-lead or 12- lead
ECGs. A 12-lead ECG is one in which 12 different electrical signals are
recorded at approximately the same time and will often be used as a one –
off the recording of an ECG typically printed out as a paper copy. 3- and 5-
lead ECGs tend to monitored continuously and viewed only on the screen
 of an appropriate monitoring device, for example during an a operation or
whilst being transported in an ambulance.

There may or may not be any permanent record of a 3 or 5 lead ECG

depending on the equipment used.

It is the best way to measure and diagnose abnormal rhythms of the

heart particularly abnormal rhythms caused by damage to

TABLE OF CONTENTS
1. Acknowledgement
2. Certificate
3. Introduction to the project
4. Basics of ECG
5. Working of ECG
 ecg
project report

Submitted To- Prepared

by- Mrs.Kamlesh Sharma
B.ScII
(Med)
13320