HEART CONDUCTIONS

Normal electrical conduction of the

heart
- the electrical impulse that stimulates
and paces the cardiac muscle normally
originates in the SA node.
- the electrical impulse quickly travels
from the sinus node through the atria
to the atrioventricular (AV) node, this
process is known as conduction.
- The electrical stimulation of the
muscle cells of the atria causes them
to contract. The structure of the AV
node slows the electrical impulse,
giving the atria time to contract and fill
the ventricles with blood. This part of
the atrial contraction is frequently
referred to as the atrial kick.
- The electrical impulse then travels very
quickly through the bundle of His to the
right and left bundle branches and the
Purkinje fibers, located in the ventricular
muscle.

-the electrical stimulation cells of the
ventricles in turn causes the mechanical
contraction of the ventricle (systole). The
cell repolarize and the ventricles then
relax (diastole).
- The process from sinus node
electrical impulse generation
through ventricular repolarization
completes the electromechanical
circuit, and the cycle begins again.

Electrocardiogram

- is a graphic representation of the
electrical currents of the heart. The
ECG is obtained by placing disposable
electrodes in standard positions on the
skin of the chest wall and extremities.
- Each phase of the cardiac cycle is
reflected by specific waveforms on
the screen of a cardiac monitor or
on a strip of ECG graph paper.
Components of Electrodes
1. an adhesive substances that
attaches to the skin to secure the
electrode in place.
2. a substance that reduces the
skins electrical impedance and
promotes detection of the
electrical current.
Lead
- is a specific view of the electrical
activity of the heart.

-the standard ECG is composed of
12 leads or 12 different views,
although it is possible to record 15
or 18 leads.
12 lead ECG
-is used to diagnose:

-Dysrhythmias
-Conduction abnormalities
-Chamber enlargement
-Myocardial ischemia
-Injury / Infarction
15 lead ECG
- adds three additional chest leads
across the right precordium and is
used for early diagnosis of right
ventricular and left posterior
(ventricular) infarction.
18 lead ECG
- adds three posterior leads to the
15 lead ECG and is useful for early
detection of myocardial ischemia
and injury.
Obtaining an Electrocardiogram

-an ECG machine placed at the
patients side for an immediate
recording (standard 12-lead ECG)
-a cardiac monitor at the patients
bedside for continuous reading; this
kind of monitoring, usually called
hardwire monitoring, is used in ICU.

-a small box that the patient carries that
continuously transmit the ECG
information by radiowaves to a central
monitor called telemetry.

- a small, lightweight tape recorder-like
machine (ambulatory ECG monitoring or
a Holter monitor) that the patient wears
and that continuously records the ECG on
a tape, which later views and analyzed
with a scanner.