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as an example of electrostatics
Introduction
This set of slides contains some background relevant to the
underlying physics explaining the electrocardiogram.
These slides were taken from 12 Lead EKG STAT! A light hearted
approach by D.M. Koenig, D. Topp, and L.G. Vonfrolio (edited
by M.L. Kahn, MD). An interactive program is available to study
ECGs more in detail, particularly from a medical point of view
(start programma).
A detailed physical description of the electrocardiogram is
provided by Russel K. Hobbie in the paper The Elctrocardiogram
as an example of electrastatics, Am.J.Phys.41(1973)824-831, and
in his book Intermediate Physics for Medicine and Biology,
Chapter 7 (pp. 181-205).
Electrocardiography (ECG, EKG)
• During the late 1800's and early 1900's, Dutch physiologist Willem
Einthoven developed the early elctrocardiogram. He won the Nobel
prize for its invention in 1924.
• Hubert Mann first uses the electrocardiogram to describe
electrocardiographic changes associated with a heart attack in 1920.
- 40 mv K+
Threshold Ca++
Depolarization
-50
0
-75
4
-100 SNP
ARP RRP
Resting Potential Active Transport
- 90 mv K+ Na+ out K+ back in
Na+ Ca++
Depolarization Wave of a Strip of Nerve Cells + +
K+ Na+ K+ Na+ K+ K+ K+
---- ++++ ----
++++ ---- ++++
Lead I - +
G
Electrocardiograph
0o
LEAD I
60o
120o LEAD II
90o
LEAD III
LEAD AVF
• Each of the limb leads (I, II, III, AVR, AVL, AVF)
can be assigned an angle of clockwise or
counterclockwise rotation to describe its position in
the frontal plane
The Concept of a "Lead" LA
Leads I II III
RA
- -
RA - + LA
LEAD I
Remember, the RL
is always the ground
- -
RA & RL LL & LA
LEAD AVF
LL +
• By combining certain limb leads into a central
terminal, which served as the negative electrode,
other leads could be formed to "fill in the gaps" in
terms of the angles of directional recording. These
leads required augmentation of voltage to be read and
are thus labeled.
The Concept of a "Lead"
The Precordial Leads
• Each of the precordial leads is unipolar (1 electrode
constitutes a lead) and is designed to view the electrical
activity of the heart in the horizontal or transverse
plane
V1 V2
V3
V4 V5 V6
Hexaxial Array for Axis Determination
determination of the angle of the main
cardiac vector in the frontal plain
Lead I Example 1
.5 mv