Physiology 5 ECG

this lecture goes through the theory behind the artistic skill of reading 12 lead ECGs

more practice is needed

polarities

RMP negative charged inside of heart positively charged outside of heart

atrial depolarisation positively charges outside of heart (in the atrial regions) negatively charged outside of heart (in the atrial regions)

ventricular depolarisation positively charges outside of heart (in the ventricular regions) negatively charged outside of heart (in the ventricular regions)

ECG vectors

At any given electrode the polarity of the voltage change depends on the direction in which the wave of potential change is moving (as well as if it is repolarisation or depolarisation

we always look from positive node

  1. depolarisation towards positive electrode: positive potential (upwards)
  2. Depolarisation away from positive electrode: negative potential (downwards)
  3. repolarisation towards positive electrode: negative potential (downwards)
  4. repolarisation away from positive electrode: positive potential (upwards)

different ecg form based on lead placement

right arm left arm left leg righ led

12 lead ecg

vertical slices I II III aVR aVL aVF

horizontal slices v1 v2 v3 v4 v5 v6

need to properly visualise flow of polarisation / depolarisation to understand the movements of

St segment elevations for myocardial attack