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Volume Conductor Principles and ECG Rules of Interpretation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Volume Conductor Principles and ECG Rules of Interpretation the last cells in the ventricle to depolarize are the first to repolarize. ATRIUM VENTRICLE
American College of Cardiology (ACC)/American Heart Association (AHA) guidelines that: “Recording the resting 12-lead ECG continues to be the most commonly used laboratory procedure for the diagnosis of heart disease.” In addition, “The procedure is safe, simple, and reproducible; the ECG record lends itself to serial studies; and the relative cost is minimal.
 
Transient current that contributes to phase 4 pacemaker currents in SA and AV nodal cells       T - type  ( I Ca - T ) Slow inward, long - lasting current; phase 2 non - pacemaker cardiac action potentials and phases 4 and 0 of SA and AV nodal cells; important in vascular smooth muscle contraction       L - type  ( I Ca - L )   Calcium Channels Open in response to Ca ++   influx in vascular smooth muscle       Calcium - activated  ( I K, Ca   or BK Ca ) Activated by acetylcholine; Gi - protein coupled       Acetylcholine - activated  ( I K, ACh ) K ATP   channels; inhibited by ATP; therefore, open when ATP decreases during hypoxia; in vascular smooth muscle, adenosine removes the ATP inhibition and opens these channels, producing vasodilation       ATP - sensitive  ( I K, ATP ) Phase 3 repolarization of cardiac action potentials       Delayed rectifier  ( I Kr ) Contributes to phase 1 of non - pacemaker cardiac action potentials       Transient outward  ( I to ) Maintains phase 4 negative potential in cardiac cells       Inward rectifier  ( I ir   or I K1 )   Potassium Channels " Funny "  pacemaker current  ( I f )  in cardiac nodal tissue       Slow Na + Phase 0 depolarization of non - pacemaker cardiac action potentials       Fast Na +   Sodium Channels CHARACTERISTICS CHANNEL
 
 
 
 
 
Electrocardiographic criteria of right ventricular enlargement
  Example #1:  (note RAD +120 degrees; RAE; R in V1 > 6 mm; R in aVR > 5 mm)
  Example #2:  (more subtle RVH: note RAD +100 degrees; RAE; Qr complex in V1 rather than qR is atypical
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],1 point Delayed intrinsicoid deflection in V5 or V6 (  0.05 sec) 1 point QRS duration 0.09 sec 2 points Left axis deviation 3 points Left Atrial Enlargement in V1   3 points 1 point ST-T Abnormalities : Without digitalis With digitalis 3 points ,[object Object],[object Object],[object Object],[object Object],Points + ECG Criteria
Example 1 : (Limb-lead Voltage Criteria; e.g., R in aVL >11 mm; note wide QRS/T angle)
Example 2 : (ESTES Criteria: 3 points for voltage in V5, 3 points for ST-T changes; also LAE and LAD of -40 degrees; note also the PVC)

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Ecg 1

  • 1.
  • 2. Volume Conductor Principles and ECG Rules of Interpretation the last cells in the ventricle to depolarize are the first to repolarize. ATRIUM VENTRICLE
  • 3. American College of Cardiology (ACC)/American Heart Association (AHA) guidelines that: “Recording the resting 12-lead ECG continues to be the most commonly used laboratory procedure for the diagnosis of heart disease.” In addition, “The procedure is safe, simple, and reproducible; the ECG record lends itself to serial studies; and the relative cost is minimal.
  • 4.  
  • 5. Transient current that contributes to phase 4 pacemaker currents in SA and AV nodal cells      T - type ( I Ca - T ) Slow inward, long - lasting current; phase 2 non - pacemaker cardiac action potentials and phases 4 and 0 of SA and AV nodal cells; important in vascular smooth muscle contraction      L - type ( I Ca - L )   Calcium Channels Open in response to Ca ++ influx in vascular smooth muscle      Calcium - activated ( I K, Ca or BK Ca ) Activated by acetylcholine; Gi - protein coupled      Acetylcholine - activated ( I K, ACh ) K ATP channels; inhibited by ATP; therefore, open when ATP decreases during hypoxia; in vascular smooth muscle, adenosine removes the ATP inhibition and opens these channels, producing vasodilation      ATP - sensitive ( I K, ATP ) Phase 3 repolarization of cardiac action potentials      Delayed rectifier ( I Kr ) Contributes to phase 1 of non - pacemaker cardiac action potentials      Transient outward ( I to ) Maintains phase 4 negative potential in cardiac cells      Inward rectifier ( I ir or I K1 )   Potassium Channels " Funny " pacemaker current ( I f ) in cardiac nodal tissue      Slow Na + Phase 0 depolarization of non - pacemaker cardiac action potentials      Fast Na +   Sodium Channels CHARACTERISTICS CHANNEL
  • 6.  
  • 7.  
  • 8.  
  • 9.  
  • 10.  
  • 11. Electrocardiographic criteria of right ventricular enlargement
  • 12.   Example #1: (note RAD +120 degrees; RAE; R in V1 > 6 mm; R in aVR > 5 mm)
  • 13.   Example #2: (more subtle RVH: note RAD +100 degrees; RAE; Qr complex in V1 rather than qR is atypical
  • 14.
  • 15. Example 1 : (Limb-lead Voltage Criteria; e.g., R in aVL >11 mm; note wide QRS/T angle)
  • 16. Example 2 : (ESTES Criteria: 3 points for voltage in V5, 3 points for ST-T changes; also LAE and LAD of -40 degrees; note also the PVC)