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Samenvatting 1MA cardiorespiratory physiotherapy 2 - ECG
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Samenvatting 1MA revalidatiewetenschappen en kinesitherapie, cardiorespiratoire physiotherapy 2. Onderdeel ECG
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1MAREVAKI
Cardiorespiratory Physiotherapy 3
ELECTROCARDIOGRAPHY (ECG) – DR. W. HENS
YORICK VAN HULST
,Cardiorespiratory Physiotherapy 3 1e master jaar Revaki UA
1 INHOUDSOPGAVE
2 Electrocardiography (ECG) – Dr. W. Hens ............................................................................... 2
2.1 Basic principles ........................................................................................................................ 2
2.1.1 Why ECG .......................................................................................................................... 2
2.1.2 Registration ..................................................................................................................... 2
2.1.3 Placement of leads: clinical ............................................................................................. 3
2.1.4 How to look at an ECG: camera position ......................................................................... 4
2.1.5 Localisation ...................................................................................................................... 6
2.2 Systematic Interpretation of an ECG ....................................................................................... 7
2.2.1 Rhythm ............................................................................................................................ 7
2.2.2 Frequency ........................................................................................................................ 9
2.2.3 Conductance Time: PQ, QRS, QT ................................................................................... 11
2.2.4 Heart axis ....................................................................................................................... 13
2.2.5 P-wave ........................................................................................................................... 15
2.2.6 QRS-morphology ........................................................................................................... 16
2.2.7 ST-morphology .............................................................................................................. 16
2.3 Examples ECG ........................................................................................................................ 20
1
,Cardiorespiratory Physiotherapy 3 1e master jaar Revaki UA
2 ELECTROCARDIOGRAPHY (ECG) – DR. W. HENS
2.1 BASIC PRINCIPLES
2.1.1 Why ECG
1. Screening/Prevention i.e. sportsmen
2. Chronic diseases i.e. heart failure, left ventricular hypertrophy, chronic atrial fibrillation…
3. Diagnosis i.e. acute heart infarction, old infarction,…
4. Aritmia (ritmic disorder): acute or chronic
5. Evaluation of the influence of medication i.e. digitalis
https://www.youtube.com/watch?v=xIZQRjkwV9Q&ab_channel=Osmosis
2.1.2 Registration
Als je kijkt naar de ECG zie je een P-wave, QRS-complex, en een T-wave.
- P-wave: atrial depolarisatie
- QRS-complex: ventriculaire depolarisatie
- T-wave: ventriculaire repolarisatie
De T-wave heeft dezelfde deflectie als QRS complex. Als de QRS-complex positief is, is T-wave ook
positief. Als het negatief is, is T-wave ook negatief. Dit kan in verschillende leads.
2.1.2.1 Conductance of the electric signal
2
, Cardiorespiratory Physiotherapy 3 1e master jaar Revaki UA
In een normale situatie kunnen we de conductance van elektrische signaal zien. Dit start normaal in
de sinal node, en gaat van de atrium naar ventrikels, naar links, en dan komt er een depolarisatie. In
een normale situatie zie je dus hoe de signaal gaat. Van rechtse atrium, tot en met linker ventrikel,
dan zie je de depolarisatie etc.
SA knoop start het, dan gaat het door de bundle van His, naar de linkere zijde, contractie etc erna.
2.1.3 Placement of leads: clinical
4 extremity leads + 6 leads around (the left) heart (precordial)
Om de hele signal op te nemen, heb je veel leads nodig. 4 extremiteiten leads, en 6 leads rond het
hart. V1-V6. Dit zijn de precardial leads. 4 extremity leads, 1 rechterarm, linkerarm, rechts bij voet,
en links bij voet. Bij een CPET pak je het niet van de voeten, maar meer ondergebied thorax. Dit geeft
je de 12 verschillende leads, gaande van 1t/m 3, AVR, AVL, AVF, en v1 t/m v6.
We krijgen elektrische signalen van de transversal plane en frontal plane.
Transversal plane = v1 t/m v6
Fronal plane = AVR naar rechterhand, AVL naar linkerhand, AVF, naar de voeten, dan heb je 1, 2, 3.
Je moet lokalisatie van leads weten, van welke hoek de camera kijkt in de current van het hart.
Wetende dat de current van rechterhand, naar linkeronderkant gaat, weten we dat in deze
camerapositie zien ze de currents naar hun toegaan. Dit is belangrijk om te weten.
Mind the colours on an ECG (course 2nd bachelor for more information)
- 4 extremity electrodes (R, L, N, F) => resulting in 6 leads II, III, I, AVR,
AVL, AVF
- 6 precordial electrodes => resulting in 6 leads V1, V2, V3, V4, V5, V6
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