The Electrocardiogram

As the cardiac mass depolarizes, time varying

differences in electrical potential exist on the
body surface. The electrocardiogram is a
recording of these potential differences. The
electrocardiogram is produced by a sequence
of cardiac action potentials; it is not a
recording of an action potential.
 A wave of depolarization approaching a positive
electrode of an ECG lead system causes a positive
deflection.

A wave of depolarization moving away from a

positive electrode of an ECG lead system causes a
negative deflection.
Detecting a wave of depolarization
or repolarization

Three ECG Actors Needed

Detecting a wave of depolarization
Detecting a wave of depolarization
Net Axis of Depolarization

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 Axis Determination

Rapid Approach:

Lead I: if positive, vector is toward left

AVF: If positive, vector is downward
Many others..think about other
general trends that give you a rapid
insight
 Axis Determination
Abberant Axes (Deviations):

Normal: QRS positive in I and AVF, vector = 0-90o

Left Axis Deviation: QRS negative in AVF, positive in I
Right axis deviation: QRS negative in I
Extreme Rt axis deviation: QRS negative-both I & AVF
Change of axis may provide diagnostic insight

Remember: You can calculate the vector from

any limb leads [Practice4]
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 RATE

300 100 60 43 300

150 75 50
# big lines
Rate = ??
Rhythm = ??
Rate = ??
Rhythm = ??
Rate = ??
Rhythm = ??