ANAPHYLAXIS BY DR.SOHAN BISWAS,MBBS,DNB(INTERNAL MEDICINE) RESIDENT.pptx
Ecg report normal sinus rhythm with variants of qrs complex.pptx
1. PERPETUAL HELP MEDICAL CENTER – BIÑAN
DEPARTMENT OF INTERNAL MEDICINE
1
Anna Katrina F. Manzano, M.D.
1st year resident
ECG HOUR
The Normal
Electrocardiogram
February 12, 2024
2. DEPARTMENT
OF
INTERNAL
MEDICINE
OBJECTIVES
At the end of the lecture, the participants will be
able to:
1. Recognize a normal sinus rhythm ECG tracing
2. Identify the QRS axis
3. Be familiar with the common variants of normal
ECG
2
3. The waves and intervals of a normal electrocardiogram
QTc = QT / √ RR
Women: 460msec
Men: 450msec
6. CARDIAC ELECTRICAL CONDUCTING SYSTEM
Electrical conduction is said to be
antegrade (or forward) if it is
directed
from the higher pacemaker sites
going downwards.
Electrical conduction is said to be
retrograde (or backwards) if it is
directed from lower pacemaker sites
going upwards.
7. CARDIAC ELECTRICAL CONDUCTING SYSTEM
The SA-node is the primary
pacemaker, the usual powerhouse,
the primary area where electrical
impulses are generated.
AV-node (junction1) is the “gate-
keeper”, the area where many very
fast electrical impulses from the SA-
node are selectively filtered &
slowed down.
His-bundle (junction2) receives the
filtered impulses from the AV-node
and carries them down almost
simultaneously to both bundle
branches.
The right bundle branch (RBB)
carries impulses to the right side of
the heart.
The left bundle branch (LBB)
carries the impulses to the left side
of the heart. It further divides into a
thin left anterior fascicle & a thick left
posterior fascicle.
8. CARDIAC ELECTRICAL CONDUCTING SYSTEM
Depolarizing (P or QRS-) wavefront that moves towards
the exploring electrode will produce an upright
deflection.
Depolarizing (P or QRS-) wavefront that moves away
from the exploring electrode will produce an inverted
deflection.
Depolarizing (P or QRS-) wavefront that moves
neutrally in relation to the exploring electrode will
produce either isoelectric or biphasic deflection.
