Clinical ElectrocardiographyTeaching Course分析课件.pptVIP

Clinical ElectrocardiographyTeaching Course 心电图学基础（一）心电发生的原理basic principles of the electromechanics When a heart muscle cell is stimulated,what happens? The normal myocardial cells are polarized; that is, they carry electrical charges on their surface. The outside of the resting cell is positive and the inside of the cell is negative. Vector Vector represents magnitude direction of force; polarity if electrical force. Two ECG vectors in the same direction, their magnitude to be added to the total vector ； Vectors Summed to Vector Vectors may be translated in space to common origin without changing magnitude or direction,and may be summed by parallelogram method to produce Integral vector. （二）心血管传导系统cardiovascular intrinsic conduction system  心脏的传导系统由以下几部分组成 窦房结 SA node 结间束 internodal atrial pathways 房室结 AV node 希氏束 AV bundle 右束支 right bundle branches 左束支 left bundle branches Purkinje 纤维网 Purkinje system 2 （四）心电图导联  leads of the ECG 双极肢体导联 bipolar extremity 心电图的临床应用Clinical application of the ECG （一）心电图的测量方法determination method of the ECG EKG Paper Standardized Methods Devices ECG Paper Device Paper Speed Device Calibration Electrode Placement Standardized Methods Devices ECG Graph Paper Vertical axis- voltage 1 small box 1 mm 0.1 mV Horizontal axis - time 1 small box 1 mm 0.04 sec. Standardized Methods Devices Paper Speed Calibration Paper Speed - 25 mm/sec standard Calibration of Voltage is Automatic Both Speed and voltage calibration can be changed on most devices （二） Components of the ECG Components of the ECG Complex P Wave first upward deflection represents atrial depolarization usually 0.10 seconds or less usually followed by QRS complex Components of the ECG Complex QRS Complex Composition of 3 Waves Q, R S represents ventricular depolarization much variability usually 0.12 sec Components of the ECG Complex Q Wave first negative deflection after P wave depolarization of