Transcript
12 Lead ECG Simulators ST2352A
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Learning Material
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Ver.1.1
An ISO 9001 : 2000 company
94, Electronic Complex Pardesipura, Indore- 452010, India Tel : 91-731- 4211100 Fax: 91- 731- 2555643 E-mail :
[email protected] Website : www.scientech.bz Toll free No. : 1800-103-5050
ST2352A
Save paper, save trees, save earth Dear User, We request you to use the Learning material in the CD form provided with this supply.
Your this act will help to save paper.
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Please remember that each paper manual requires 50-100 sheets of paper
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Your CD learning material has
plenty of theory,
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colourful diagrams,
detailed experiments with observation tables, frequently asked questions, etc. …….. and more so sometimes videos as well. Scientech Eco Foundation
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ST2352A
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ST2352A 12 Lead ECG Simulators ST2352A Table of Contents Safety Instructions
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2.
Introduction
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3.
Features
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4.
Technical Specifications
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5.
Controls and Indicators
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6.
Human Cardiovascular System
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7.
Electrocardiogram (ECG/EKG)
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8.
Standards of ECG Leads Configuration used for measurement
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9.
Operating Instructions
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10.
All Standard ECG Lead Diagrams
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Experiments
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1.
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Experiment 2 Study of Lead II of Standard Bipolar Lead Configuration
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Experiment 3 Study of Lead III of Standard Bipolar Lead Configuration
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Experiment 4 Study of avR Lead of Standard Augmented Uni-polar Lead Configuration
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Experiment 5 Study of avL Lead of Standard Augmented Uni-polar Lead Configuration
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Experiment 6 Study of avF Lead of Standard Augmented Uni-polar Lead Configuration
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Experiment 7 Study of Chest Lead V1 of Standard Uni-polar Lead Configuration
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Experiment 8 Study of Chest Lead V2 of Standard Uni-polar Lead Configuration
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Experiment 1 Study of Lead I of Standard Bipolar Lead Configuration
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ST2352A Experiment 9 Study of Chest Lead V3 of Standard Uni-polar Lead Configuration
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Experiment 10 Study of Chest Lead V4 of Standard Uni-polar Lead Configuration
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Experiment 11 Study of Chest Lead V5 of Standard Uni-polar Lead Configuration
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Experiment 12 Study of Chest Lead V6 of Standard Uni-polar Lead Configuration
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Experiment 13 Study of all the standard ECG Lead (12 Leads) Unipolar and Bipolar Configuration simultaneously
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Experiment 14 Study of measurement of normal Heart-Rate using 12 Lead ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351
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Experiment 15 Study of abnormalities (Tachycardia, Bradycardia) present in Human cardiovascular system using ECG simulator ST2352
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Glossary
14.
Warranty
15.
List of Accessories
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Frequently asked questions
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ST2352A Safety Instructions Read the following safety instructions carefully before operating the instrument. To avoid any personal injury or damage to the instrument or any product connected to it. Do not operate the instrument if suspect any damage to it. The instrument should be serviced by qualified personnel only. For your safety: : Use only the mains cord designed for this instrument. Ensure that the mains cord is suitable for your country.
Ground the Instrument
: This instrument is grounded through the protective earth conductor of the mains cord. To avoid electric shock the grounding conductor must be connected to the earth ground. Before making connections to the input terminals, ensure that the instrument is properly grounded.
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Use proper Mains cord
Use only the proper Fuse
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Observe Terminal Ratings : To avoid fire or shock hazards, observe all ratings and marks on the instrument.
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: Use the fuse type and rating specified for this instrument.
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Do not operate in wet / damp conditions.
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Do not operate in an explosive atmosphere.
3.
Keep the product dust free, clean and dry.
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Use in proper Atmosphere : Please refer to operating conditions given in the manual.
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ST2352A Introduction An Electrocardiogram (ECG or EKG, abbreviated from the German Elektrokardiogramm) is a graphical representation of an electrocardiograph, which records the electrical activity of the heart over time. Analysis of the various waves and normal vectors of depolarization and repolarization yields important diagnostic information. •
It is the gold standard for the diagnosis of cardiac arrhythmias
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It guides therapy and risk stratification for patients with suspected acute myocardial infarction
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It helps detect electrolyte disturbances (e.g. hyperkalemia and hypokalemia)
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It allows for the detection of conduction abnormalities (e.g. right and left bundle branch block)
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12 Lead ECG Simulator ST2352A provides a quick, accurate measurement of all 12 Leads including both Unipolar and Bipolar Configurations for verifying the performance of real time ECG monitoring, Heart-rate Monitoring. ST2352A illustrates the fundamentals of standard limbs (unipolar and bipolar) and chest Leads interpretation and rhythm recognition in an easy-to-use, ECG rhythms produced by ST2352A can be changed in specific boundaries (Heart rate, Amplitude).
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ST2352A also demonstrates ECG observation comprising P, Q, R, S, T, U (U wave is only for Lead II) waves in different Leads arrangements. This trainer is compatible with Heart-rate Monitor cum ECG Trainer ST2351 which receives the ECG signals generated by ST2352A and measures the heart-rate as number of heartbeats per minute. The abnormalities occurring in human cardiovascular system like Tachycardia (faster Heart-rate) and Bradycardia (slower Heart-rate) can also be studied.
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ST2352A is also capable to illustrate the all 12 Leads of ECG simultaneously at a single point, using this point you can observe all waveforms one by one which helps you to understand ECG graph interpretations.
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ST2352A Features •
Provides amplified ECG output with P, Q, R, S, T, U waves
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Compatible with Heart-rate monitor cum ECG Trainer ST2351
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Provides in-depth study of Standard Unipolar and Bipolar Leads Configuration for ECG measurement Variable Heart-rate generation from 30-300 heartbeats/minute
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Variable ECG amplitude 200mV – 4V DC
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Every Systole indication by LED (visible) and audible (Buzzer) sound controls
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ST2352A Technical Specifications Generating Range
:
30-300 heart beats/minute
ECG Amplitude Range :
200mV- 4V DC
Heartbeat Indication
:
Both visible (LED) and Audible (Buzzer) controls
Bipolar Leads
:
Lead I, Lead II, Lead III
Unipolar Leads
:
avR, avL, avF, Chest Leads (V1-V6)
Power Supply
:
220/110V ±10%, 50Hz/60Hz
Dimensions (mm)
:
W 360 x D 260 x H 120
Weight
:
1 Kg (approx.)
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Separate output channels Left Arm (LA), Right Arm (RA), Left Leg (LL), Right Leg (RL) and Chest Leads (V1-V6) for representing Standards Limbs and chest Leads Configurations. A separate point indicated as (12 Lead) is given to observe the 12 Lead standard ECG waveforms simultaneously.
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ST2352A
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Controls and Indicators •
Power On/Off: Rocker switch for supplying power to the instrument
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On-board buzzer: Audio indication for each heartbeat event executed by heart of human body
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On-board LED: Visible indication for each systole of human body
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ECG Amplitude adjust: Control used to adjust the amplitude of generated ECG wave 200mv - 4Vpp
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ECG Pulse-rate Adjust: Control used to adjust the rate of generated ECG wave from 30 - 300 bpm
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ST2352A Human Cardio-Vascular System The Anatomy of the Human Heart: The heart is basically a hollow muscular pump, which pushes the blood through out the body via the blood vessels. It is located between the lungs and slightly to the left of centre. The heart is an involuntary muscle that has approximately seventy to ninety contractions per minute during a restful state. It begins to pump early in the life of a fetus and will continue unceasingly until death. Heart Walls: The heart wall are divided into three layers: •
Pericardium
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Myocardium
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Endocardium
Heart Chambers:
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The heart is divided by a partition or septum into two halves. The halves are in turn divided into chambers. The upper two chambers of the heart are called Atria and the lower two chambers are called Ventricles. Valves allow blood to flow in one direction between the chambers of the heart. The heart has four distinct chambers:
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Right Atrium is the thin-walled area that receives the venous or "used" blood returning to the body by the veins.
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Right Ventricle is the "pump" area of the heart's right side. The atrium dumps the blood into the ventricle where it is then pumped out the pulmonary arteries and to the lungs.
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Left Atrium receives the oxygenated blood returning from the lungs.
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Left Ventricle has the thickest walls of all. It is from this chamber the blood is pumped out of the heart, into the aorta and out to the rest of the body.
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Heart Valves: 1.
Tricuspid valve is the one located at the entrance of the right ventricle. It prevents the blood from washing back into the right atrium.
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Pulmonary Semilunar valve is located between the right ventricle and the pulmonary artery.
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Mitral valve is made of very heavy cusps and is located at the entrance of the left ventricle. This is a powerful valve that closes as the left ventricle begins each of its contractions to ensure the oxygenated blood does not re-enter the left atrium.
4.
Aortic valve is located, as its name would imply, between the left ventricle's exit and the aorta itself.
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ST2352A Even though the heart is split up into two distinct halves, these two must work together to function properly.
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Heart as a Pump:
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Human Heart
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Blood from the body that enters the right side of the heart contains carbon dioxide, a gaseous waste the cells produce in creating energy. Blood enters the right atrium through the Superior vena cava and Inferior vena cava. The atrium fills with blood and then contracts, squeezing the blood through the tricuspid valve into the right ventricle. After the ventricle is filled, pressure forces the tricuspid valve to close and the pulmonic valve, leading to the pulmonary artery, to open. The ventricle contracts and the blood gushes through the pulmonary artery and into the lungs. In the lungs, carbon dioxide is removed from the blood and oxygen is added. The oxygenated blood then flows through the pulmonary veins to the left side of the heart. Oxygenated blood from the lungs enters and fills the left atrium. The atrium then contracts, which squeezes the blood through the Mitral valve into the left ventricle. After blood fills the ventricle, the Mitral valve closes and the Aortic valve opens. Blood pours into the aorta and flows through arteries to the body tissues.
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ST2352A
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Figure 3
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Both sides of the heart pump blood at the same time. As the right ventricle contracts and sends blood to the lungs, the left ventricle contracts and squeezes blood out to the body. The heart's cycle of activity has two periods, systole and diastole. Systole occurs when the ventricles contract, and diastole when they relax. One complete contraction and relaxation of the heart muscle makes up one heartbeat. The heart-rate is a rate at which the heart beats per minute.
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The Heart's Conduction System:
There are four basic components to the heart's conduction system. 1.
Sinoatrial node (SA node)
2.
Inter-nodal fibre bundles
3.
Atrioventricular node (AV node)
4.
Atrioventricular bundle
At the right top corner of the heart there is a special group of excitable cells, called Natural Pacemaker or Sinoatrial Node. This natural pacemaker generates electrical impulses spontaneously. At the lower part of the right atrium there is another mass of specialized group of cells called Atrioventriculer Node. From the atrioventriculer node a bundle of conducting fibers called Bundle of His, passes down to interventriculer septum. A natural pacemaker generates electrical impulses at regular rate. To initiate the heartbeat the action potentials generated by the natural pacemaker or S.A. node gets propagated in all directions along the surface of both atria and atrioventricular node. Scientech Technologies Pvt. Ltd.
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ST2352A This spreads through out the right and left atrium, their wall tissues and results into contraction of atria. Now the waveform reaches to the A.V. node through special nerve fibers which provide the delay in propagation so as to have proper timing between the pumping action of atrium and ventricles. During the delay time the atria completes their contraction forcing blood into ventricles in order to complete their filling. At this point A.V. node initiates an impulse that gets propagated into the ventricles throughout bundles of his then into left and right bundle branch and further into purkenje fibres causing contraction of both the ventricles and forcing blood into lungs and the whole body. During the contraction of ventricles the atria complete their filling and to initiate the next heart beat a pacemaker generates another electrical impulse. With the natural pacemaker providing the impulse, the rate of contraction of the heart is maintains and controlled. Normally this action occurs for 60-100 times in a minute, when additional blood is required, the flow must be increased. This is achieved by generating the impulse at faster rate by natural pacemaker.
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ST2352A Electrocardiogram (ECG / EKG) As the heart undergoes depolarization and repolarization, the electrical currents that are generated and spread not only within the heart, but also through out the body. This electrical activity generated by the heart can be measured by an array of electrodes placed on the body surface. The recorded tracing is called an Electrocardiogram (ECG or EKG). A "typical" ECG tracing is shown below. The different waves that comprise the ECG represent the sequence of depolarization and repolarization of the atria and ventricles. The P wave represents the wave of depolarization that spreads from the SA node throughout the atria, and is usually 0.08 to 0.1 seconds (80-100 ms) in duration.
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Standard ECG Wave
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The QRS complex represents ventricular depolarization. The duration of the QRS complex is normally 0.06 to 0.1 seconds. This relatively short duration indicates that ventricular depolarization normally occurs very rapidly. The T wave represents ventricular repolarization and is longer in duration than depolarization (i.e., conduction of the repolarization wave is slower than the wave of depolarization). Typically the total time required for one complete cycle of the heart electrical activity ranges from approximately 0.4 to 0.6 second while 0.8 seconds is the standard value of one complete heart cycle. The remaining 0.2 second is either including U wave or not. This U wave represents the state of heart when all four chambers of heart receive the blood generally this wave is not present in the normal ECG graph.
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ST2352A A healthy ECG shows a normal sinus rhythm. This is when each depolarization of the cardiac conduction system creates a P wave, followed by a QRS complex, followed by a T wave. During a normal sinus rhythm, the atria are contracting first (around the time of the P wave), and the ventricles contract second (around the time of the QRS complex). Ventricular relaxation occurs around the time of the T wave. The Heart-rate is a rate at which the heart beats per minute. It is controlled by the frequency at which the natural pacemaker generates electrical pulses. However cardiac and vagus nerves of the sympathetic systems and parasympathetic systems causes the heart-rate to increase or decrease respectively according to body requirements. When measured using heart-sounds or ECG it is called heart-rate. A person's physiological size largely determines a person's resting heart rate. The bigger a person is, the slower the heart rate. A newborn baby's heart beats about 120 times per minute. The typical rate for adults is 72 beats per minute. But doctors consider resting rates from 60 to 100 beats per minute within the normal range (normal sinus rhythm).
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A slower rate than normal sinus rhythm this is called Bradycardia
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A higher rate than normal sinus rhythm this is called Tachycardia
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Standards of ECG Leads Configuration used for measurement
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The voltage generated by the pumping action of the heart is actually a vector whose magnitude, as well as spatial orientation, changes with time. Because the ECG signal is measured from electrodes applied to the surface of the body, the waveform of this signal is very dependent on the placement of electrodes.
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Limb Leads (Bipolar)
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Augmented Limb Leads (Unipolar)
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Chest Leads (Unipolar)
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To record the ECG pattern of a subject (human body) it is necessary to apply ECG metal electrodes to the patient's limbs in special formats called Leads, on each Arm and Leg, and six electrodes are placed at defined locations on the chest. These electrode Leads are connected to a device that measures potential differences between selected electrodes to produce the characteristic electro-cardio-graphic tracings.
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ST2352A Limb Leads (Bipolar): Sr. No.
Lead name
1.
Electrode location and polarity Positive (Yellow)
Negative (Red)
Ref. (Black)
I
Left Arm
Right Arm
Right Leg
2.
II
Left Leg
Right Arm
Right Leg
3.
III
Left Leg
Left Arm
Right Leg
Lead Limb
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Augmented Limb Leads (Unipolar):
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Sr. No.
Lead name
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Electrode location and polarity Negative (Red)
Positive (Yellow)at Central terminal of
Ref.(Black)
avR
RA
LA+LL
Right Leg
2.
avL
LA
RA+LL
Right Leg
3.
avF
LL
LA+RA
Right Leg
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ST2352A Augmented Limb Leads
Limb Lead (Unipolar) Configuration Figure 7 Chest Leads (Unipolar):
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Position of electrode for pericardial Leads:
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The chest ECG Leads are considered as the precordial, unipolar chest Leads. There are six positive electrodes placed on the surface of the chest over the heart in order to record electrical activity in a plane perpendicular to the frontal plane (see Figure 8). These six Leads are named V1–V6. The rules of interpretation are the same as for the limb Leads. For example, a wave of depolarization travelling towards a ventricular electrode on the chest surface will elicit a positive deflection. In chest Leads positive electrode (yellow) placed on chest, negative electrode(Red) is placed on central terminal of Left Arm , Right Arm, Left Leg (in ST2352A negative electrode is open) and reference Electrode(Black) is placed on Right Leg of subject(Human body). V1: Right sternal margin at 4th intercostal space (ICS)
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V2: Left sternal margin at 4th ICS
V4: Intersection of 5th ICS and left mid-clavicular line V3: midway between V2 and V4
V5: Intersection of left anterior axillary line with a horizontal line through V4 V6: Intersection of left mid-axillary line with a horizontal line through V4 and V5
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ST2352A
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ST2352A Precordial Leads
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Chest Lead (Unipolar) Configuration
Electrode location and polarity
Sr. No. Lead name
Positive (Yellow)
Negative (Red)
Ref. (Black)
1.
V1
V1(Ch1)
Not connected
Right Leg
2.
V2
V2(Ch2)
Not connected
Right Leg
3.
V3
V3(Ch3)
Not connected
Right Leg
4.
V4
V4(Ch4)
Not connected
Right Leg
5.
V5
V5(Ch5)
Not connected
Right Leg
6.
V6
V6(Ch6)
Not connected
Right Leg
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ST2352A
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Einthoven Triangle:
Figure 10
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For defining the bipolar Leads Einthoven postulated that at any given state of the cardiac cycle electrical axis of the heart can be represented as a two dimensional vector, he proposed that the electric field of the heart could be represented by diagrammatically as a triangle. With the heart ideally located at the centre. The side of the triangle represent the line along which the three projection of the ECG vector are measured. It was shown that the instantaneous voltage measured from any of the limb Lead position is approximately equal to the algebraic sum of the other two or that the vector sum of the projections on all three lines is equal to zero.
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ST2352A
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Einthoven Triangle for defining ECG Leads
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Figure 11
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Colour Codes for ECG Measurement: There are different colours codes are used for the measurement for ECG in different Nations as mentions in the table. Generally India uses the colour code of USA for measurement of Standard Unipolar and Bipolar Leads of ECG. Monitoring cable connections
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Connect to
U.S.A.
Red
Right Arm
White
Yellow
Left Arm
Black
Green
Left Leg
Red
Black
Chest
Brown
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Europe
Individual chest Leads White / Red
C1 / V1
Brown / Red
White / Yellow
C2 / V2
Brown / Yellow
White / Green
C3 / V3
Brown / Green
White / Brown
C4 / V4
Brown / Blue
White / Black
C5 / V5
Brown / Orange
White / Violet
C6 / V6
Brown / Purple
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ST2352A Correlation between number of wires and Leads of ECG •
A 3 wire cable (red, yellow, green) or (red, yellow, black) can only give you a choice of limb Leads.
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A 4 wire cable (red, yellow, green, black) can only give you a choice of limb Leads.
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A 5 wire cable (red, yellow, green, black, white) will give you limb Leads plus a chest Lead (using the white wire - usually placed in the V1 position).
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A 10 wire cable is for recording a 12 Lead ECG.
It is important to remember that the 12-Lead ECG provides spatial information about the heart's electrical activity in 3 approximately orthogonal directions : Left
Superior
Inferior
Anterior
Posterior
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Right
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Lead I
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RA (-) to LA (+)
Lead II
:
RA (-) to LF (+)
(Superior Inferior)
Lead III
:
LA (-) to LF (+)
(Superior Inferior)
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(Right Left, or lateral)
Augmented unipolar limb Leads (frontal plane) :
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Lead avR
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RA (+) to [LA & LF] (-) (Rightward)
Lead avL
:
LA (+) to [RA & LF] (-) (Leftward)
Lead avF
:
LF (+) to [RA & LA] (-) (Inferior)
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Bipolar limb Leads (frontal plane) :
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Each of the 12 Leads represents a particular orientation in space, as indicated below (RA = right Arm; LA = left Arm, LF = left foot, RF = right foot) :
Unipolar (+) chest Leads (horizontal plane) : Leads V1, V2 and V3 :
(Posterior Anterior)
Leads V4, V5 and V6 :
(Right Left or Lateral)
Electrical Axis of Heart: The heart's electrical axis refers to the general direction of the heart's depolarization wavefront (or mean electrical vector) in the frontal plane. It is usually oriented in a right shoulder to left Leg direction, which corresponds to the left inferior quadrant of the hexaxial reference system, although -30o to +90o is considered to be normal. •
Left axis deviation: (-30o to -90o) may indicate left anterior fascicular block or Q waves from inferior myocardial infraction.
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ST2352A •
Right axis deviation: (+90o to +180o) may indicate left posterior fascicular block, Q waves from high lateral myocardial infraction or a right ventricular strain pattern.
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ECG Electrical axises Figure 12
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ST2352A The Mean Electrical Axis: The mean electrical axis will be the sum of all of the mean electrical vectors. The mean electrical axis corresponds to the axis that is perpendicular to the Lead axis that has the smallest net QRS amplitude (net amplitude = positive minus negative deflection voltages of QRS complex To determine the mean electrical axis from the ECG, find the Lead axis that has a biphasic (equally positive and negative QRS deflections - i.e, no net deflection), then find the Lead axis that is perpendicular (90º) to the biphasic Lead and that has a positive net deflection. In the six limb Leads in the example below, aVL is biphasic. The positive perpendicular axis to aVL is +60º. Therefore, the mean electrical axis is +60º, which is normal.
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Figure 14 Determination of Electrical Axis of the Heart: The concept of the electric axis of the heart usually denotes the average direction of the electric activity throughout ventricular (or sometimes atrial) activation. The term mean vector is frequently used instead of "electric axis." The direction of the electric axis may also denote the instantaneous direction of the electric heart vector. The normal range of the electric axis lies between +30° and -110° in the frontal plane and between +30° and -30° in the transverse plane. The direction of the electric axis may be approximated from the 12-Lead ECG by finding the Lead in the frontal plane, where the QRS-complex has largest positive deflection. The direction of the electric axis is in the direction of this Lead vector. The result can be checked by observing that the QRS-complex is symmetrically biphasic in the Lead that is normal to the electric axis. Deviation of the electric axis to the right is an indication of increased electric activity in the right ventricle due to increased right ventricular mass. This is usually a consequence of chronic obstructive lung disease, pulmonary emboli, certain types of congenital heart disease, or other disorders causing severe pulmonary hypertension and corpulmonale. Deviation of the electric axis to the left is an indication of increased electric activity in the left ventricle due to increased left ventricular mass. This is usually a consequence of hypertension, aortic stenosis, ischemic heart disease, or some intraventricular conduction defect. Scientech Technologies Pvt. Ltd.
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ST2352A Operating Instructions While studying different Leads Configuration, the connections should be correct with respect to standard Leads Configuration so that correct waveform will be observed on the positive electrode terminal of ST2352A or tp3 of Heart-rate monitor cum ECG Trainer ST2351.
2.
Adjust the ECG amplitude so that each heartbeat event is detected in different Leads Configuration with respect to threshold level on the Heart-rate monitor cum ECG Trainer ST2351.
3.
Amplitude level should be at maximum level when ST2352A is connected with the ST2351 trainer.
4.
Switch (SW1) is only for audible Piezo Buzzer On /Off.
5.
SW 2 should be ON for Lead I, II, III, avR, avL and avF measurements.
6.
SW 2 should be OFF for all Chest Leads (V1-V6) measurements.
7.
SW 3 should be ON for measurement of all 12 Leads standard simultaneously.
8.
When measuring 12 Lead simultaneously it does not matter that SW2 is ON/OFF (It may be in any position).
9.
During measurement of 12 Lead simultaneously, by default simulator produces each ECG waveform twice.
10.
When ST2352A is interfaced with the ST2351 trainer kit, the mode selection toggle switch should be in Simulation Mode (SM)
11.
Preamplifier and filter will not be in the function, when ST2352A is connected with ST2351 because simulator output is already filtered and amplified.
12.
Wave shape which is coming on the display window of software will be come in proper shape when typical frequency signal will come from the simulator kit, in case frequency is very high the wave will be reduced in the amplitude which is the limitation of the software.
13.
You can see all the wave of 12 Lead ECG using ST2352A and oscilloscope, interfacing of ST2352A with the ST2351 allowed you to see all the waveforms and also measurement of abnormalities of the heart like Bradycardia and Tachycardia.
14.
All the experiments from experiment -1 to 12 you can perform using ST2352A and Oscilloscope, while experiment-13, 14 and 15 also require trainer ST2351 trainer kit.
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ST2352A All Standard ECG Lead Diagrams
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ST2352A
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ST2352A Experiment 1 Objective: Study of Lead I of standard Bipolar Lead Configuration. Equipments Needed: 1.
Heart rate monitor cum ECG trainer ST2351
2.
12 Lead ECG Simulator ST2352A.
3.
2 mm Banana cable to 5 pin Din connector (ECG Lead cable).
4.
Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent.
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Select Lead I by rotating the Lead selection switch.
4.
Make the position of SW2 in ‘On’ position and SW3 in ‘Off’ position.
5.
Now make connections as in Lead I of standard Bipolar Lead Configuration i.e. positive electrode cable (Yellow) in Left Arm of subject, negative electrode cable (Red) in Right Arm, and common (reference) electrode cable (Black) in the Right Leg of subject, properly on 12 Lead ECG Simulator ST2352A.
Observation:
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Observe the ECG waveform in Lead I Configuration in oscilloscope at positive electrode terminal of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required).
2.
Observe the each Systolic action of the Heart by LED indication.
3.
Compare the Lead I wave shape with the standard Lead I wave shape given in the manual (Figure 15).
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Conclusion: 1. ECG waveform of Standard Lead I Configuration is observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer. 2. The absence of Q wave is the indication of the standard Lead I Configuration of the ECG (Sometime it is present, depending on the electrical axis of the Heart). 3. Amplitude and frequency of all other waves (P, R, S, T) are appearing, as in standard Lead I Configuration of ECG. Questions: 1. How the heart rate is controlled? 2. What is the heart rate for various human beings? 3. To measure the ECG signals where the electrodes are placed on human body?
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ST2352A Experiment 2 Objective: Study of Lead II of standard Bipolar Lead Configuration. Equipments Needed: 1.
Heart rate monitor cum ECG trainer ST2351
2.
12 Lead ECG simulator ST2352A
3.
2mm Banana to 5 pin Din connector (ECG Lead cable)
4.
Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Select Lead II by rotating the Lead selection switch.
4.
Make the position of SW2 in ‘On’ position and SW3 in ‘Off’ position.
5.
Now make connections as in Lead II of standard bipolar Leads Configuration i.e. positive electrode cable (Yellow) in Left Leg of subject, negative electrode cable (Red) in Right Arm, and common (reference) electrode cable (Black) in the Right Leg of subject, properly on ECG Simulator ST2352A
Observation:
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Observe the ECG waveform in Lead II Configuration in the oscilloscope at positive electrode terminal of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required).
2.
Observe the each systolic action of the heart by LED indication.
3.
Compare the Lead II wave shape with the standard Lead II wave shape given in the manual (Figure 15).
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Conclusion: 1. ECG waveform of Standard Lead II Configuration is observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer. 2. The presence of all P, Q, R, S, T, U wave is the indication of the standard Lead II Configuration of the ECG. 3. Amplitude and frequency of all waves (P, Q, R, S, T, U) are observed, as in standard Lead II Configuration of ECG. 4. U wave is generally absent in all other Lead Configurations of ECG. Questions: 1. What T wave represents? 2. How much time period is required to complete one cycle by the heart?
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ST2352A Experiment 3 Objective: Study of Lead III of standard Bipolar Lead Configuration Equipments Needed: 1.
Heart rate monitor cum ECG trainer ST2351
2.
12 Lead ECG Simulator ST2352A
3.
2 mm Banana to 5 pin Din connector (ECG Lead cable)
4.
Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Select Lead III by rotating the Lead selection switch
4.
Make the position of SW2 in ‘On’ position and SW3 in ‘Off’ position.
5.
Now make connections as in Lead III of standard bipolar Leads Configuration i.e. positive electrode cable (Yellow) in Left Leg of subject, negative electrode cable (Red)in Left Arm, and common (reference) electrode cable (Black) in the Right Leg of subject, properly on ECG Simulator ST2352.
Observation:
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Observe the ECG. Waveform in Lead III Configuration in oscilloscope at positive terminal of electrode of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required).
2.
Observe the each systolic action of the heart by LED indication.
3.
Compare the Lead III wave shape with the standard Lead III wave shape given in the manual (Figure 15).
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Conclusion: 1. ECG waveform of Standard Lead III Configuration is observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer. 2. The presence of all P, Q, R, S, T, wave is the indication of the standard Lead III Configuration of the ECG. 3. The QRS complex has approximately same positive and negative amplitude is the most common indication of Lead III bipolar Lead Configuration. 4. Amplitude and frequency of all waves (P, Q, R, S, T,) are observed, as in standard Lead III Configuration of ECG. Questions: 1. How many components heart conduction system have? 2. How the electrical activity of heart can be sensed?
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ST2352A Experiment 4 Objective: Study of avR Lead of standard Unipolar Leads Configuration. Equipments Needed: 1. Heart rate monitor cum ECG trainer ST2351 2. 12 Lead ECG simulator ST2352A 3. 2mm Banana to 5 pin Din Connector (ECG Lead cable) 4. Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2. 3. 4. 5.
Switch ‘On’ the mains power supply, then trainers. Select Lead avR by rotating the Lead selection switch. Make the position of SW2 in ‘On’ position and SW3 in ‘Off’ position. Make connections as in avR Lead of standard Augmented Unipolar limb Leads Configuration.
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Connect negative electrode (Red) to the Right Arm of subject and positive electrode (Yellow) to the junction point of the Left Arm and Left Leg of the subject indicated by avR.
•
Connect reference electrode (Black) to the Right Leg (RL) of the subject.
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Observation: 1. Observe the avR waveform of standard Augmented Unipolar limb Lead in oscilloscope at positive electrode terminal of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required). Observe the each systolic action of the heart by LED indication. Compare the Lead avR wave shape with the standard Lead avR wave shape given in the manual (Figure 15). Conclusion: 1. ECG waveform of Standard Lead avR Configuration is observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer. 2. The presence of inverted P, R and T wave is the indication of the standard Lead avR Configuration of the ECG. 3. The QRS complex has negative amplitude is the most common indication of avR unipolar Lead Configuration. 4.
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Amplitude and frequency of all waves (P, Q, R, S, T,) are observed, as in standard Lead avR Configuration of ECG.
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ST2352A Questions: 1.
What is PR-segment?
2.
What is the duration of PR-segment?
3.
What is the amplitude of Q wave?
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ST2352A Experiment 5 Objective: Study of avL Lead of standard unipolar limb Leads Configuration. Equipments Needed: 1.
Heart rate monitor cum ECG trainer ST2351
2.
12 Lead ECG simulator ST2352A
3.
2mm Banana to 5 pin Din connector
4.
Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent.
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Select Lead avL by rotating the Lead selection switch.
4.
Make the position of SW2 in ‘On’ position and SW3 in ‘Off’ position.
5.
Make connections as in avL of standard Augmented Unipolar Leads Configuration.
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Connect the negative electrode (Red) to the Left Arm and positive electrode (Yellow) to the junction point of Right Arm and Left Leg (indicated by avL) of subject.
•
Connect reference electrode (Black) to the Right Leg of subject.
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Observation:
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Observe the avL waveform of standard Augmented Unipolar limb Lead in oscilloscope at positive electrode terminal of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required).
2.
Observe the each systolic action of the heart by LED indication.
3.
Compare the Lead avL wave shape with the standard Lead avL wave shape given in the manual (Figure 15).
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Conclusion: 1.
ECG waveform of Standard Lead avL Configuration is observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer.
2.
The QRS complex has positive amplitude with little negative amplitude is the most common indication of avL unipolar Lead Configuration.
3.
Amplitude and frequency of all waves (P, Q, R, S, T,) are observed, as in standard Lead avL Configuration of ECG. (some time Q wave is absent)
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ST2352A Questions: 1. Which type of activity is held during ‘P’,’QRS’ and ‘T’ wave? 2.
How different waves are generated?
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ST2352A Experiment 6 Objective: Study of avF Lead of standard Unipolar Leads Configuration Equipments Needed: 1.
Heart rate monitor cum ECG trainer ST2351
2.
12 Lead ECG simulator ST2352A
3.
2 mm Banana to 5 pin Din connector (ECG Lead cable)
4.
Oscilloscope (DS1102C 100 MHz,400MSa/s) or Equivalent
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Select Lead avF by rotating the Lead selection switch.
4.
Make the position of SW2 in ‘On’ position and SW3 in ‘Off’ position.
5.
Make connections as in avF Lead of standard Augmented Unipolar Leads Configuration.
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Connect the negative electrode (Red) to the left Leg and positive electrode (Yellow) to the junction point of Right Arm and Left Arm (indicated by avF) of subject.
•
Connect reference electrode (Black) to the Right Leg of subject.
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Observation:
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Observe the waveform in avF Lead of Augmented Unipolar Leads Configuration in oscilloscope at positive electrode terminal of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required).
2.
Observe the each systolic action of the heart by LED indication.
3.
Compare the Lead avF wave shape with the standard Lead avF wave shape given in the manual (Figure 15).
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Conclusion: 1.
ECG waveform of Standard Lead avF Configuration is observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer.
2.
The QRS complex has positive amplitude with no negative amplitude is the most common indication of avL unipolar Lead Configuration.
3.
All waves of this Lead Configuration are positive.
4.
Amplitude and frequency of all waves (P, R, T,) are coming, as in standard Lead avF Configuration of ECG.
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ST2352A Questions: 1.
What ‘P’ wave represent?
2.
What is the duration of ‘P’ wave?
3.
What is the standard value of one complete cycle for ‘T’ wave?
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ST2352A Experiment 7 Objective: Study of Chest Lead V1 of standard Unipolar Leads Configuration. Equipments Needed: 1.
Heart rate monitor cum ECG trainer ST2351
2.
12 Lead ECG simulator ST2352A
3.
2 mm Banana to 5 pin Din connector
4.
Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Select the chest Lead V1 by rotating the Lead selection switch.
4.
Make the position of SW2 in ‘Off’ position and SW3 in ‘Off’ position.
5.
Make connections of Unipolar Chest Leads from V1 for getting the chest Lead signals as follows :
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Connect the positive electrode (Yellow) to the V1 terminal while negative electrode (Red) remains open.
•
Connect reference electrode (Black) to the Right Leg (RL) of the subject.
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Observation:
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Observe the waveform in Chest Lead of standard Unipolar Leads V1 Configuration in oscilloscope at positive electrode terminal of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required).
2.
Observe the each systolic action of the heart by LED indication.
3.
Compare the Lead V1 wave shape with the standard Lead V1 wave shape given in the manual (Figure 16).
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Conclusion: 1.
ECG waveform of Standard Lead V1 Configuration is observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer.
2.
The QRS complex has negative amplitude is the most common indication of V1 unipolar Lead Configuration.
3.
T wave has large positive amplitude.
4.
R wave has large negative amplitude.
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ST2352A Questions: 1.
What QRS complex represents?
2.
What T wave represents?
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ST2352A Experiment 8 Objective: Study of Chest Leads V2 of standard Unipolar Lead Configuration. Equipments Needed: 1.
Heart rate monitor cum ECG trainer ST2351
2.
12 Lead ECG simulator ST2352A
3.
2 mm Banana to 5 pin Din connector
4.
Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent.
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Select the chest Lead V2 by rotating the Lead selection switch.
4.
Make the position of SW2 in ‘Off’ position and SW3 in ‘Off’ position.
5.
Make connections of Unipolar Chest Leads from V1 for getting the chest Lead signals as follows :
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Connect the positive electrode (Yellow) to the V2 terminal while negative electrode (Red) remains open.
•
Connect reference electrode (Black) to the Right Leg (RL) of the subject.
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Observation:
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Observe the waveform in Chest Lead of standard Unipolar Leads V1 Configuration in oscilloscope at positive electrode terminal of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required).
2.
Observe the each systolic action of the heart by LED indication.
3.
Compare the Lead V2 wave shape with the standard Lead V2 wave shape given in the manual (Figure 16).
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Conclusion: 1.
ECG waveform of Standard Lead V2 Configuration is observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer.
2.
The QRS complex has negative amplitude with little negative value is the most common indication of V2 unipolar Lead Configuration.
3.
T wave has large positive amplitude than V1.
4.
R wave has large negative amplitude.
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ST2352A Questions: 1.
What is the amplitude of ‘T’ Wave?
2.
What normal ‘T’ waves represents?
3.
What is the duration of ST-Interval?
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ST2352A Experiment 9 Objective: Study of Chest Leads V3 of standard Unipolar Configuration. Equipments Needed: 1.
Heart rate monitor cum ECG trainer ST2351
2.
12 Lead ECG simulator ST2352A
3.
2 mm Banana to 5 pin Din connector
4.
Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Select the chest Lead V3 by rotating the Lead selection switch.
4.
Make the position of SW2 in ‘Off’ position and SW3 in ‘Off’ position.
5.
Make connections of Unipolar Chest Leads from V3 for getting the chest Lead signals as follows :
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Connect the positive electrode (Yellow) to the V3 terminal while negative electrode (Red) remains open.
•
Connect reference electrode (Black) to the Right Leg (RL) of the subject.
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Observation:
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Observe the waveform in Chest Lead of standard Unipolar Leads V3 Configuration in oscilloscope at positive electrode terminal of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required).
2.
Observe the each systolic action of the heart by LED indication.
3.
Compare the Lead V3 wave shape with the standard Lead V3 wave shape given in the manual (Figure 16).
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Conclusion: 1.
ECG waveform of Standard Lead V3 Configuration is observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer.
2.
The QRS complex has approximately equal negative and positive amplitude is the most common indication of V3 unipolar Lead Configuration.
3.
T wave has large positive amplitude than V1 with sharp edges.
4.
S wave has large negative amplitude.
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ST2352A Questions: 1.
What is the amplitude of ‘R’ Wave?
2.
What ‘R’ wave represents?
3.
What is the amplitude of ‘S’ Wave?
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ST2352A Experiment 10 Objective: Study of Chest Leads V4 of standard Unipolar Configuration. Equipments Needed: 1.
Heart rate monitor cum ECG trainer ST2351
2.
12 Lead ECG simulator ST2352A
3.
2 mm Banana to 5 pin Din connector
4.
Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Select the chest Lead V4 by rotating the Lead selection switch.
4.
Make the position of SW2 in ‘Off’ position and SW3 in ‘Off’ position.
5.
Make connections of Unipolar Chest Leads from V4 for getting the chest Lead signals as follows:
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Connect the positive electrode (Yellow) to the V4 terminal while negative electrode (Red) remains open.
•
Connect reference electrode (Black) to the Right Leg (RL) of the subject.
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Observation:
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Observe the waveform in Chest Lead of standard Unipolar Leads V4 Configuration in oscilloscope at positive electrode terminal of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required).
2.
Observe the each systolic action of the heart by LED indication.
3.
Compare the Lead V4 wave shape with the standard Lead V4 wave shape given in the manual (Figure 16).
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Conclusion: 1.
ECG waveform of Standard Lead V4 Configuration is observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer.
2.
The QRS complex has approximately equal negative and positive amplitude is the most common indication of V4 unipolar Lead Configuration.
3.
T wave has positive amplitude but slightly flatter than V1, V2, V3.
4.
S wave has negative amplitude.
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ST2352A Questions: 1.
What is the amplitude of ‘T’ Wave?
2.
What normal ‘T’ waves represents?
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ST2352A Experiment 11 Objective: Study of Chest Leads V5 of standard Unipolar Configuration. Equipments Needed: 1.
Heart rate monitor cum ECG trainer ST2351
2.
12 Lead ECG simulator ST2352A
3.
2 mm Banana to 5 pin Din connector
4.
Oscilloscope (DS1102C 100 MHz,400MSa/s) or Equivalent
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Select the chest Lead V5 by rotating the Lead selection switch.
4.
Make the position of SW2 in ‘Off’ position and SW3 in ‘Off’ position.
5.
Make connections of Unipolar Chest Leads from V5 for getting the chest Lead signals as follows :
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Connect the positive electrode (Yellow) to the V5 terminal while negative electrode (Red) remains open.
•
Connect reference electrode (Black) to the Right Leg (RL) of the subject.
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Observation:
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Observe the waveform in Chest Lead of standard Unipolar Leads V5 Configuration in oscilloscope at positive electrode terminal of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required).
2.
Observe the each systolic action of the heart by LED indication.
3.
Compare the Lead V5 wave shape with the standard Lead V5 wave shape given in the manual (Figure 16).
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Conclusion: 1.
ECG waveform of Standard Lead V5 Configuration is observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer.
2.
The QRS complex has positive amplitude with little flatter shape of S wave is the most common indication of V5 unipolar Lead Configuration.
3.
R wave has large positive amplitude.
4.
ST slope is more flat than other chest Lead Configurations.
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ST2352A Questions: 1. What is the amplitude of ‘R’ Wave? 2.
What ‘R’ wave represents?
3.
What is the amplitude of ‘S’ Wave?
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ST2352A Experiment 12 Objective: Study of Chest Leads V6 of standard Unipolar Configuration. Equipments Needed: 1.
Heart rate monitor cum ECG trainer ST2351
2.
12 Lead ECG simulator ST2352A
3.
2 mm Banana to 5 pin Din connector
4.
Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Select the chest Lead V6 by rotating the Lead selection switch.
4.
Make the position of SW2 in ‘Off’ position and SW3 in ‘Off’ position.
5.
Make connections of Unipolar Chest Leads from V6 for getting the chest Lead signals as follows:
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Connect the positive electrode (Yellow) to the V6 terminal while negative electrode (Red) remains open.
•
Connect reference electrode (Black) to the Right Leg (RL) of the subject.
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Observation:
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Observe the waveform in Chest Lead of standard Unipolar Leads V6 Configuration in oscilloscope at positive electrode terminal of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required).
2.
Observe the each systolic action of the heart by LED indication.
3.
Compare the Lead V6 wave shape with the standard Lead V6 wave shape given in the manual (Figure 16).
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Conclusion: 1.
ECG waveform of Standard Lead V6 Configuration is observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer.
2.
The QRS complex has positive amplitude with little negative S wave is the most common indication of V6 unipolar Lead Configuration.
3.
R wave has large positive amplitude
4.
ST slope is less than other chest Lead Configurations.
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ST2352A Questions: 1.
What is the amplitude of ‘QRS’ Complex?
2.
What ‘QRS’ complex represents?
3.
What is the duration of ‘QRS’ wave?
4.
What short duration indicates in ‘QRS’ wave?
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ST2352A Experiment 13 Objective: Study of all the standard ECG Leads (12 Leads) Unipolar and Bipolar Configuration simultaneously. Equipments Needed: 1.
Heart rate monitor cum ECG trainer ST2351
2.
12 Lead ECG simulator ST2352A
3.
2 mm Banana to 5 pin Din connector (ECG Lead cable)
4.
Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Make the position of SW2 in ‘Off’ position and SW3 in ‘On’ position.
4.
Make connections of 12 Lead for getting all Leads simultaneously.
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Connect the positive electrode (Yellow) to the 12 Lead terminal while negative electrode (Red) remains open.
•
Connect reference electrode (Black) to the Right Leg (RL) of the subject.
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Observe the waveform of all standard Unipolar and Bipolar Leads Configuration in oscilloscope at positive electrode terminal of ST2352A or tp3 terminal of ST2351 (Adjust gain and frequency if required).
2.
Observe the each systolic action of the heart by LED indication.
3.
Compare the all Lead wave shape with the standard Lead wave shape given in the manual (Figure 15 and 16).
4.
By default each ECG wave will come two times.
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Conclusion: 1.
ECG waveforms of all Standard Leads Configuration are observed in proper shape and frequency which is previously adjusted by the pulse adjustment Potentiometer.
Questions: 1.
What is unipolar and bipolar configuration?
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ST2352A Experiment 14 Objective: Study of measurement of normal Heart-Rate using 12 Lead ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351. Equipments Needed: 1.
Heart-rate monitor cum ECG Trainer ST2351.
2.
12 Lead ECG Simulator ST2352A.
3.
2 mm Banana to 5 pin Din connector.
4.
Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent.
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Before monitoring the Heart-rate of human body the Count/Reset selection switch should be in Reset mode to allow the Heart-rate Monitor to start measuring from beginning (Reset value) and to reset the timer.
4.
The Display mode provided at front panel displays either Heart-rate or Tachycardia limit or Bradycardia limit depending up on their selection. Initially in case of Heart-rate it will give reset value, and if Tachycardia limit or Bradycardia limit is selected then it will display their present value.
5.
Make connections in any of the Bipolar or Unipolar Leads Configurations properly on ST2352A and connect the cables to the Trainer ST2351.
6.
Select Count Mode using Count/Reset selection switch and observe each heartbeat event executed by the subject (human body) on heartbeat event indicator with in one minute duration. One minute duration is indicated by one minute timer LED.
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1.
Observation: 1.
Now observe the Heart rate displayed on the digital panel meter.
2.
Vary the Pulse rate by pulse-rate Adjustment pot till DPM (digital panel meter) shows 72 heartbeats (Standard) per minute. Then observe the ECG waveform obtained with normal sinus rhythm.
3.
All amplified waves you can see at tp3 in ST2351.
Conclusion: 1.
Digital Panel Meter shows the normal readings of the Heart rate (72 bpm).
2.
Any abnormality (Tachycardia and Bradycardia) are not indicated by the DPM.
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ST2352A Questions: 1.
How much time period is required to complete one cycle by the heart?
2.
Define heart rate?
3.
How the heart rate is controlled?
4.
What is the heart rate for various human beings?
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ST2352A Experiment 15 Objective: Study of abnormalities (Tachycardia, Bradycardia) present in human cardiovascular system using ECG simulator ST2352. Equipments Needed: 1. Heart-Rate Monitor cum ECG Trainer ST2351. 2.
12 Lead ECG Simulator ST2352A.
3.
2 mm Banana to 5 pin Din Connector.
4.
Oscilloscope (DS1102C 100 MHz, 400MSa/s) or Equivalent.
Procedure: Connect one end of each power supply to the ECG Simulator ST2352A and Heart rate monitor cum ECG trainer ST2351 while other end to mains power supply.
2.
Switch ‘On’ the mains power supply, then trainers.
3.
Before monitoring the Heart-rate of human body the Count / Reset selection switch on ST2351 should be in Reset mode to allow the Heart-rate Monitor to start measuring from beginning (reset value) and to reset the timer.
4.
The Display mode provided at front panel of ST2351 displays either Heart rate or Tachycardia limit or Bradycardia limit depending upon their selection. Initially, in case of Heart rate it will give reset value indication, and if Tachycardia limit or Bradycardia limit is selected then it will display their present value.
5.
Make connections as in any of the standard unipolar or bipolar Lead Configuration properly on ST2352A and connect the cables to the ST2351 Trainer.
6.
Select Count Mode using Count / Reset selection switch and observe each heartbeat event executed by the subject (human body) with in one minute duration. One minute duration is indicated by one minute timer LED.
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Observation: 1.
Observe the heart-rate displayed on the digital panel meter.
2.
To test the Tachycardia conditions, select the Tachycardia limit mode using mode selection switch so that the display mode comes to display tachycardia limit with LED indication.
3.
Set the Tachycardia limit by adjusting the Limit adjustment potentiometer (preferable to set 90 heart beats per minute).
4.
Set the Bradycardia limit by adjusting the Limit adjustment potentiometer (preferable to set 40 heartbeats per minute) and then returns to Heart-rate mode by selecting it.
5.
Select Reset mode, before counting current Heart-rate in Count Mode.
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ST2352A 6.
Rotate ECG Pulse-rate Adjustment control on 12 Lead ECG Simulator ST2352A to vary the pulse rate, Whenever the rate exceeds than the current Tachycardia limit, or less than the current Bradycardia limit, the out of control visible indications are given by Tachycardia LED and Bradycardia LED.
Conclusion: 1.
While rotating the pulse rate adjustment pot, when Heart rate Exceeds beyond the Tachycardia limit, the tachycardia indication is given by the LED.
2.
When heart rate is below the Bradycardia limit, the indication is given by the LED for the Bradycardia.
3.
When Heart rate lies in between the Tachycardia and Bradycardia limit, not any indication is given by the LED. Questions: How many contractions heart have?
2.
In how many layers heart wall is divided, name them?
3.
What Tachycardia, Bradycardia represents?
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ST2352A Frequently Asked Questions 1.
What is the Anatomy of the human heart? The heart is basically a hollow muscular pump, which pushes the blood through out the body via the blood vessels. It is located between the lungs and slightly to the left of centre.
2.
How many contractions heart have? The heart is an involuntary muscle that has approximately seventy to ninety contractions per minute during a restful state. It begins to pump early in the life of a fetus and will continue unceasingly until death.
3.
In how many layers heart wall is divided, name them? The heart wall is divided into three layers: Pericardium
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Myocardium
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Endocardium
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How chamber is sub divided?
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How many chambers does heart have?
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The heart is divided by a partition or septum into two halves. The halves are in turn divided into chambers. The upper two chambers of the heart are called atria and the lower two chambers are called ventricles. The heart has four distinct chambers.
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Right atrium is the thin-walled area that receives the venous or "used" blood returning to the body by the veins.
2.
Right ventricle is the "pump" area of the heart's right side. The atrium dumps the blood into the ventricle where it is then pumped out the pulmonary arteries and to the lungs.
3.
Left atrium receives the oxygenated blood returning from the lungs.
4.
Left ventricle has the thickest walls of all. It is from this chamber the blood is pumped out of the heart, into the aorta and out to the rest of the body.
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1.
How many types of heart valves are there? There are four types of heart valves which are as follows: a.
Tricuspid valve: is the one located at the entrance of the right ventricle. It prevents the blood from washing back into the right atrium.
b.
Pulmonary semi lunar valve: is located between the right ventricle and the pulmonary artery.
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ST2352A
7.
c.
Mitral valve: is made of very heavy cusps and is located at the entrance of the left ventricle. This is a powerful valve that closes as the left ventricle begins each of its contractions to ensure the oxygenated blood doesn't reenter the left atrium.
d.
Aortic valve: is located, as its name would imply, between the left ventricle's exit and the aorta itself.
How right ventricle and left ventricle works? As the right ventricle contracts and sends blood to the lungs, the left ventricle contracts and squeezes blood out to the body.
8.
What is systole and diastole? Systole occurs when the ventricles contract, and diastole when they relax. One complete contraction and relaxation of the heart muscle makes up one heartbeat.
9.
How many components heart conduction system have? i.
Sinoatrial node (SA node)
ii.
Inter-nodal fibre bundles
iii.
Atrioventricular node (AV node)
iv.
Atrioventricular bundle
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There are four basic components to the heart's conduction system.
What is the function of natural pacemaker?
What is the full form of ECG? Electrocardiogram
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A natural pacemaker generates electrical impulses at regular rate. To initiate the heartbeat the action potentials generated by the natural pacemaker or S.A. node gets propagated in all directions along the surface of both atria and atrioventriculer node.
How the electrical activity of heart can be sensed? This electrical activity generated by the heart can be measured by an array of electrodes placed on the body surface.
13.
What P wave represents? The P wave represents the wave of depolarization that spreads from the SA node throughout the atria, and is usually 0.08 to 0.1 seconds (80-100 ms) in duration.
14.
What QRS complex represents? The QRS complex represents ventricular depolarization. The duration of the QRS complex is normally 0.06 to 0.1 seconds. This relatively short duration indicates that ventricular depolarization normally occurs very rapidly.
15.
What T wave represents?
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ST2352A The T wave represents ventricular repolarization and is longer in duration than depolarization (i.e., conduction of the repolarization wave is slower than the wave of depolarization). 16.
How much time period is required to complete one cycle by the heart? The total time required for one complete cycle of the heart electrical activity ranges from approximately 0.4 to 0.6 second.
17.
Define heart rate? The Heart-rate is a rate at which the heart beats per minute.
18
How the heart rate is controlled? It is controlled by the frequency at which the natural pacemaker generates electrical pulses. What is the heart rate for various human beings?
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To measure the ECG signals where the electrodes are placed on human body?
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The bigger a person is, the slower the heart rate. A newborn baby's heart beats about 120 times per minute. The typical rate for adults is 72 beats per minute. But doctors consider resting rates from 60 to 100 beats per minute within the normal range.
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To record the ECG pattern of a subject (human body) it is necessary to apply ECG metal electrodes to the patient's limbs in special formats called leads, on each arm and leg, and six electrodes are placed at defined locations on the chest. How electrical signals are generated through the heart?
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As the heart undergoes depolarization and repolarization, the electrical currents that are generated and spread not only within the heart, but also through out the body. 22.
How the electrical current is measured from the heart? The electrical activity generated by the heart can be measured by an array of electrodes placed on the body surface.
23.
How different waves are generated? The different waves that comprise the ECG represent the sequence of depolarization and repolarization of the atria and ventricles.
24.
What ‘P’ wave represent? The ‘P’ wave represents the wave of depolarization that spreads from the SA node throughout the atria.
25.
What is the duration of ‘P’ wave? The duration is usually of 0.08 to 0.1 seconds (80-100 ms).
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ST2352A 26.
What ‘QRS’ complex represents? The QRS complex represents ventricular depolarization.
27.
What is the duration of ‘QRS’ wave? The duration of the QRS complex is normally 0.06 to 0.1 seconds.
28.
What short duration indicates in ‘QRS’ wave? The relative short duration indicates that ventricular depolarization normally occurs very rapidly.
29.
What ‘T’ wave represents? The T wave represents ventricular repolarization and is longer in duration than depolarization
30.
What is the duration of ‘T’ wave?
31.
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Typically the total time required for one complete cycle of the heart electrical activity ranges from approximately 0.4 to 0.6 second. What is the standard value of one complete cycle for ‘T’ wave?
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0.8 seconds is the standard value of one complete heart cycle.
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What ‘T’ wave represents?
Which type of activity is held during ‘P’,’QRS’ and ‘T’ wave?
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This U wave represents the state of heart when all four chambers of heart receive the blood generally this wave is not present in the normal ECG graph.
What heart's electrical axis refers?
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During a normal sinus rhythm, the atria are contracting first (around the time of the P wave), and the ventricles contract second (around the time of the QRS complex). Ventricular relaxation occurs around the time of the T wave. The heart's electrical axis refers to the general direction of the heart's depolarization wave front (or mean electrical vector) in the frontal plane. 35.
What is the orientation of heart's electrical axis? It is usually oriented in a right shoulder to left Leg direction, which corresponds to the left inferior quadrant of the hex axial reference system, although -30o to +90 o is considered to be normal.
36.
What the electric axis of the heart usually denotes? The concept of the electric axis of the heart usually denotes the average direction of the electric activity throughout ventricular (or sometimes atrial) activation.
37.
What is the range of electric axis? The normal range of the electric axis lies between +30° and -110° in the frontal plane and between +30° and -30° in the transverse plane. The direction of the
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ST2352A electric axis may be approximated from the 12-Lead ECG by finding the Lead in the frontal plane, where the QRS-complex has largest positive deflection. The direction of the electric axis is in the direction of this Lead vector. The result can be checked by observing that the QRS-complex is symmetrically biphasic in the Lead that is normal to the electric axis. 38.
What the deviation of the electric axis to the right indicates? Deviation of the electric axis to the right is an indication of increased electric activity in the right ventricle due to increased right ventricular mass.
39.
Due to which types of diseases the deviation of the electric axis to the right occurs? This is usually a consequence of chronic obstructive lung disease, pulmonary emboli, certain types of congenital heart disease, or other disorders causing severe pulmonary hypertension and corpulmonale.
40.
What the deviation of the electric axis to the left indicates?
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Due to which types of diseases the deviation of the electric axis to the left occurs?
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Deviation of the electric axis to the left is an indication of increased electric activity in the left ventricle due to increased left ventricular mass.
42.
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This is usually a consequence of hypertension, aortic Stenosis, ischemic heart disease, or some interventricular conduction defect. What is the amplitude of ‘P’ wave? 0.25mV
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What should be the dimensions of ‘P’ wave?
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The P wave in general should not be more than 1 box wide or 1 box tall. If it exceeds these, it generally means that either or both atria is enlarged (hypertrophied). 44.
What are the characteristics of ‘P’ wave? Positive deflection of P wave greater than 1 box wide or 1 box in height indicates right atrial hypertrophy Negative deflection of P wave greater than 1 box wide or 1 box in depth indicates left atrial hypertrophy.
45.
What is the duration of PR-Interval? Duration: 180-220 m sec The distance from the beginning of the P wave to the beginning of Q wave is PR interval. It’s a period from the beginning of atria depolarization to the beginning of ventricular depolarization.
46.
What is PR-segment? It is the distance from end of the P wave and beginning of Q wave.
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ST2352A 47.
What is the duration of PR-segment? Duration: 0.01 sec (approximately)
48.
What is the amplitude of Q wave? Amplitude
49.
:
0.2 mV
What normal Q wave represents? Normal Q waves are small, less than 1 mm deep or wide and one fourth the height of their R wave.
50.
When Q wave Develops? Pathological Q waves usually develop when ST segments are elevated and appear several hours or days after the clinical manifestations of the Myocardial Infarction.
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What abnormal Q wave represents?
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Abnormal Q must be one Small Square (0.04 sec) wide and greater than onethird of QRS height in Lead III. Myocardial infarction causes pathological Q waves over the affected area of the ventricle. The age of the infection can be determined.
52.
What is the amplitude of ‘R’ Wave? :
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What ‘R’ wave represents?
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If only Q wave is present without elevated ST segment then it indicates old infarction while if ST segment is there (with or without T wave inversion) then it indicates acute infraction. Q waves with inverted T waves may indicate undetermined age.
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R wave is the largest wave of the ECG graph and it is always above iso electric line, No such thing as a "negative R-wave" exists. 54.
What is the amplitude of ‘S’ Wave? Amplitude
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0.4 - 0.5 mV
What is the amplitude of ‘QRS’ Complex? Amplitude
56.
: :
1.5 mv
What is the duration of ST-Segment? Short segment from end of S wave to beginning of T wave and has duration of about 0.07 sec.
57.
What is the amplitude of ‘T’ Wave? Amplitude
58.
:
0.1 - 0.5 m sec
What normal ‘T’ waves represents?
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ST2352A Normal T waves are in the same direction as their complex, wave is asymmetrical and it peaks toward the end, instead of the middle. Normal T wave in frontal plan is about 5 mm and in precordial plane 10 mm tall. 59.
What is the duration of ST-Interval? Period from end of S wave to end of T wave and has the duration of about 0.20 0.27 m sec.
60.
What QT-Interval represents? It is the interval from beginning of Q wave to end of T wave, or we can say this is the period from beginning of ventricular depolarization to the end of repolarization.
61.
What is the duration of QT-Interval? It has the duration of about 0.26 - 0.49 m sec.
62.
What RR-Interval represents?
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This is the distance between QRS-complexes.
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ST2352A Glossary Artery: A muscular blood vessel that carries blood away from the heart. Arrhythmia: Is an abnormal heart rhythm. Atrium: One of the chambers of the heart that receives blood directly from a vein. Bradycardia: When the heart-rate less than the normal heart-rate rhythm. Circulatory system: The system of the body responsible for internal transport. Composed of the heart, blood vessels, lymphatic vessels, lymph, and the blood. Cardiology: Is the branch of medicine that deals with the diagnosis and treatment of disorders of the heart. Diastole: Pronounced dy AS tuh lee, is the period of heart activity when the ventricles relax.
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Diastolic pressure: The decreased pressure due to the relaxation of the ventricles is called diastolic pressure.
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Electrocardiograph (ECG): Is an instrument used to detect heart damage or diagnose heart disorders.
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Heart: The muscular organ composed of cardiac muscle that is responsible for pumping blood throughout the body.
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Normal sinus rhythm: Normal pumping action of heart generates 60 -100 heartbeats per minute.
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Septum: The wall dividing the two ventricles.
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Systole: Is the period of heart activity when the ventricles contract.
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Systolic pressure: The increased pressure due to the contraction of the ventricles is called systolic pressure. Tachycardia: When the heart-rate exceeds than the normal heart-rate rhythm. Ventricle: One of the muscular chambers of the heart that is responsible for pumping blood from the heart into the arteries.
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ST2352A Warranty 1.
We guarantee this product against all manufacturing defects for 24 months from the date of sale by us or through our dealers. Consumables like dry cell etc. are not covered under warranty.
2.
The guarantee will become void, if a. The product is not operated as per the instruction given in the operating manual. b. The agreed payment terms and other conditions of sale are not followed. c. The customer resells the instrument to another party. d. Any attempt is made to service and modify the instrument. The non-working of the product is to be communicated to us immediately giving full details of the complaints and defects noticed specifically mentioning the type, serial number of the product and date of purchase etc.
4.
The repair work will be carried out, provided the product is dispatched securely packed and insured. The transportation charges shall be borne by the customer.
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List of Accessories 1.
ECG Gel........................................................................................................1 No.
2.
Clamp Electrodes..........................................................................................4 Nos.
3.
Banana to 5 pin Cable...................................................................................1 No.
4.
Learning Material (CD)..................................................................................1 No.
5.
Power Supply.................................................................................................1 No.
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