How to understand ECG paper

Time : 2023-03-24

An ECG can be called normal only if many indicators reach a common standard. However, not all ECG are normal. Here we judge whether the ECG shows whether our heart is normal from events such as heart rate, premature beats, atrial fibrillation, and atrial flutter.

basic terms

Heart rate: the number of heartbeats per minute
P wave: a short period of steady fluctuation between every two heartbeats, indicating the excitation process of the left and right atria
r-peak: the high point of the ECG
pr interval: the time elapsed between the excitation of the sinoatrial node reaching the ventricle and causing the ventricle to begin to excite
qrs interval: three connected fluctuations representing potential changes during the propagation of excitation in two ventricles
f wave: Atrial activity presents a regular saw-tooth flutter wave, and the atrial rate of atrial flutter is usually 250-300 beats/min

watch heart rate

Heart rate < 60 beats per minute is sinus bradycardia
Heart rate >100 beats per minute is sinus tachycardia
The ideal heart rate should be 55-70 beats/minute (the heart rate of athletes is slower than that of ordinary adults, generally around 50 beats/minute).
If there is chest tightness, fatigue, dizziness and other discomforts at the same time as the bradycardia, you should go to the hospital as soon as possible for advanced examinations such as dynamic electrocardiogram and cardiac color Doppler ultrasound to understand the cause of the bradycardia. If the heartbeat is slow, it can be relieved by installing a cardiac pacemaker Symptoms improve prognosis.
Sinus bradycardia: more than 5 frames per cardiac cycle

see premature beat

The qrs complex occurred ahead of time, and the time limit exceeded 0.12 seconds
Premature beats can be asymptomatic, or there may be palpitations or a feeling of cardiac arrest. In case of frequent seizures, obvious symptoms or accompanied by organic heart disease, it is advisable to find out the etiology and inducement of the seizures as soon as possible, and give corresponding treatment.

How to read an EKG

Watch house flutter
The p wave disappears, and the f wave with basically the same amplitude (size, shape, spacing) appears. Heart rate 250-350 beats/min
If the ventricular rate is slow and the underlying condition of the heart is good, atrial flutter can go unnoticed for many years.
Atrial flutter can suddenly stop the attack, and the ventricular rate is fast and regular during atrial flutter, which is easy to be misdiagnosed. Therefore, it is very difficult to diagnose atrial flutter without an ECG.

watch atrial fibrillation

Like atrial flutter, the normal p wave disappears, the difference is that it is replaced by flutter waves of different sizes and shapes
In atrial fibrillation, the atrium loses its systolic function, and the blood easily stagnates in the atrium to form a thrombus. If the thrombus falls off and stops at a key position with the blood, it will cause cerebral embolism, stroke, and limb arterial embolism (amputation in severe cases)
The harm of atrial fibrillation and the necessity of treatment have nothing to do with the severity of the patient's symptoms. Patients with atrial fibrillation, whether they have symptoms or not, should undergo a systematic examination to assess the risk of atrial fibrillation and receive timely treatment.
There is no necessary connection between atrial fibrillation and coronary heart disease. Patients with coronary heart disease are excluded, and atrial fibrillation is sometimes very serious.

watch heart rate

Heart rhythm is not the same as heart rate, heart rhythm is the rhythm and regularity of heart beating, and heart rate is the frequency of heart beating.
Arrhythmia Arrhythmia occurs when the interval between each beat of the heart is inconsistent.
If the difference in the rr interval time exceeds 120ms (3 small divisions) and it is not a premature beat, it is called "sinus arrhythmia"

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