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The ECG

 

Everyone has heard the term, an “ECG curve"(electrocardiogram curve) - but what exactly does it mean? 
The path from the sinus node, the clock of the heart, to the heart muscle will be explained in these pages.
The heart rhythm is generated by the sinus node (SA node). Specialized cardiac muscle cells are the source of regular electrical impulses to the heart muscle cells of the atria. After they are generated, they are forwarded to the atrioventricular node (AV node). The AV node has the function of a frequency regulator. Firstly, it ensures that the contractions of the pre-chamber (antechamber; atria) and the main chamber are synchronized - but with a slight delay. The blood from the pre-chamber is first pumped into the main chambers, only afterwards should the main chamber then contract. Secondly, the AV node acts to prevent impulses that may become too rapid (e.g. arrhythmias) from being transmitted from the pre-chamber to the main chambers. From the AV node, the signal is distributed through the so-called “Bundle of His” (named after a Swiss cardiologist) to three major "channels" (the Tawara node).
  Abbildung Medtronic
Two of these channels lead into the left heart chamber and one into the right heart chamber. These channels branch off in the Purkinje fibers, eventually activating the individual heart muscle fibers. This process creates a directional synchronous contraction for the pre-chamber and the main chamber and a structured sequence of the actual chamber contraction. A representation of this is made by conducting the electrical current (“the curve”) from the heart to the exterior of the body through the skin (ECG).
The ECG: The wave sequence of the ECG reflects the conduction of electrical impulses in the heart. After the impulse is formed in the sinus node, the heart muscle fibers of the atria are energized. This is displayed in the ECG by the so-called P-wave. The AV node causes a delay - the PQ time. The course of the electrical excitation in the heart is represented by the QRS pattern, or curve. 
(see illustration)

 

  Figs: Medtronic      

 

 

 

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