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<li id="toc-Screening" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Screening"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1</span> <span>Screening</span> </div> </a> <ul id="toc-Screening-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Electrocardiograph_machines" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Electrocardiograph_machines"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Electrocardiograph machines</span> </div> </a> <button aria-controls="toc-Electrocardiograph_machines-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Electrocardiograph machines subsection</span> </button> <ul id="toc-Electrocardiograph_machines-sublist" class="vector-toc-list"> <li id="toc-Cardiac_monitors" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Cardiac_monitors"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Cardiac monitors</span> </div> </a> <ul id="toc-Cardiac_monitors-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Electrodes_and_leads" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Electrodes_and_leads"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Electrodes and leads</span> </div> </a> <button aria-controls="toc-Electrodes_and_leads-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Electrodes and leads subsection</span> </button> <ul id="toc-Electrodes_and_leads-sublist" class="vector-toc-list"> <li id="toc-12-Lead_ECG" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#12-Lead_ECG"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>12-Lead ECG</span> </div> </a> <ul id="toc-12-Lead_ECG-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Virtual_Electrode" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Virtual_Electrode"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Virtual Electrode</span> </div> </a> <ul id="toc-Virtual_Electrode-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Limb_leads" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Limb_leads"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3</span> <span>Limb leads</span> </div> </a> <ul id="toc-Limb_leads-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Augmented_limb_leads" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Augmented_limb_leads"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4</span> <span>Augmented limb leads</span> </div> </a> <ul id="toc-Augmented_limb_leads-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Precordial_leads" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Precordial_leads"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.5</span> <span>Precordial leads</span> </div> </a> <ul id="toc-Precordial_leads-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Specialized_leads" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Specialized_leads"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.6</span> <span>Specialized leads</span> </div> </a> <ul id="toc-Specialized_leads-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Lead_locations_on_an_ECG_report" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Lead_locations_on_an_ECG_report"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.7</span> <span>Lead locations on an ECG report</span> </div> </a> <ul id="toc-Lead_locations_on_an_ECG_report-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Contiguity_of_leads" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Contiguity_of_leads"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.8</span> <span>Contiguity of leads</span> </div> </a> <ul id="toc-Contiguity_of_leads-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Electrophysiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Electrophysiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Electrophysiology</span> </div> </a> <ul id="toc-Electrophysiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Interpretation" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Interpretation"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Interpretation</span> </div> </a> <button aria-controls="toc-Interpretation-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Interpretation subsection</span> </button> <ul id="toc-Interpretation-sublist" class="vector-toc-list"> <li id="toc-Theory" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Theory"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.1</span> <span>Theory</span> </div> </a> <ul id="toc-Theory-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Background_grid" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Background_grid"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.2</span> <span>Background grid</span> </div> </a> <ul id="toc-Background_grid-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Rate_and_rhythm" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Rate_and_rhythm"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.3</span> <span>Rate and rhythm</span> </div> </a> <ul id="toc-Rate_and_rhythm-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Axis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Axis"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.4</span> <span>Axis</span> </div> </a> <ul id="toc-Axis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Amplitudes_and_intervals" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Amplitudes_and_intervals"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.5</span> <span>Amplitudes and intervals</span> </div> </a> <ul id="toc-Amplitudes_and_intervals-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Time-Frequency_Analysis_in_ECG_Signal_Processing" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Time-Frequency_Analysis_in_ECG_Signal_Processing"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.6</span> <span>Time-Frequency Analysis in ECG Signal Processing</span> </div> </a> <ul id="toc-Time-Frequency_Analysis_in_ECG_Signal_Processing-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Limb_leads_and_electrical_conduction_through_the_heart" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Limb_leads_and_electrical_conduction_through_the_heart"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.7</span> <span>Limb leads and electrical conduction through the heart</span> </div> </a> <ul id="toc-Limb_leads_and_electrical_conduction_through_the_heart-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Ischemia_and_infarction" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Ischemia_and_infarction"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.8</span> <span>Ischemia and infarction</span> </div> </a> <ul id="toc-Ischemia_and_infarction-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Artifacts" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Artifacts"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.9</span> <span>Artifacts</span> </div> </a> <ul id="toc-Artifacts-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-A_Method_for_Interpretation" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#A_Method_for_Interpretation"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.10</span> <span>A Method for Interpretation</span> </div> </a> <ul id="toc-A_Method_for_Interpretation-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Diagnosis</span> </div> </a> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>History</span> </div> </a> <button aria-controls="toc-History-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle History subsection</span> </button> <ul id="toc-History-sublist" class="vector-toc-list"> <li id="toc-Etymology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Etymology"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.1</span> <span>Etymology</span> </div> </a> <ul id="toc-Etymology-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Notes" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Notes"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>Notes</span> </div> </a> <ul id="toc-Notes-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Electrocardiography</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 56 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-56" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">56 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%AA%D8%AE%D8%B7%D9%8A%D8%B7_%D9%83%D9%87%D8%B1%D8%A8%D8%A7%D8%A6%D9%8A%D8%A9_%D8%A7%D9%84%D9%82%D9%84%D8%A8" title="تخطيط كهربائية القلب – Arabic" lang="ar" hreflang="ar" data-title="تخطيط كهربائية القلب" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Elektrokardioqrafiya" title="Elektrokardioqrafiya – Azerbaijani" lang="az" hreflang="az" data-title="Elektrokardioqrafiya" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%87%E0%A6%B2%E0%A7%87%E0%A6%95%E0%A6%9F%E0%A7%8D%E0%A6%B0%E0%A7%8B%E0%A6%95%E0%A6%BE%E0%A6%B0%E0%A7%8D%E0%A6%A1%E0%A6%BF%E0%A6%93%E0%A6%97%E0%A7%8D%E0%A6%B0%E0%A6%BE%E0%A6%AB%E0%A6%BF" title="ইলেকট্রোকার্ডিওগ্রাফি – Bangla" lang="bn" hreflang="bn" data-title="ইলেকট্রোকার্ডিওগ্রাফি" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-zh-min-nan mw-list-item"><a href="https://zh-min-nan.wikipedia.org/wiki/Sim-ti%C4%81n-t%C3%B4%CD%98" title="Sim-tiān-tô͘ – Minnan" lang="nan" hreflang="nan" data-title="Sim-tiān-tô͘" data-language-autonym="閩南語 / Bân-lâm-gú" data-language-local-name="Minnan" class="interlanguage-link-target"><span>閩南語 / Bân-lâm-gú</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%AD%D0%BB%D0%B5%D0%BA%D1%82%D1%80%D0%B0%D0%BA%D0%B0%D1%80%D0%B4%D1%8B%D1%8F%D0%B3%D1%80%D0%B0%D1%84%D1%96%D1%8F" title="Электракардыяграфія – Belarusian" lang="be" hreflang="be" data-title="Электракардыяграфія" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%AD%D0%BB%D0%B5%D0%BA%D1%82%D1%80%D0%B0%D0%BA%D0%B0%D1%80%D0%B4%D1%8B%D1%8F%D0%B3%D1%80%D0%B0%D1%84%D1%96%D1%8F" title="Электракардыяграфія – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Электракардыяграфія" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target"><span>Беларуская (тарашкевіца)</span></a></li><li class="interlanguage-link interwiki-br mw-list-item"><a href="https://br.wikipedia.org/wiki/Elektrokardiografiezh" title="Elektrokardiografiezh – Breton" lang="br" hreflang="br" data-title="Elektrokardiografiezh" data-language-autonym="Brezhoneg" data-language-local-name="Breton" class="interlanguage-link-target"><span>Brezhoneg</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Electrocardiografia" title="Electrocardiografia – Catalan" lang="ca" hreflang="ca" data-title="Electrocardiografia" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%97%CE%BB%CE%B5%CE%BA%CF%84%CF%81%CE%BF%CE%BA%CE%B1%CF%81%CE%B4%CE%B9%CE%BF%CE%B3%CF%81%CE%AC%CF%86%CE%B7%CE%BC%CE%B1" title="Ηλεκτροκαρδιογράφημα – Greek" lang="el" hreflang="el" data-title="Ηλεκτροκαρδιογράφημα" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es badge-Q70893996 mw-list-item" title=""><a href="https://es.wikipedia.org/wiki/Electrocardiograf%C3%ADa" title="Electrocardiografía – Spanish" lang="es" hreflang="es" data-title="Electrocardiografía" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Elektrokardiografio" title="Elektrokardiografio – Esperanto" lang="eo" hreflang="eo" data-title="Elektrokardiografio" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-eu badge-Q70893996 mw-list-item" title=""><a href="https://eu.wikipedia.org/wiki/Elektrokardiografia" title="Elektrokardiografia – Basque" lang="eu" hreflang="eu" data-title="Elektrokardiografia" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%86%D9%88%D8%A7%D8%B1_%D9%82%D9%84%D8%A8" title="نوار قلب – Persian" lang="fa" hreflang="fa" data-title="نوار قلب" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/%C3%89lectrocardiographie" title="Électrocardiographie – French" lang="fr" hreflang="fr" data-title="Électrocardiographie" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Leictreacardagrafa%C3%ADocht" title="Leictreacardagrafaíocht – Irish" lang="ga" hreflang="ga" data-title="Leictreacardagrafaíocht" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gan mw-list-item"><a href="https://gan.wikipedia.org/wiki/%E5%BF%83%E9%9B%BB%E5%9C%96" title="心電圖 – Gan" lang="gan" hreflang="gan" data-title="心電圖" data-language-autonym="贛語" data-language-local-name="Gan" class="interlanguage-link-target"><span>贛語</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%8B%AC%EC%A0%84%EB%8F%84" title="심전도 – Korean" lang="ko" hreflang="ko" data-title="심전도" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B7%D5%AC%D5%A5%D5%AF%D5%BF%D6%80%D5%A1%D5%BD%D6%80%D5%BF%D5%A1%D5%A3%D6%80%D5%B8%D6%82%D5%A9%D5%B5%D5%B8%D6%82%D5%B6" title="Էլեկտրասրտագրություն – Armenian" lang="hy" hreflang="hy" data-title="Էլեկտրասրտագրություն" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%87%E0%A4%B2%E0%A5%88%E0%A4%95%E0%A5%8D%E0%A4%9F%E0%A5%8D%E0%A4%B0%E0%A5%8B%E0%A4%95%E0%A4%BE%E0%A4%B0%E0%A5%8D%E0%A4%A1%E0%A4%BF%E0%A4%AF%E0%A5%8B%E0%A4%97%E0%A5%8D%E0%A4%B0%E0%A4%BE%E0%A4%AB%E0%A5%80" title="इलैक्ट्रोकार्डियोग्राफी – Hindi" lang="hi" hreflang="hi" data-title="इलैक्ट्रोकार्डियोग्राफी" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%90%D7%9C%D7%A7%D7%98%D7%A8%D7%95%D7%A7%D7%A8%D7%93%D7%99%D7%95%D7%92%D7%A8%D7%9D" title="אלקטרוקרדיוגרם – Hebrew" lang="he" hreflang="he" data-title="אלקטרוקרדיוגרם" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-kn mw-list-item"><a href="https://kn.wikipedia.org/wiki/%E0%B2%B5%E0%B2%BF%E0%B2%A6%E0%B3%8D%E0%B2%AF%E0%B3%81%E0%B2%A4%E0%B3%8D_%E0%B2%B9%E0%B3%83%E0%B2%B2%E0%B3%8D%E0%B2%B2%E0%B3%87%E0%B2%96%E0%B2%A8" title="ವಿದ್ಯುತ್ ಹೃಲ್ಲೇಖನ – Kannada" lang="kn" hreflang="kn" data-title="ವಿದ್ಯುತ್ ಹೃಲ್ಲೇಖನ" data-language-autonym="ಕನ್ನಡ" data-language-local-name="Kannada" class="interlanguage-link-target"><span>ಕನ್ನಡ</span></a></li><li class="interlanguage-link interwiki-ks mw-list-item"><a href="https://ks.wikipedia.org/wiki/%D8%A7%DB%8C_%D8%B3%DB%8C_%D8%AC%DB%8C" title="ای سی جی – Kashmiri" lang="ks" hreflang="ks" data-title="ای سی جی" data-language-autonym="कॉशुर / کٲشُر" data-language-local-name="Kashmiri" class="interlanguage-link-target"><span>कॉशुर / کٲشُر</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%AD%D0%BB%D0%B5%D0%BA%D1%82%D1%80%D0%BE%D0%BA%D0%B0%D1%80%D0%B4%D0%B8%D0%BE%D0%B3%D1%80%D0%B0%D1%84%D0%B8%D1%8F" title="Электрокардиография – Kazakh" lang="kk" hreflang="kk" data-title="Электрокардиография" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-gcr mw-list-item"><a href="https://gcr.wikipedia.org/wiki/%C3%89lektrokardyografi" title="Élektrokardyografi – Guianan Creole" lang="gcr" hreflang="gcr" data-title="Élektrokardyografi" data-language-autonym="Kriyòl gwiyannen" data-language-local-name="Guianan Creole" class="interlanguage-link-target"><span>Kriyòl gwiyannen</span></a></li><li class="interlanguage-link interwiki-ku mw-list-item"><a href="https://ku.wikipedia.org/wiki/EKG" title="EKG – Kurdish" lang="ku" hreflang="ku" data-title="EKG" data-language-autonym="Kurdî" data-language-local-name="Kurdish" class="interlanguage-link-target"><span>Kurdî</span></a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Elektrokardiogr%C4%81fija" title="Elektrokardiogrāfija – Latvian" lang="lv" hreflang="lv" data-title="Elektrokardiogrāfija" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target"><span>Latviešu</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Elektrokardiografija" title="Elektrokardiografija – Lithuanian" lang="lt" hreflang="lt" data-title="Elektrokardiografija" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Elektrokardiogr%C3%A1fia" title="Elektrokardiográfia – Hungarian" lang="hu" hreflang="hu" data-title="Elektrokardiográfia" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%95%D0%BB%D0%B5%D0%BA%D1%82%D1%80%D0%BE%D0%BA%D0%B0%D1%80%D0%B4%D0%B8%D0%BE%D0%B3%D1%80%D0%B0%D1%84%D0%B8%D1%98%D0%B0" title="Електрокардиографија – Macedonian" lang="mk" hreflang="mk" data-title="Електрокардиографија" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%87.%E0%B4%B8%E0%B4%BF.%E0%B4%9C%E0%B4%BF." title="ഇ.സി.ജി. – Malayalam" lang="ml" hreflang="ml" data-title="ഇ.സി.ജി." data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%9B%E0%A4%A4%E0%A5%8D%E0%A4%B8%E0%A5%8D%E0%A4%AA%E0%A4%82%E0%A4%A6_%E0%A4%B5%E0%A4%BF%E0%A4%A6%E0%A5%8D%E0%A4%AF%E0%A5%81%E0%A4%A4_%E0%A4%B2%E0%A5%87%E0%A4%96%E0%A4%BE" title="छत्स्पंद विद्युत लेखा – Marathi" lang="mr" hreflang="mr" data-title="छत्स्पंद विद्युत लेखा" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target"><span>मराठी</span></a></li><li class="interlanguage-link interwiki-arz mw-list-item"><a href="https://arz.wikipedia.org/wiki/%D8%B1%D8%B3%D9%85_%D9%82%D9%84%D8%A8" title="رسم قلب – Egyptian Arabic" lang="arz" hreflang="arz" data-title="رسم قلب" data-language-autonym="مصرى" data-language-local-name="Egyptian Arabic" class="interlanguage-link-target"><span>مصرى</span></a></li><li class="interlanguage-link interwiki-my mw-list-item"><a href="https://my.wikipedia.org/wiki/%E1%80%A1%E1%80%AE%E1%80%B8%E1%80%85%E1%80%AE%E1%80%82%E1%80%BB%E1%80%AE" title="အီးစီဂျီ – Burmese" lang="my" hreflang="my" data-title="အီးစီဂျီ" data-language-autonym="မြန်မာဘာသာ" data-language-local-name="Burmese" class="interlanguage-link-target"><span>မြန်မာဘာသာ</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E5%BF%83%E9%9B%BB%E5%9B%B3" title="心電図 – Japanese" lang="ja" hreflang="ja" data-title="心電図" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Elektrokardiografi" title="Elektrokardiografi – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Elektrokardiografi" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target"><span>Norsk nynorsk</span></a></li><li class="interlanguage-link interwiki-ps mw-list-item"><a href="https://ps.wikipedia.org/wiki/%D8%B2%DA%93%D9%87_%DA%AF%D8%B1%D8%A7%D9%81" title="زړه گراف – Pashto" lang="ps" hreflang="ps" data-title="زړه گراف" data-language-autonym="پښتو" data-language-local-name="Pashto" class="interlanguage-link-target"><span>پښتو</span></a></li><li class="interlanguage-link interwiki-jam mw-list-item"><a href="https://jam.wikipedia.org/wiki/Ilekchokaadiagrafi" title="Ilekchokaadiagrafi – Jamaican Creole English" lang="jam" hreflang="jam" data-title="Ilekchokaadiagrafi" data-language-autonym="Patois" data-language-local-name="Jamaican Creole English" class="interlanguage-link-target"><span>Patois</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Elektrokardiografia" title="Elektrokardiografia – Polish" lang="pl" hreflang="pl" data-title="Elektrokardiografia" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%AD%D0%BB%D0%B5%D0%BA%D1%82%D1%80%D0%BE%D0%BA%D0%B0%D1%80%D0%B4%D0%B8%D0%BE%D0%B3%D1%80%D0%B0%D1%84%D0%B8%D1%8F" title="Электрокардиография – Russian" lang="ru" hreflang="ru" data-title="Электрокардиография" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sah mw-list-item"><a href="https://sah.wikipedia.org/wiki/%D0%AD%D0%BB%D0%B5%D0%BA%D1%82%D1%80%D0%BE%D0%BA%D0%B0%D1%80%D0%B4%D0%B8%D0%BE%D0%B3%D1%80%D0%B0%D1%84%D0%B8%D1%8F" title="Электрокардиография – Yakut" lang="sah" hreflang="sah" data-title="Электрокардиография" data-language-autonym="Саха тыла" data-language-local-name="Yakut" class="interlanguage-link-target"><span>Саха тыла</span></a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Elektrokardiografia" title="Elektrokardiografia – Albanian" lang="sq" hreflang="sq" data-title="Elektrokardiografia" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target"><span>Shqip</span></a></li><li class="interlanguage-link interwiki-sd mw-list-item"><a href="https://sd.wikipedia.org/wiki/%D8%A7%D9%84%D9%8A%DA%AA%D9%BD%D8%B1%D9%88_%DA%AA%D8%A7%D8%B1%DA%8A%D9%8A%D9%88%DA%AF%D8%B1%D8%A7%D9%81%D9%8A" title="اليڪٽرو ڪارڊيوگرافي – Sindhi" lang="sd" hreflang="sd" data-title="اليڪٽرو ڪارڊيوگرافي" data-language-autonym="سنڌي" data-language-local-name="Sindhi" class="interlanguage-link-target"><span>سنڌي</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Elektrokardiografia" title="Elektrokardiografia – Slovak" lang="sk" hreflang="sk" data-title="Elektrokardiografia" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Elektrokardiografija" title="Elektrokardiografija – Slovenian" lang="sl" hreflang="sl" data-title="Elektrokardiografija" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr badge-Q70893996 mw-list-item" title=""><a href="https://sr.wikipedia.org/wiki/Elektrokardiografija" title="Elektrokardiografija – Serbian" lang="sr" hreflang="sr" data-title="Elektrokardiografija" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Syd%C3%A4ns%C3%A4hk%C3%B6k%C3%A4yr%C3%A4" title="Sydänsähkökäyrä – Finnish" lang="fi" hreflang="fi" data-title="Sydänsähkökäyrä" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/EKG" title="EKG – Swedish" lang="sv" hreflang="sv" data-title="EKG" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%87%E0%AE%A4%E0%AE%AF_%E0%AE%A4%E0%AF%81%E0%AE%9F%E0%AE%BF%E0%AE%AA%E0%AF%8D%E0%AE%AA%E0%AE%B2%E0%AF%88%E0%AE%85%E0%AE%B3%E0%AE%B5%E0%AE%BF" title="இதய துடிப்பலைஅளவி – Tamil" lang="ta" hreflang="ta" data-title="இதய துடிப்பலைஅளவி" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%81%E0%B8%B2%E0%B8%A3%E0%B8%9A%E0%B8%B1%E0%B8%99%E0%B8%97%E0%B8%B6%E0%B8%81%E0%B8%84%E0%B8%A5%E0%B8%B7%E0%B9%88%E0%B8%99%E0%B9%84%E0%B8%9F%E0%B8%9F%E0%B9%89%E0%B8%B2%E0%B8%AB%E0%B8%B1%E0%B8%A7%E0%B9%83%E0%B8%88" title="การบันทึกคลื่นไฟฟ้าหัวใจ – Thai" lang="th" hreflang="th" data-title="การบันทึกคลื่นไฟฟ้าหัวใจ" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Elektrokardiyografi" title="Elektrokardiyografi – Turkish" lang="tr" hreflang="tr" data-title="Elektrokardiyografi" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%95%D0%BB%D0%B5%D0%BA%D1%82%D1%80%D0%BE%D0%BA%D0%B0%D1%80%D0%B4%D1%96%D0%BE%D0%B3%D1%80%D0%B0%D1%84%D1%96%D1%8F" title="Електрокардіографія – Ukrainian" lang="uk" hreflang="uk" data-title="Електрокардіографія" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/%C4%90i%E1%BB%87n_t%C3%A2m_%C4%91%E1%BB%93" title="Điện tâm đồ – Vietnamese" lang="vi" hreflang="vi" data-title="Điện tâm đồ" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-war mw-list-item"><a href="https://war.wikipedia.org/wiki/Elektrokardyograpiya" title="Elektrokardyograpiya – Waray" lang="war" hreflang="war" data-title="Elektrokardyograpiya" data-language-autonym="Winaray" data-language-local-name="Waray" class="interlanguage-link-target"><span>Winaray</span></a></li><li class="interlanguage-link interwiki-wuu mw-list-item"><a href="https://wuu.wikipedia.org/wiki/%E5%BF%83%E7%94%B5%E5%9B%BE" title="心电图 – Wu" lang="wuu" hreflang="wuu" data-title="心电图" data-language-autonym="吴语" data-language-local-name="Wu" class="interlanguage-link-target"><span>吴语</span></a></li><li class="interlanguage-link interwiki-zh-yue mw-list-item"><a href="https://zh-yue.wikipedia.org/wiki/%E5%BF%83%E9%9B%BB%E5%9C%96" title="心電圖 – Cantonese" lang="yue" hreflang="yue" data-title="心電圖" data-language-autonym="粵語" data-language-local-name="Cantonese" class="interlanguage-link-target"><span>粵語</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E5%BF%83%E7%94%B5%E6%8F%8F%E8%AE%B0%E6%9C%AF" title="心电描记术 – Chinese" lang="zh" hreflang="zh" data-title="心电描记术" data-language-autonym="中文" data-language-local-name="Chinese" 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class="mw-redirectedfrom">(Redirected from <a href="/w/index.php?title=EKG&redirect=no" class="mw-redirect" title="EKG">EKG</a>)</span></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Examination of the heart's electrical activity</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">"ECG" and "EKG" redirect here. For other uses, see <a href="/wiki/ECG_(disambiguation)" class="mw-disambig" title="ECG (disambiguation)">ECG (disambiguation)</a> and <a href="/wiki/EKG_(disambiguation)" class="mw-disambig" title="EKG (disambiguation)">EKG (disambiguation)</a>.</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Not to be confused with <a href="/wiki/Electrography_(disambiguation)" class="mw-disambig" title="Electrography (disambiguation)">other types of electrography</a> or with <a href="/wiki/Echocardiography" title="Echocardiography">echocardiography</a>.</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical intervention</div> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Electrocardiography</th></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:SinusRhythmLabels.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/9e/SinusRhythmLabels.svg/330px-SinusRhythmLabels.svg.png" decoding="async" width="280" height="280" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/9e/SinusRhythmLabels.svg/500px-SinusRhythmLabels.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/9e/SinusRhythmLabels.svg/560px-SinusRhythmLabels.svg.png 2x" data-file-width="512" data-file-height="512" /></a></span><div class="infobox-caption">ECG of a heart in normal <a href="/wiki/Sinus_rhythm" title="Sinus rhythm">sinus rhythm</a></div></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/ICD-10_Procedure_Coding_System" title="ICD-10 Procedure Coding System">ICD-10-PCS</a></th><td class="infobox-data">R94.31</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/ICD-9-CM_Volume_3" title="ICD-9-CM Volume 3">ICD-9-CM</a></th><td class="infobox-data">89.52</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D004562">D004562</a></span></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://medlineplus.gov/ency/article/003868.htm">003868</a></span></td></tr><tr class="noprint"><td colspan="2" class="infobox-full-data"><div style="text-align: right;">[<a href="https://www.wikidata.org/wiki/Q79785" class="extiw" title="d:Q79785">edit on Wikidata</a>]</div></td></tr></tbody></table> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Patient_lying_in_hospital_bed_in_intensive_care_unit_in_Germany_in_2015.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/53/Patient_lying_in_hospital_bed_in_intensive_care_unit_in_Germany_in_2015.jpg/250px-Patient_lying_in_hospital_bed_in_intensive_care_unit_in_Germany_in_2015.jpg" decoding="async" width="220" height="270" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/53/Patient_lying_in_hospital_bed_in_intensive_care_unit_in_Germany_in_2015.jpg/330px-Patient_lying_in_hospital_bed_in_intensive_care_unit_in_Germany_in_2015.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/53/Patient_lying_in_hospital_bed_in_intensive_care_unit_in_Germany_in_2015.jpg/500px-Patient_lying_in_hospital_bed_in_intensive_care_unit_in_Germany_in_2015.jpg 2x" data-file-width="1479" data-file-height="1818" /></a><figcaption>Use of <a href="/wiki/Monitoring_(medicine)" title="Monitoring (medicine)">real time monitoring</a> of the heart in an <a href="/wiki/Intensive_care_unit" title="Intensive care unit">intensive care unit</a> in a German hospital (2015), the monitoring screen above the patient displaying an electrocardiogram and various values of parameters of the heart like heart rate and blood pressure</figcaption></figure> <p><b>Electrocardiography</b> is the process of producing an <b>electrocardiogram</b> (<b>ECG</b> or <b>EKG</b><sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>a<span class="cite-bracket">]</span></a></sup>), a recording of the heart's electrical activity through repeated <a href="/wiki/Cardiac_cycle" title="Cardiac cycle">cardiac cycles</a>.<sup id="cite_ref-Kumar2020_5-0" class="reference"><a href="#cite_note-Kumar2020-5"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> It is an <a href="/wiki/Electrogram" title="Electrogram">electrogram</a> of the <a href="/wiki/Heart" title="Heart">heart</a> which is a graph of <a href="/wiki/Voltage" title="Voltage">voltage</a> versus time of the electrical activity of the heart<sup id="cite_ref-Lilly_2016_6-0" class="reference"><a href="#cite_note-Lilly_2016-6"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> using <a href="/wiki/Electrode" title="Electrode">electrodes</a> placed on the skin. These electrodes detect the small electrical changes that are a consequence of <a href="/wiki/Cardiac_muscle" title="Cardiac muscle">cardiac muscle</a> <a href="/wiki/Depolarization" title="Depolarization">depolarization</a> followed by <a href="/wiki/Repolarization" title="Repolarization">repolarization</a> during each <a href="/wiki/Cardiac_cycle" title="Cardiac cycle">cardiac cycle</a> (heartbeat). Changes in the normal ECG pattern occur in numerous cardiac abnormalities, including: </p> <ul><li><a href="/wiki/Cardiac_rhythmicity" title="Cardiac rhythmicity">Cardiac rhythm</a> disturbances, such as <a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">atrial fibrillation</a><sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Ventricular_tachycardia" title="Ventricular tachycardia">ventricular tachycardia</a>;<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup></li> <li>Inadequate coronary artery blood flow, such as <a href="/wiki/Myocardial_ischemia" class="mw-redirect" title="Myocardial ischemia">myocardial ischemia</a><sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">myocardial infarction</a>;<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup></li></ul> <ul><li>and electrolyte disturbances, such as <a href="/wiki/Hypokalemia" title="Hypokalemia">hypokalemia</a>.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li></ul> <p>Traditionally, "ECG" usually means a <b>12-lead ECG</b> taken while lying down as discussed below. However, other devices can record the electrical activity of the heart such as a <a href="/wiki/Holter_monitor" title="Holter monitor">Holter monitor</a> but also some models of <a href="/wiki/Smartwatch" title="Smartwatch">smartwatch</a> are capable of recording an ECG. ECG signals can be recorded in other contexts with other devices. </p><p>In a conventional 12-lead ECG, ten electrodes are placed on the patient's limbs and on the surface of the chest. The overall <a href="/wiki/Magnitude_(mathematics)" title="Magnitude (mathematics)">magnitude</a> of the heart's <a href="/wiki/Electrical_potential" class="mw-redirect" title="Electrical potential">electrical potential</a> is then measured from twelve different angles ("leads") and is recorded over a period of time (usually ten seconds). In this way, the overall magnitude and direction of the heart's electrical depolarization is captured at each moment throughout the <a href="/wiki/Cardiac_cycle" title="Cardiac cycle">cardiac cycle</a>.<sup id="cite_ref-LHC_12-0" class="reference"><a href="#cite_note-LHC-12"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p><p>There are three main components to an ECG:<sup id="cite_ref-FOOTNOTELilly201680_13-0" class="reference"><a href="#cite_note-FOOTNOTELilly201680-13"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <ul><li>The <a href="/wiki/P_wave_(electrocardiography)" title="P wave (electrocardiography)">P wave</a>, which represents depolarization of the atria.</li> <li>The <a href="/wiki/QRS_complex" title="QRS complex">QRS complex</a>, which represents depolarization of the <a href="/wiki/Ventricle_(heart)" title="Ventricle (heart)">ventricles</a>.</li> <li>The <a href="/wiki/T_wave" title="T wave">T wave</a>, which represents repolarization of the ventricles.</li></ul> <p>During each heartbeat, a healthy heart has an orderly progression of depolarization that starts with <a href="/wiki/Pacemaker_cells" class="mw-redirect" title="Pacemaker cells">pacemaker cells</a> in the <a href="/wiki/Sinoatrial_node" title="Sinoatrial node">sinoatrial node</a>, spreads throughout the <a href="/wiki/Atrium_(heart)" title="Atrium (heart)">atrium</a>, and passes through the <a href="/wiki/Atrioventricular_node" title="Atrioventricular node">atrioventricular node</a> down into the <a href="/wiki/Bundle_of_His" title="Bundle of His">bundle of His</a> and into the <a href="/wiki/Purkinje_fibers" title="Purkinje fibers">Purkinje fibers</a>, spreading down and to the left throughout the <a href="/wiki/Ventricle_(heart)" title="Ventricle (heart)">ventricles</a>.<sup id="cite_ref-FOOTNOTELilly201680_13-1" class="reference"><a href="#cite_note-FOOTNOTELilly201680-13"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> This orderly pattern of depolarization gives rise to the characteristic ECG tracing. To the trained <a href="/wiki/Clinician" title="Clinician">clinician</a>, an ECG conveys a large amount of information about the structure of the heart and the function of its electrical conduction system.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> Among other things, an ECG can be used to measure the rate and rhythm of heartbeats, the size and position of the <a href="/wiki/Heart_chambers" class="mw-redirect" title="Heart chambers">heart chambers</a>, the presence of any damage to the heart's muscle cells or conduction system, the effects of heart drugs, and the function of implanted <a href="/wiki/Artificial_pacemaker" class="mw-redirect" title="Artificial pacemaker">pacemakers</a>.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Medical_uses">Medical uses</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=1" title="Edit section: Medical uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Normal_12_lead_EKG.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/18/Normal_12_lead_EKG.jpg/220px-Normal_12_lead_EKG.jpg" decoding="async" width="220" height="162" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/18/Normal_12_lead_EKG.jpg/330px-Normal_12_lead_EKG.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/18/Normal_12_lead_EKG.jpg/440px-Normal_12_lead_EKG.jpg 2x" data-file-width="6678" data-file-height="4929" /></a><figcaption>Normal 12-lead ECG</figcaption></figure> <figure typeof="mw:File/Thumb"><a href="/wiki/File:12_lead_ECG_of_a_26_year_old_male.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/12_lead_ECG_of_a_26_year_old_male.jpg/325px-12_lead_ECG_of_a_26_year_old_male.jpg" decoding="async" width="325" height="127" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/12_lead_ECG_of_a_26_year_old_male.jpg/488px-12_lead_ECG_of_a_26_year_old_male.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a2/12_lead_ECG_of_a_26_year_old_male.jpg/650px-12_lead_ECG_of_a_26_year_old_male.jpg 2x" data-file-width="1040" data-file-height="407" /></a><figcaption>A 12-lead ECG of a 26-year-old male with an incomplete <a href="/wiki/Right_bundle_branch_block" title="Right bundle branch block">right bundle branch block</a> (RBBB)</figcaption></figure> <p>The overall goal of performing an ECG is to obtain information about the electrical functioning of the heart. Medical uses for this information are varied and often need to be combined with knowledge of the structure of the heart and physical examination signs to be interpreted. Some <a href="/wiki/Indication_(medicine)" title="Indication (medicine)">indications</a> for performing an ECG include the following: </p> <ul><li>Chest pain or suspected <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">myocardial infarction</a> (heart attack), such as ST elevated myocardial infarction (STEMI)<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> or non-ST elevated myocardial infarction (NSTEMI)<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup></li> <li>Symptoms such as <a href="/wiki/Shortness_of_breath" title="Shortness of breath">shortness of breath</a>, <a href="/wiki/Cardiac_murmur" class="mw-redirect" title="Cardiac murmur">murmurs</a>,<sup id="cite_ref-masters_18-0" class="reference"><a href="#cite_note-masters-18"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Syncope_(medicine)" title="Syncope (medicine)">fainting</a>, <a href="/wiki/Seizure" title="Seizure">seizures</a>, funny turns, or <a href="/wiki/Cardiac_dysrhythmia" class="mw-redirect" title="Cardiac dysrhythmia">arrhythmias</a> including new onset <a href="/wiki/Palpitations" title="Palpitations">palpitations</a> or monitoring of known cardiac arrhythmias</li> <li>Medication monitoring (e.g., <a href="/wiki/Drug-induced_QT_prolongation" title="Drug-induced QT prolongation">drug-induced QT prolongation</a>, <a href="/wiki/Digoxin_toxicity" title="Digoxin toxicity">digoxin toxicity</a>) and management of overdose (e.g., <a href="/wiki/Tricyclic_antidepressant_overdose" title="Tricyclic antidepressant overdose">tricyclic overdose</a>)</li> <li><a href="/wiki/Electrolyte_imbalance" title="Electrolyte imbalance">Electrolyte abnormalities</a>, such as <a href="/wiki/Hyperkalemia" title="Hyperkalemia">hyperkalemia</a></li> <li><a href="/wiki/Perioperative" title="Perioperative">Perioperative</a> monitoring in which any form of <a href="/wiki/Anesthesia" title="Anesthesia">anesthesia</a> is involved (e.g., <a href="/wiki/Intraoperative_neurophysiological_monitoring" title="Intraoperative neurophysiological monitoring">monitored anesthesia care</a>, <a href="/wiki/General_anesthesia" class="mw-redirect" title="General anesthesia">general anesthesia</a>). This includes <a href="/wiki/Preoperative_care" title="Preoperative care">preoperative assessment</a> and intraoperative and postoperative monitoring.</li> <li><a href="/wiki/Cardiac_stress_test" title="Cardiac stress test">Cardiac stress testing</a></li> <li><a href="/wiki/Computed_tomography_angiography" title="Computed tomography angiography">Computed tomography angiography</a> (CTA) and <a href="/wiki/Magnetic_resonance_angiography" title="Magnetic resonance angiography">magnetic resonance angiography</a> (MRA) of the heart (ECG is used to "gate" the scanning so that the anatomical position of the heart is steady)</li> <li><a href="/wiki/Clinical_cardiac_electrophysiology" title="Clinical cardiac electrophysiology">Clinical cardiac electrophysiology</a>, in which a <a href="/wiki/Catheter" title="Catheter">catheter</a> is inserted through the <a href="/wiki/Femoral_vein" title="Femoral vein">femoral vein</a> and can have several electrodes along its length to record the direction of electrical activity from within the heart.</li></ul> <p>ECGs can be recorded as short intermittent tracings or <i>continuous</i> ECG monitoring. Continuous monitoring is used for critically ill patients, patients undergoing general anesthesia,<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-masters_18-1" class="reference"><a href="#cite_note-masters-18"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> and patients who have an infrequently occurring cardiac arrhythmia that would unlikely be seen on a conventional ten-second ECG. Continuous monitoring can be conducted by using <a href="/wiki/Holter_monitor" title="Holter monitor">Holter monitors</a>, internal and external <a href="/wiki/Defibrillator" class="mw-redirect" title="Defibrillator">defibrillators</a> and <a href="/wiki/Pacemaker" title="Pacemaker">pacemakers</a>, and/or <a href="/wiki/Biotelemetry" title="Biotelemetry">biotelemetry</a>.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Screening">Screening</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=2" title="Edit section: Screening"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:ECGfemaleathlete.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e7/ECGfemaleathlete.jpg/220px-ECGfemaleathlete.jpg" decoding="async" width="220" height="293" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e7/ECGfemaleathlete.jpg/330px-ECGfemaleathlete.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e7/ECGfemaleathlete.jpg/440px-ECGfemaleathlete.jpg 2x" data-file-width="3024" data-file-height="4032" /></a><figcaption>A patient undergoing an ECG</figcaption></figure> <p>For adults, evidence does not support the use of ECGs among those without symptoms or at low risk of <a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">cardiovascular disease</a> as an effort for prevention.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Annals2012_22-0" class="reference"><a href="#cite_note-Annals2012-22"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-whenyouneedEKGs_23-0" class="reference"><a href="#cite_note-whenyouneedEKGs-23"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> This is because an ECG may falsely indicate the existence of a problem, leading to <a href="/wiki/Misdiagnosis" class="mw-redirect" title="Misdiagnosis">misdiagnosis</a>, the recommendation of invasive procedures, and <a href="/wiki/Overtreatment" class="mw-redirect" title="Overtreatment">overtreatment</a>. However, persons employed in certain critical occupations, such as aircraft pilots,<sup id="cite_ref-FAA_Medical_Standards_2006_24-0" class="reference"><a href="#cite_note-FAA_Medical_Standards_2006-24"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> may be required to have an ECG as part of their routine health evaluations. <a href="/wiki/Hypertrophic_cardiomyopathy" title="Hypertrophic cardiomyopathy">Hypertrophic cardiomyopathy</a> screening may also be considered in adolescents as part of a <a href="/wiki/Preparticipation_physical_evaluation" title="Preparticipation physical evaluation">sports physical</a> out of concern for <a href="/wiki/Sudden_cardiac_death" class="mw-redirect" title="Sudden cardiac death">sudden cardiac death</a>.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Electrocardiograph_machines">Electrocardiograph machines</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=3" title="Edit section: Electrocardiograph machines"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:EKG_sensor.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/0a/EKG_sensor.jpg/250px-EKG_sensor.jpg" decoding="async" width="220" height="148" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/0a/EKG_sensor.jpg/330px-EKG_sensor.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/0a/EKG_sensor.jpg/500px-EKG_sensor.jpg 2x" data-file-width="4725" data-file-height="3168" /></a><figcaption>An ECG electrode</figcaption></figure> <p>Electrocardiograms are recorded by machines that consist of a set of electrodes connected to a central unit.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> Early ECG machines were constructed with <a href="/wiki/Analog_electronics" class="mw-redirect" title="Analog electronics">analog electronics</a>, where the signal drove a motor to print out the signal onto paper. Today, electrocardiographs use <a href="/wiki/Analog-to-digital_converter" title="Analog-to-digital converter">analog-to-digital converters</a> to convert the electrical activity of the heart to a <a href="/wiki/Digital_signal" title="Digital signal">digital signal</a>. Many ECG machines are now portable and commonly include a screen, keyboard, and printer on a small wheeled cart. Recent advancements in electrocardiography include developing even smaller devices for inclusion in fitness trackers and <a href="/wiki/Smartwatch" title="Smartwatch">smart watches</a>.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> These smaller devices often rely on only two electrodes to deliver a single lead I.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> Portable twelve-lead devices powered by batteries are also available. </p><p>Recording an ECG is a safe and painless procedure.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> The machines are powered by <a href="/wiki/Mains_power" class="mw-redirect" title="Mains power">mains power</a> but they are designed with several safety features including an earthed (ground) lead. Other features include: </p> <ul><li><a href="/wiki/Defibrillation" title="Defibrillation">Defibrillation</a> protection: any ECG used in healthcare may be attached to a person who requires defibrillation and the ECG needs to protect itself from this source of energy.</li> <li><a href="/wiki/Electrostatic_discharge" title="Electrostatic discharge">Electrostatic discharge</a> is similar to defibrillation discharge and requires voltage protection up to 18,000 volts.</li> <li>Additionally, circuitry called the <a href="/wiki/Driven_right_leg_circuit" title="Driven right leg circuit">right leg driver</a> can be used to reduce <a href="/wiki/Common-mode_interference" class="mw-redirect" title="Common-mode interference">common-mode interference</a> (typically the 50 or 60 Hz mains power).</li> <li>ECG voltages measured across the body are very small. This low voltage necessitates a low <a href="/wiki/Noise_(electronics)" title="Noise (electronics)">noise</a> circuit, <a href="/wiki/Instrumentation_amplifier" title="Instrumentation amplifier">instrumentation amplifiers</a>, and <a href="/wiki/Electromagnetic_shielding" title="Electromagnetic shielding">electromagnetic shielding</a>.</li> <li>Simultaneous lead recordings: earlier designs recorded each lead sequentially, but current models record multiple leads simultaneously.</li></ul> <p>Most modern ECG machines include <a href="/wiki/Automated_ECG_interpretation" title="Automated ECG interpretation">automated interpretation</a> <a href="/wiki/Algorithm" title="Algorithm">algorithms</a>. This analysis calculates features such as the <a href="/wiki/PR_interval" title="PR interval">PR interval</a>, <a href="/wiki/QT_interval" title="QT interval">QT interval</a>, <a href="/wiki/Correction_for_heart_rate" class="mw-redirect" title="Correction for heart rate">corrected QT (QTc) interval</a>, PR axis, QRS axis, rhythm and more. The results from these automated algorithms are considered "preliminary" until verified and/or modified by expert interpretation. Despite recent advances, computer misinterpretation remains a significant problem and can result in clinical mismanagement.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Cardiac_monitors">Cardiac monitors</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=4" title="Edit section: Cardiac monitors"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Besides the standard electrocardiograph machine, there are other devices capable of recording ECG signals. Portable devices have existed since the <a href="/wiki/Holter_monitor" title="Holter monitor">Holter monitor</a> was introduced in 1962. Traditionally, these monitors have used electrodes with patches on the skin to record the ECG, but new devices can stick to the chest as a single patch without need for wires, developed by Zio (Zio XT), TZ Medical (Trident), <a href="/wiki/Philips" title="Philips">Philips</a> (BioTel) and BardyDx (CAM) among many others. Implantable devices such as the <a href="/wiki/Artificial_cardiac_pacemaker" class="mw-redirect" title="Artificial cardiac pacemaker">artificial cardiac pacemaker</a> and <a href="/wiki/Implantable_cardioverter-defibrillator" title="Implantable cardioverter-defibrillator">implantable cardioverter-defibrillator</a> are capable of measuring a "far field" signal between the leads in the heart and the implanted battery/generator that resembles an ECG signal (technically, the signal recorded in the heart is called an <a href="/wiki/Electrogram" title="Electrogram">electrogram</a>, which is interpreted differently). Advancement of the Holter monitor became the <a href="/wiki/Implantable_loop_recorder" title="Implantable loop recorder">implantable loop recorder</a> that performs the same function but in an implantable device with batteries that last on the order of years. </p><p>Additionally, there are available various <a href="/wiki/Arduino" title="Arduino">Arduino</a> kits with ECG sensor modules and <a href="/wiki/Smartwatch" title="Smartwatch">smartwatch</a> devices that are capable of recording an ECG signal as well, such as with the 4th generation <a href="/wiki/Apple_Watch" title="Apple Watch">Apple Watch</a>, <a href="/wiki/Samsung_Galaxy_Watch_4" title="Samsung Galaxy Watch 4">Samsung Galaxy Watch 4</a> and newer devices. </p> <div class="mw-heading mw-heading2"><h2 id="Electrodes_and_leads">Electrodes and leads</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=5" title="Edit section: Electrodes and leads"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Limb_leads.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c9/Limb_leads.svg/220px-Limb_leads.svg.png" decoding="async" width="220" height="147" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c9/Limb_leads.svg/330px-Limb_leads.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c9/Limb_leads.svg/440px-Limb_leads.svg.png 2x" data-file-width="1500" data-file-height="1000" /></a><figcaption>Proper placement of the limb electrodes. The limb electrodes can be far down on the limbs or close to the hips/shoulders as long as they are placed symmetrically.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup></figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:ECG_limb_and_chest_electrodes_placement.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/cd/ECG_limb_and_chest_electrodes_placement.png/250px-ECG_limb_and_chest_electrodes_placement.png" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/cd/ECG_limb_and_chest_electrodes_placement.png/330px-ECG_limb_and_chest_electrodes_placement.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/cd/ECG_limb_and_chest_electrodes_placement.png/500px-ECG_limb_and_chest_electrodes_placement.png 2x" data-file-width="1600" data-file-height="1200" /></a><figcaption>Placement of European-color-coded ECG electrodes (using a 10-electrode yoke)</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Precordial_leads_in_ECG.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/41/Precordial_leads_in_ECG.png/250px-Precordial_leads_in_ECG.png" decoding="async" width="220" height="291" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/41/Precordial_leads_in_ECG.png/330px-Precordial_leads_in_ECG.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/41/Precordial_leads_in_ECG.png/500px-Precordial_leads_in_ECG.png 2x" data-file-width="2067" data-file-height="2733" /></a><figcaption>Placement of the precordial electrodes</figcaption></figure> <p>Electrodes are the actual conductive pads attached to the body surface.<sup id="cite_ref-EMT_EKG_32-0" class="reference"><a href="#cite_note-EMT_EKG-32"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> Any pair of electrodes can measure the <a href="/wiki/Electrical_potential_difference" class="mw-redirect" title="Electrical potential difference">electrical potential difference</a> between the two corresponding locations of attachment. Such a pair forms <i>a lead</i>. However, "leads" can also be formed between a physical electrode and a <i>virtual electrode</i>, which is the average of numerous leads. All clinical ECGs use <b>Wilson's central terminal</b> (<b>WCT</b>) as the virtual electrode from which the precordial leads are measured, whose potential is defined as the average potential measured by the three standard limb leads.<sup id="cite_ref-AHA_ECG_pt1_33-0" class="reference"><a href="#cite_note-AHA_ECG_pt1-33"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p><p>Commonly, 10 electrodes attached to the body are used to form 12 ECG leads, with each lead measuring a specific electrical potential difference.<sup id="cite_ref-12Leads_34-0" class="reference"><a href="#cite_note-12Leads-34"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="12-Lead_ECG">12-Lead ECG</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=6" title="Edit section: 12-Lead ECG"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Leads are broken down into three types: limb; augmented limb; and precordial or chest. The 12-lead ECG has a total of three <i>limb leads</i> and three <i>augmented limb leads</i> arranged like spokes of a wheel in the <a href="/wiki/Coronal_plane" title="Coronal plane">coronal plane</a> (vertical), and six <i>precordial leads</i> or <i>chest leads</i> that lie on the perpendicular <a href="/wiki/Transverse_plane" title="Transverse plane">transverse plane</a> (horizontal).<sup id="cite_ref-EKGInterp_35-0" class="reference"><a href="#cite_note-EKGInterp-35"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </p><p>Electrodes should be placed in standard positions, with 'left' or 'right' referring to <a href="/wiki/Anatomical" class="mw-redirect" title="Anatomical">anatomical</a> directions, being the patient's left or right. Exceptions due to emergency or other issues should be recorded to avoid erroneous analysis.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p><p>The 12 standard ECG leads and electrodes are listed below.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> All leads are effectively bipolar, with one positive and one negative electrode; the term "unipolar" is not true, nor useful.<sup id="cite_ref-AHA_ECG_pt1_33-1" class="reference"><a href="#cite_note-AHA_ECG_pt1-33"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p> <table class="wikitable collapsible"> <caption>ECG Electrodes and positioning </caption> <tbody><tr> <th>Type </th> <th>Name (<a href="/wiki/American_Heart_Association" title="American Heart Association">AHA</a>) </th> <th>Color (<a href="/wiki/American_Heart_Association" title="American Heart Association">AHA</a>) </th> <th>Placement </th> <th>Name (<a href="/wiki/International_Electrotechnical_Commission" title="International Electrotechnical Commission">IEC</a>) </th> <th>Color (<a href="/wiki/International_Electrotechnical_Commission" title="International Electrotechnical Commission">IEC</a>) </th></tr> <tr> <th scope="rowgroup" rowspan="4">Limb </th> <td>RA (Right Arm) </td> <td>White </td> <td>On the right arm, below the shoulders, avoiding thick <a href="/wiki/Muscle" title="Muscle">muscle</a>. </td> <td>R (Right) </td> <td>Red </td></tr> <tr> <td>LA (Left Arm) </td> <td>Black </td> <td>Symmetrical to the placement of the RA. </td> <td>L (Left) </td> <td>Yellow </td></tr> <tr> <td>RL (Right Leg) </td> <td>Green </td> <td>On the right leg, below the hips. </td> <td>N (Neutral) </td> <td>Black </td></tr> <tr> <td>LL (Left Leg) </td> <td>Red </td> <td>Symmetrical to the placement of the RL. </td> <td>F (Foot) </td> <td>Green </td></tr> <tr> <th scope="rowgroup" rowspan="6">Precordial </th> <td>V1 </td> <td>Brown & Red </td> <td>Fourth <a href="/wiki/Intercostal_space" title="Intercostal space">intercostal space</a> on the right <a href="/wiki/Sternal" class="mw-redirect" title="Sternal">sternal</a> border. </td> <td>C1 </td> <td>White & Red </td></tr> <tr> <td>V2 </td> <td>Brown & Yellow </td> <td>Fourth intercostal space on the left sternal border (symmetrical to V1). </td> <td>C2 </td> <td>White & Yellow </td></tr> <tr> <td>V3 </td> <td>Brown & Green </td> <td>Halfway between electrodes V2 and V4 (in a straight line). </td> <td>C3 </td> <td>White & Green </td></tr> <tr> <td>V4 </td> <td>Brown & Blue </td> <td>Fifth intercostal space on the <a href="/wiki/Midclavicular_line" class="mw-redirect" title="Midclavicular line">midclavicular line</a>. </td> <td>C4 </td> <td>White & Brown </td></tr> <tr> <td>V5 </td> <td>Brown & Orange </td> <td>Left <a href="/wiki/Anterior_axillary_line" class="mw-redirect" title="Anterior axillary line">anterior axillary line</a> on the same horizontal plane as V4. If the anterior axillary line is ambiguous, place halfway between V4 and V6. </td> <td>C5 </td> <td>White & Black </td></tr> <tr> <td>V6 </td> <td>Brown & Purple </td> <td>Left <a href="/wiki/Midaxillary_line" class="mw-redirect" title="Midaxillary line">midaxillary line</a> on the same horizontal plane as V4. </td> <td>C6 </td> <td>White & Purple. </td></tr></tbody></table> <table class="wikitable collapsible"> <caption>ECG Leads and Views </caption> <tbody><tr> <th>Type </th> <th>Name </th> <th>Lead view </th></tr> <tr> <th rowspan="3">Limb </th> <td>I </td> <td>From the RA to the LA. Along the frontal and horizontal planes at 0° (directly to the left). </td></tr> <tr> <td>II </td> <td>From the RA to the LL. Along the frontal plane at 60° clockwise from I. </td></tr> <tr> <td>III </td> <td>From the LA to the LL. Along the frontal plane at 120° clockwise from I. </td></tr> <tr> <th rowspan="3">Augmented Limb </th> <td>aVL </td> <td>From WCT to the LA. Along the frontal plane at -30° (which is 330° clockwise from I). </td></tr> <tr> <td>aVR </td> <td>From WCT to the RA. Along the frontal plane at -150° (which is 210° from I). </td></tr> <tr> <td>aVF </td> <td>From WCT to the LL. Along the front plane at 90°. </td></tr> <tr> <th rowspan="6">Precordial </th> <td>V<sub>1</sub> </td> <td>In the fourth <a href="/wiki/Intercostal_space" title="Intercostal space">intercostal space</a> (between ribs 4 and 5) just to the right of the <a href="/wiki/Sternum" title="Sternum">sternum</a> (breastbone) </td></tr> <tr> <td>V<sub>2</sub> </td> <td>In the fourth intercostal space (between ribs 4 and 5) just to the left of the sternum. </td></tr> <tr> <td>V<sub>3</sub> </td> <td>Between leads V<sub>2</sub> and V<sub>4</sub>. </td></tr> <tr> <td>V<sub>4</sub> </td> <td>In the fifth intercostal space (between ribs 5 and 6) in the <a href="/wiki/Mid-clavicular_line" class="mw-redirect" title="Mid-clavicular line">mid-clavicular line</a>. </td></tr> <tr> <td>V<sub>5</sub> </td> <td>Along the same horizontal line as V<sub>4</sub>, in the left <a href="/wiki/Anterior_axillary_line" class="mw-redirect" title="Anterior axillary line">anterior axillary line</a>. </td></tr> <tr> <td>V<sub>6</sub> </td> <td>Along the same horizontal line as V<sub>4</sub> and V<sub>5</sub> in the <a href="/wiki/Midaxillary_line" class="mw-redirect" title="Midaxillary line">mid-axillary line</a>. </td></tr></tbody></table> <p>Two types of electrodes in common use are a flat paper-thin sticker and a self-adhesive circular pad. The former are typically used in a single ECG recording while the latter are for continuous recordings as they stick longer. Each electrode consists of an <a href="/wiki/Electrically_conductive" class="mw-redirect" title="Electrically conductive">electrically conductive</a> electrolyte gel and a <a href="/wiki/Silver_chloride_electrode#Biological_electrode_systems" title="Silver chloride electrode">silver/silver chloride</a> conductor.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> The gel typically contains <a href="/wiki/Potassium_chloride" title="Potassium chloride">potassium chloride</a> – sometimes <a href="/wiki/Silver_chloride" title="Silver chloride">silver chloride</a> as well – to permit <a href="/wiki/Electron" title="Electron">electron</a> conduction from the skin to the wire and to the electrocardiogram.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Virtual_Electrode">Virtual Electrode</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=7" title="Edit section: Virtual Electrode"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The virtual electrode is used to obtain useful measurements from the precordial leads, and also allows the creation of the augmented limb leads. </p><p>The virtual electrode is known as <b>Wilson's Central Terminal</b> (<b>WCT</b>). For the precordial leads, WCT is formed by averaging the three standard limb leads (I, II, and III): </p> <dl><dd><span class="mwe-math-element"><span class="mwe-math-mathml-inline mwe-math-mathml-a11y" style="display: none;"><math xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle V_{W}={\frac {1}{3}}(RA+LA+LL)}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <msub> <mi>V</mi> <mrow class="MJX-TeXAtom-ORD"> <mi>W</mi> </mrow> </msub> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mn>1</mn> <mn>3</mn> </mfrac> </mrow> <mo stretchy="false">(</mo> <mi>R</mi> <mi>A</mi> <mo>+</mo> <mi>L</mi> <mi>A</mi> <mo>+</mo> <mi>L</mi> <mi>L</mi> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle V_{W}={\frac {1}{3}}(RA+LA+LL)}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/0e6d42ea32aab13b15d6e51930624cbf1641d7c3" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.838ex; width:25.895ex; height:5.176ex;" alt="{\displaystyle V_{W}={\frac {1}{3}}(RA+LA+LL)}" /></span></dd></dl> <p>WCT is therefore a virtual electrode which sits slightly <a href="/wiki/Posterior_(anatomy)" class="mw-redirect" title="Posterior (anatomy)">posteriorly</a> to the heart. It is a useful point, from which the electrical potential of the precordial leads is measured.<sup id="cite_ref-AHA_ECG_pt1_33-2" class="reference"><a href="#cite_note-AHA_ECG_pt1-33"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p><p>WCT used to be used as a reference for the virtual limb leads, however use in this way produced leads with very small amplitudes. Goldberger's modification is now used to produce each augmented limb lead, aVF, aVR, and aVL, which produces 50% larger amplitude leads than the standard WCT. Goldberger's WCT is formed according to the following:<sup id="cite_ref-AHA_ECG_pt1_33-3" class="reference"><a href="#cite_note-AHA_ECG_pt1-33"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p> <dl><dd><span class="mwe-math-element"><span class="mwe-math-mathml-inline mwe-math-mathml-a11y" style="display: none;"><math xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle aVR={\frac {LA+LL}{2}}}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>a</mi> <mi>V</mi> <mi>R</mi> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mi>L</mi> <mi>A</mi> <mo>+</mo> <mi>L</mi> <mi>L</mi> </mrow> <mn>2</mn> </mfrac> </mrow> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle aVR={\frac {LA+LL}{2}}}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/ac53dd0333a83d296175b4d943f57fe9ebf8856b" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.838ex; width:18.048ex; height:5.343ex;" alt="{\displaystyle aVR={\frac {LA+LL}{2}}}" /></span></dd> <dd><span class="mwe-math-element"><span class="mwe-math-mathml-inline mwe-math-mathml-a11y" style="display: none;"><math xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle aVL={\frac {RA+LL}{2}}}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>a</mi> <mi>V</mi> <mi>L</mi> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mi>R</mi> <mi>A</mi> <mo>+</mo> <mi>L</mi> <mi>L</mi> </mrow> <mn>2</mn> </mfrac> </mrow> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle aVL={\frac {RA+LL}{2}}}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/3422620885abe1293fdc926f300503f591ceda98" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.838ex; width:18.048ex; height:5.343ex;" alt="{\displaystyle aVL={\frac {RA+LL}{2}}}" /></span></dd> <dd><span class="mwe-math-element"><span class="mwe-math-mathml-inline mwe-math-mathml-a11y" style="display: none;"><math xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle aVF={\frac {RA+LA}{2}}}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>a</mi> <mi>V</mi> <mi>F</mi> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mrow> <mi>R</mi> <mi>A</mi> <mo>+</mo> <mi>L</mi> <mi>A</mi> </mrow> <mn>2</mn> </mfrac> </mrow> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle aVF={\frac {RA+LA}{2}}}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/f8a6cda4536ae4995d68b9704287829d1a5ba48f" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.838ex; width:18.366ex; height:5.343ex;" alt="{\displaystyle aVF={\frac {RA+LA}{2}}}" /></span></dd></dl> <p>In a 12-lead ECG, all leads except the limb leads are assumed to be unipolar (aVR, aVL, aVF, V<sub>1</sub>, V<sub>2</sub>, V<sub>3</sub>, V<sub>4</sub>, V<sub>5</sub>, and V<sub>6</sub>). The measurement of a voltage requires two contacts and so, electrically, the unipolar leads are measured from the common lead (negative) and the unipolar lead (positive). This averaging for the common lead and the abstract unipolar lead concept makes for a more challenging understanding and is complicated by sloppy usage of "lead" and "electrode". In fact, instead of being a constant reference, V<sub>W</sub> has a value that fluctuates throughout the heart cycle. It also does not truly represent the center-of-heart potential due to the body parts the signals travel through.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> Because voltage is by definition a bipolar measurement between two points, describing an electrocardiographic lead as "unipolar" makes little sense electrically and should be avoided. The American Heart Association states "All leads are effectively 'bipolar,' and the term 'unipolar' in description of the augmented limb leads and the precordial leads lacks precision."<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Limb_leads">Limb leads</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=8" title="Edit section: Limb leads"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Limb_leads_of_EKG.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/19/Limb_leads_of_EKG.png/600px-Limb_leads_of_EKG.png" decoding="async" width="600" height="400" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/19/Limb_leads_of_EKG.png/900px-Limb_leads_of_EKG.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/19/Limb_leads_of_EKG.png/1200px-Limb_leads_of_EKG.png 2x" data-file-width="1500" data-file-height="1000" /></a><figcaption>The limb leads and augmented limb leads (Wilson's central terminal is used as the negative pole for the latter in this representation)</figcaption></figure> <figure typeof="mw:File/Thumb"><a href="/wiki/File:EKG_leads.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/0e/EKG_leads.png/330px-EKG_leads.png" decoding="async" width="300" height="268" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/0e/EKG_leads.png/500px-EKG_leads.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/0e/EKG_leads.png/600px-EKG_leads.png 2x" data-file-width="814" data-file-height="726" /></a><figcaption></figcaption></figure> <p>Leads I, II and III are called the <i>limb leads</i>. The electrodes that form these signals are located on the limbs – one on each arm and one on the left leg.<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> The limb leads form the points of what is known as <a href="/wiki/Einthoven%27s_triangle" title="Einthoven's triangle">Einthoven's triangle</a>.<sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> </p> <ul><li>Lead I is the voltage between the (positive) left arm (LA) electrode and right arm (RA) electrode:</li></ul> <dl><dd><span class="mwe-math-element"><span class="mwe-math-mathml-inline mwe-math-mathml-a11y" style="display: none;"><math xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle I=LA-RA}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>I</mi> <mo>=</mo> <mi>L</mi> <mi>A</mi> <mo>−</mo> <mi>R</mi> <mi>A</mi> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle I=LA-RA}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/41f044d2fd4d470cdafd94d5ffbfda0aaff905c2" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.505ex; width:13.944ex; height:2.343ex;" alt="{\displaystyle I=LA-RA}" /></span></dd></dl> <ul><li>Lead II is the voltage between the (positive) left leg (LL) electrode and the right arm (RA) electrode:</li></ul> <dl><dd><span class="mwe-math-element"><span class="mwe-math-mathml-inline mwe-math-mathml-a11y" style="display: none;"><math xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle II=LL-RA}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>I</mi> <mi>I</mi> <mo>=</mo> <mi>L</mi> <mi>L</mi> <mo>−</mo> <mi>R</mi> <mi>A</mi> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle II=LL-RA}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/96c9c507b3a67bd37355721fd1f89e2d63233f74" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.505ex; width:14.955ex; height:2.343ex;" alt="{\displaystyle II=LL-RA}" /></span></dd></dl> <ul><li>Lead III is the voltage between the (positive) left leg (LL) electrode and the left arm (LA) electrode:</li></ul> <dl><dd><span class="mwe-math-element"><span class="mwe-math-mathml-inline mwe-math-mathml-a11y" style="display: none;"><math xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle III=LL-LA}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>I</mi> <mi>I</mi> <mi>I</mi> <mo>=</mo> <mi>L</mi> <mi>L</mi> <mo>−</mo> <mi>L</mi> <mi>A</mi> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle III=LL-LA}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/0b3ff3dd11cbc992ac0acad4edf384c6112bac36" class="mwe-math-fallback-image-inline mw-invert skin-invert" aria-hidden="true" style="vertical-align: -0.505ex; width:15.946ex; height:2.343ex;" alt="{\displaystyle III=LL-LA}" /></span></dd></dl> <div class="mw-heading mw-heading3"><h3 id="Augmented_limb_leads">Augmented limb leads</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=9" title="Edit section: Augmented limb leads"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Leads aVR, aVL, and aVF are the <i>augmented limb leads</i>. They are derived from the same three electrodes as leads I, II, and III, but they use Goldberger's central terminal as their negative pole. Goldberger's central terminal is a combination of inputs from two limb electrodes, with a different combination for each augmented lead. It is referred to immediately below as "the negative pole". </p> <ul><li>Lead <i>augmented vector right</i> (aVR) has the positive electrode on the right arm. The negative pole is a combination of the left arm electrode and the left leg electrode: <span class="mwe-math-element"><span class="mwe-math-mathml-display mwe-math-mathml-a11y" style="display: none;"><math display="block" xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle aVR=RA-{\frac {1}{2}}(LA+LL)={\frac {3}{2}}(RA-V_{W})}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>a</mi> <mi>V</mi> <mi>R</mi> <mo>=</mo> <mi>R</mi> <mi>A</mi> <mo>−</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mn>1</mn> <mn>2</mn> </mfrac> </mrow> <mo stretchy="false">(</mo> <mi>L</mi> <mi>A</mi> <mo>+</mo> <mi>L</mi> <mi>L</mi> <mo stretchy="false">)</mo> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mn>3</mn> <mn>2</mn> </mfrac> </mrow> <mo stretchy="false">(</mo> <mi>R</mi> <mi>A</mi> <mo>−</mo> <msub> <mi>V</mi> <mrow class="MJX-TeXAtom-ORD"> <mi>W</mi> </mrow> </msub> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle aVR=RA-{\frac {1}{2}}(LA+LL)={\frac {3}{2}}(RA-V_{W})}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/daf15fc5cc643651c933c6fe1975317d131ce124" class="mwe-math-fallback-image-display mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.838ex; width:43.93ex; height:5.176ex;" alt="{\displaystyle aVR=RA-{\frac {1}{2}}(LA+LL)={\frac {3}{2}}(RA-V_{W})}" /></span></li> <li>Lead <i>augmented vector left</i> (aVL) has the positive electrode on the left arm. The negative pole is a combination of the right arm electrode and the left leg electrode: <span class="mwe-math-element"><span class="mwe-math-mathml-display mwe-math-mathml-a11y" style="display: none;"><math display="block" xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle aVL=LA-{\frac {1}{2}}(RA+LL)={\frac {3}{2}}(LA-V_{W})}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>a</mi> <mi>V</mi> <mi>L</mi> <mo>=</mo> <mi>L</mi> <mi>A</mi> <mo>−</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mn>1</mn> <mn>2</mn> </mfrac> </mrow> <mo stretchy="false">(</mo> <mi>R</mi> <mi>A</mi> <mo>+</mo> <mi>L</mi> <mi>L</mi> <mo stretchy="false">)</mo> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mn>3</mn> <mn>2</mn> </mfrac> </mrow> <mo stretchy="false">(</mo> <mi>L</mi> <mi>A</mi> <mo>−</mo> <msub> <mi>V</mi> <mrow class="MJX-TeXAtom-ORD"> <mi>W</mi> </mrow> </msub> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle aVL=LA-{\frac {1}{2}}(RA+LL)={\frac {3}{2}}(LA-V_{W})}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/4b39fb58ce4ea0fa48547fbf121b13dc01d8e934" class="mwe-math-fallback-image-display mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.838ex; width:43.568ex; height:5.176ex;" alt="{\displaystyle aVL=LA-{\frac {1}{2}}(RA+LL)={\frac {3}{2}}(LA-V_{W})}" /></span></li> <li>Lead <i>augmented vector foot</i> (aVF) has the positive electrode on the left leg. The negative pole is a combination of the right arm electrode and the left arm electrode: <span class="mwe-math-element"><span class="mwe-math-mathml-display mwe-math-mathml-a11y" style="display: none;"><math display="block" xmlns="http://www.w3.org/1998/Math/MathML" alttext="{\displaystyle aVF=LL-{\frac {1}{2}}(RA+LA)={\frac {3}{2}}(LL-V_{W})}"> <semantics> <mrow class="MJX-TeXAtom-ORD"> <mstyle displaystyle="true" scriptlevel="0"> <mi>a</mi> <mi>V</mi> <mi>F</mi> <mo>=</mo> <mi>L</mi> <mi>L</mi> <mo>−</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mn>1</mn> <mn>2</mn> </mfrac> </mrow> <mo stretchy="false">(</mo> <mi>R</mi> <mi>A</mi> <mo>+</mo> <mi>L</mi> <mi>A</mi> <mo stretchy="false">)</mo> <mo>=</mo> <mrow class="MJX-TeXAtom-ORD"> <mfrac> <mn>3</mn> <mn>2</mn> </mfrac> </mrow> <mo stretchy="false">(</mo> <mi>L</mi> <mi>L</mi> <mo>−</mo> <msub> <mi>V</mi> <mrow class="MJX-TeXAtom-ORD"> <mi>W</mi> </mrow> </msub> <mo stretchy="false">)</mo> </mstyle> </mrow> <annotation encoding="application/x-tex">{\displaystyle aVF=LL-{\frac {1}{2}}(RA+LA)={\frac {3}{2}}(LL-V_{W})}</annotation> </semantics> </math></span><img src="https://wikimedia.org/api/rest_v1/media/math/render/svg/2b4e8d97775efdc8b82dfd724d0524ade48ca84f" class="mwe-math-fallback-image-display mw-invert skin-invert" aria-hidden="true" style="vertical-align: -1.838ex; width:43.566ex; height:5.176ex;" alt="{\displaystyle aVF=LL-{\frac {1}{2}}(RA+LA)={\frac {3}{2}}(LL-V_{W})}" /></span></li></ul> <p>Together with leads I, II, and III, augmented limb leads aVR, aVL, and aVF form the basis of the <a href="/wiki/Hexaxial_reference_system" title="Hexaxial reference system">hexaxial reference system</a>, which is used to calculate the heart's electrical axis in the frontal plane.<sup id="cite_ref-Meek_415–418_45-0" class="reference"><a href="#cite_note-Meek_415–418-45"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> </p><p>Older versions of the nodes (VR, VL, VF) use Wilson's central terminal as the negative pole, but the amplitude is too small for the thick lines of old ECG machines. The Goldberger terminals scale up (augments) the Wilson results by 50%, at the cost of sacrificing physical correctness by not having the same negative pole for all three.<sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Precordial_leads">Precordial leads</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=10" title="Edit section: Precordial leads"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The <i>precordial leads</i> lie in the transverse (horizontal) plane, perpendicular to the other six leads. The six precordial electrodes act as the positive poles for the six corresponding precordial leads: (V<sub>1</sub>, V<sub>2</sub>, V<sub>3</sub>, V<sub>4</sub>, V<sub>5</sub>, and V<sub>6</sub>). Wilson's central terminal is used as the negative pole. Recently, unipolar precordial leads have been used to create bipolar precordial leads that explore the right to left axis in the horizontal plane.<sup id="cite_ref-McLoughlin2020_47-0" class="reference"><a href="#cite_note-McLoughlin2020-47"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Specialized_leads">Specialized leads</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=11" title="Edit section: Specialized leads"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Additional electrodes may rarely be placed to generate other leads for specific diagnostic purposes. <i>Right-sided</i> precordial leads may be used to better study pathology of the right ventricle or for <a href="/wiki/Dextrocardia" title="Dextrocardia">dextrocardia</a> (and are denoted with an R (e.g., V<sub>5R</sub>). <i>Posterior leads</i> (V<sub>7</sub> to V<sub>9</sub>) may be used to demonstrate the presence of a posterior myocardial infarction. The <a href="/wiki/Lewis_lead" title="Lewis lead">Lewis lead</a> or S5-lead (requiring an electrode at the right sternal border in the second intercostal space) can be used to better detect atrial activity in relation to that of the ventricles.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> </p><p>An <i>esophageal lead</i> can be inserted to a part of the <a href="/wiki/Esophagus" title="Esophagus">esophagus</a> where the distance to the posterior wall of the <a href="/wiki/Left_atrium" class="mw-redirect" title="Left atrium">left atrium</a> is only approximately 5–6 mm (remaining constant in people of different age and weight).<sup id="cite_ref-MeigasKaik2008_49-0" class="reference"><a href="#cite_note-MeigasKaik2008-49"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> An esophageal lead avails for a more accurate differentiation between certain cardiac arrhythmias, particularly <a href="/wiki/Atrial_flutter" title="Atrial flutter">atrial flutter</a>, <a href="/wiki/AV_nodal_reentrant_tachycardia" title="AV nodal reentrant tachycardia">AV nodal reentrant tachycardia</a> and orthodromic <a href="/wiki/Atrioventricular_reentrant_tachycardia" title="Atrioventricular reentrant tachycardia">atrioventricular reentrant tachycardia</a>.<sup id="cite_ref-PehrsonBlomströ-LUNDQVIST1994_50-0" class="reference"><a href="#cite_note-PehrsonBlomströ-LUNDQVIST1994-50"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> It can also evaluate the risk in people with <a href="/wiki/Wolff-Parkinson-White_syndrome" class="mw-redirect" title="Wolff-Parkinson-White syndrome">Wolff-Parkinson-White syndrome</a>, as well as terminate <a href="/wiki/Supraventricular_tachycardia" title="Supraventricular tachycardia">supraventricular tachycardia</a> caused by <a href="/wiki/Cardiac_arrhythmia#Re-entry" class="mw-redirect" title="Cardiac arrhythmia">re-entry</a>.<sup id="cite_ref-PehrsonBlomströ-LUNDQVIST1994_50-1" class="reference"><a href="#cite_note-PehrsonBlomströ-LUNDQVIST1994-50"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> </p><p>An intracardiac electrogram (ICEG) is essentially an ECG with some added <i>intracardiac leads</i> (that is, inside the heart). The standard ECG leads (external leads) are I, II, III, aVL, V<sub>1</sub>, and V<sub>6</sub>. Two to four intracardiac leads are added via cardiac catheterization. The word "electrogram" (EGM) without further specification usually means an intracardiac electrogram.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Lead_locations_on_an_ECG_report">Lead locations on an ECG report</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=12" title="Edit section: Lead locations on an ECG report"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A standard 12-lead ECG report (an electrocardiograph) shows a 2.5 second tracing of each of the twelve leads. The tracings are most commonly arranged in a grid of four columns and three rows. The first column is the limb leads (I, II, and III), the second column is the augmented limb leads (aVR, aVL, and aVF), and the last two columns are the precordial leads (V<sub>1</sub> to V<sub>6</sub>). Additionally, a rhythm strip may be included as a fourth or fifth row.<sup id="cite_ref-Meek_415–418_45-1" class="reference"><a href="#cite_note-Meek_415–418-45"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> </p><p>The timing across the page is continuous and notes tracings of the 12 leads for the same time period. In other words, if the output were traced by needles on paper, each row would switch which leads as the paper is pulled under the needle. For example, the top row would first trace lead I, then switch to lead aVR, then switch to V<sub>1</sub>, and then switch to V<sub>4</sub>, and so none of these four tracings of the leads are from the same time period as they are traced in sequence through time.<sup id="cite_ref-Conquering_the_ECG_52-0" class="reference"><a href="#cite_note-Conquering_the_ECG-52"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Contiguity_of_leads"><span class="anchor" id="Lead_groups"></span>Contiguity of leads</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=13" title="Edit section: Contiguity of leads"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Contiguous_leads.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/33/Contiguous_leads.svg/330px-Contiguous_leads.svg.png" decoding="async" width="300" height="154" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/33/Contiguous_leads.svg/450px-Contiguous_leads.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/33/Contiguous_leads.svg/600px-Contiguous_leads.svg.png 2x" data-file-width="370" data-file-height="190" /></a><figcaption>Diagram showing the contiguous leads in the same color in the standard 12-lead layout</figcaption></figure> <p>Each of the 12 ECG leads records the electrical activity of the heart from a different angle, and therefore align with different anatomical areas of the heart. Two leads that look at neighboring anatomical areas are said to be <i>contiguous</i>.<sup id="cite_ref-Meek_415–418_45-2" class="reference"><a href="#cite_note-Meek_415–418-45"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> </p> <table class="wikitable"> <tbody><tr> <th>Category </th> <th>Leads </th> <th>Activity </th></tr> <tr> <td>Inferior leads </td> <td>Leads II, III and aVF </td> <td>Look at electrical activity from the vantage point of the <a href="https://en.wiktionary.org/wiki/inferior" class="extiw" title="wikt:inferior">inferior</a> surface (<a href="/wiki/Diaphragmatic_surface_of_heart" class="mw-redirect" title="Diaphragmatic surface of heart">diaphragmatic surface of heart</a>) </td></tr> <tr> <td>Lateral leads </td> <td>I, aVL, V<sub>5</sub> and V<sub>6</sub> </td> <td>Look at the electrical activity from the vantage point of the <a href="/wiki/Lateral_(anatomy)" class="mw-redirect" title="Lateral (anatomy)">lateral</a> wall of left <a href="/wiki/Ventricle_(heart)" title="Ventricle (heart)">ventricle</a> </td></tr> <tr> <td>Septal leads </td> <td>V<sub>1</sub> and V<sub>2</sub> </td> <td>Look at electrical activity from the vantage point of the <a href="/wiki/Septal" class="mw-redirect" title="Septal">septal</a> surface of the heart (<a href="/wiki/Interventricular_septum" title="Interventricular septum">interventricular septum</a>) </td></tr> <tr> <td>Anterior leads </td> <td>V<sub>3</sub> and V<sub>4</sub> </td> <td>Look at electrical activity from the vantage point of the <a href="/wiki/Anterior" class="mw-redirect" title="Anterior">anterior</a> wall of the right and left ventricles (<a href="/wiki/Sternocostal_surface_of_heart" class="mw-redirect" title="Sternocostal surface of heart">Sternocostal surface of heart</a>) </td></tr></tbody></table> <p>In addition, any two precordial leads next to one another are considered to be contiguous. For example, though V<sub>4</sub> is an anterior lead and V<sub>5</sub> is a lateral lead, they are contiguous because they are next to one another. </p> <div class="mw-heading mw-heading2"><h2 id="Electrophysiology">Electrophysiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=14" title="Edit section: Electrophysiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Cardiac_electrophysiology" title="Cardiac electrophysiology">Cardiac electrophysiology</a></div> <p>The study of the conduction system of the heart is called <a href="/wiki/Cardiac_electrophysiology" title="Cardiac electrophysiology">cardiac electrophysiology</a> (EP). An EP study is performed via a right-sided <a href="/wiki/Cardiac_catheterization" title="Cardiac catheterization">cardiac catheterization</a>: a wire with an electrode at its tip is inserted into the right heart chambers from a peripheral vein, and placed in various positions in close proximity to the conduction system so that the electrical activity of that system can be recorded.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2024)">citation needed</span></a></i>]</sup> </p><p>Standard catheter positions for an EP study include "high right atrium" or hRA near the <a href="/wiki/Sinus_node" class="mw-redirect" title="Sinus node">sinus node</a>, a "His" across the septal wall of the tricuspid valve to measure <a href="/wiki/Bundle_of_His" title="Bundle of His">bundle of His</a>, a "coronary sinus" into the <a href="/wiki/Coronary_sinus" title="Coronary sinus">coronary sinus</a>, and a "right ventricle" in the apex of the right ventricle.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Interpretation">Interpretation</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=15" title="Edit section: Interpretation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Interpretation of the ECG is fundamentally about understanding the <a href="/wiki/Electrical_conduction_system_of_the_heart" class="mw-redirect" title="Electrical conduction system of the heart">electrical conduction system of the heart</a>. Normal conduction starts and propagates in a predictable pattern, and deviation from this pattern can be a normal variation or be <a href="/wiki/Pathological" class="mw-redirect" title="Pathological">pathological</a>. An ECG does not equate with mechanical pumping activity of the heart; for example, <a href="/wiki/Pulseless_electrical_activity" title="Pulseless electrical activity">pulseless electrical activity</a> produces an ECG that should pump blood but no pulses are felt (and constitutes a <a href="/wiki/Medical_emergency" title="Medical emergency">medical emergency</a> and <a href="/wiki/Cardiopulmonary_resuscitation" title="Cardiopulmonary resuscitation">CPR</a> should be performed). <a href="/wiki/Ventricular_fibrillation" title="Ventricular fibrillation">Ventricular fibrillation</a> produces an ECG but is too dysfunctional to produce a life-sustaining cardiac output. Certain rhythms are known to have good cardiac output and some are known to have bad cardiac output. Ultimately, an <a href="/wiki/Echocardiogram" class="mw-redirect" title="Echocardiogram">echocardiogram</a> or other anatomical imaging modality is useful in assessing the mechanical function of the heart.<sup id="cite_ref-54" class="reference"><a href="#cite_note-54"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> </p><p>Like all medical tests, what constitutes "normal" is based on <a href="/wiki/Population_studies" class="mw-redirect" title="Population studies">population studies</a>. The heartrate range of between 60 and 100 beats per minute (bpm) is considered normal since data shows this to be the usual resting heart rate.<sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Theory">Theory</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=16" title="Edit section: Theory"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:ECG_Vector.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/94/ECG_Vector.svg/250px-ECG_Vector.svg.png" decoding="async" width="230" height="230" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/94/ECG_Vector.svg/500px-ECG_Vector.svg.png 1.5x" data-file-width="700" data-file-height="700" /></a><figcaption>QRS is upright in a lead when its axis is aligned with that lead's <a href="/wiki/Euclidean_vector" title="Euclidean vector">vector</a></figcaption></figure> <figure typeof="mw:File/Thumb"><a href="/wiki/File:EKG_Complex_en.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/34/EKG_Complex_en.svg/330px-EKG_Complex_en.svg.png" decoding="async" width="280" height="219" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/34/EKG_Complex_en.svg/500px-EKG_Complex_en.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/34/EKG_Complex_en.svg/560px-EKG_Complex_en.svg.png 2x" data-file-width="581" data-file-height="455" /></a><figcaption>Schematic representation of a normal ECG</figcaption></figure> <p>Interpretation of the ECG is ultimately that of pattern recognition. In order to understand the patterns found, it is helpful to understand the theory of what ECGs represent. The theory is rooted in <a href="/wiki/Electromagnetics" class="mw-redirect" title="Electromagnetics">electromagnetics</a> and boils down to the four following points:<sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> </p> <ul><li>depolarization of the heart <i>toward</i> the positive electrode produces a positive deflection</li> <li>depolarization of the heart <i>away</i> from the positive electrode produces a negative deflection</li> <li>repolarization of the heart <i>toward</i> the positive electrode produces a negative deflection</li> <li>repolarization of the heart <i>away</i> from the positive electrode produces a positive deflection</li></ul> <p>Thus, the overall direction of depolarization and repolarization produces positive or negative deflection on each lead's trace. For example, depolarizing from right to left would produce a positive deflection in lead I because the two vectors point in the same direction. In contrast, that same depolarization would produce minimal deflection in V<sub>1</sub> and V<sub>2</sub> because the vectors are perpendicular, and this phenomenon is called isoelectric. </p><p>Normal rhythm produces four entities – a <a href="/wiki/P_wave_(electrocardiography)" title="P wave (electrocardiography)">P wave</a>, a <a href="/wiki/QRS_complex" title="QRS complex">QRS complex</a>, a <a href="/wiki/T_wave" title="T wave">T wave</a>, and a <a href="/wiki/U_wave" title="U wave">U wave</a> – that each have a fairly unique pattern. </p> <ul><li>The P wave represents atrial depolarization.</li> <li>The QRS complex represents ventricular depolarization.</li> <li>The T wave represents ventricular repolarization.</li> <li>The U wave represents papillary muscle repolarization.</li></ul> <p>Changes in the structure of the heart and its surroundings (including blood composition) change the patterns of these four entities. </p><p>The U wave is not typically seen and its absence is generally ignored. Atrial repolarization is typically hidden in the much more prominent QRS complex and normally cannot be seen without additional, specialized electrodes. </p> <div class="mw-heading mw-heading3"><h3 id="Background_grid">Background grid</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=17" title="Edit section: Background grid"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>ECGs are normally printed on a grid. The horizontal axis represents time and the vertical axis represents voltage. The standard values on this grid are shown in the adjacent image at 25mm/sec (or 40ms per mm):<sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> </p> <ul><li>A small box is 1 mm × 1 mm and represents 0.1 mV × 0.04 seconds.</li> <li>A large box is 5 mm × 5 mm and represents 0.5 mV × 0.20 seconds.</li></ul> <p>The "large" box is represented by a heavier <a href="/wiki/Font_weight" class="mw-redirect" title="Font weight">line weight</a> than the small boxes. </p> <figure class="mw-halign-left" typeof="mw:File"><a href="/wiki/File:ECG_Paper_v2.svg" class="mw-file-description" title="Measuring time and voltage with ECG graph paper"><img alt="Measuring time and voltage with ECG graph paper" src="//upload.wikimedia.org/wikipedia/commons/thumb/9/96/ECG_Paper_v2.svg/500px-ECG_Paper_v2.svg.png" decoding="async" width="500" height="365" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/96/ECG_Paper_v2.svg/750px-ECG_Paper_v2.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/96/ECG_Paper_v2.svg/1000px-ECG_Paper_v2.svg.png 2x" data-file-width="480" data-file-height="350" /></a><figcaption>Measuring time and voltage with ECG graph paper</figcaption></figure> <div style="clear:both;" class=""></div> <p>The standard printing speed in the United States is 25 mm per sec (5 big boxes per second), but in other countries it can be 50 mm per sec. Faster speeds such as 100 and 200 mm per sec are used during electrophysiology studies. </p><p>Not all aspects of an ECG rely on precise recordings or having a known scaling of amplitude or time. For example, determining if the tracing is a sinus rhythm only requires feature recognition and matching, and not measurement of amplitudes or times (i.e., the scale of the grids are irrelevant). An example to the contrary, the voltage requirements of <a href="/wiki/Left_ventricular_hypertrophy" title="Left ventricular hypertrophy">left ventricular hypertrophy</a> require knowing the grid scale. </p> <div class="mw-heading mw-heading3"><h3 id="Rate_and_rhythm">Rate and rhythm</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=18" title="Edit section: Rate and rhythm"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In a normal heart, the heart rate is the rate at which the <a href="/wiki/Sinoatrial_node" title="Sinoatrial node">sinoatrial node</a> depolarizes since it is the source of depolarization of the heart. Heart rate, like other <a href="/wiki/Vital_signs" title="Vital signs">vital signs</a> such as blood pressure and respiratory rate, change with age. In adults, a normal heart rate is between 60 and 100 bpm (normocardic), whereas it is higher in children.<sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup> A heart rate below normal is called "<a href="/wiki/Bradycardia" title="Bradycardia">bradycardia</a>" (<60 in adults) and above normal is called "<a href="/wiki/Tachycardia" title="Tachycardia">tachycardia</a>" (>100 in adults). A complication of this is when the atria and ventricles are not in synchrony and the "heart rate" must be specified as atrial or ventricular (e.g., the ventricular rate in <a href="/wiki/Ventricular_fibrillation" title="Ventricular fibrillation">ventricular fibrillation</a> is 300–600 bpm, whereas the atrial rate can be normal [60–100] or faster [100–150]).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2024)">citation needed</span></a></i>]</sup> </p><p>In normal resting hearts, the physiologic rhythm of the heart is <a href="/wiki/Normal_sinus_rhythm" class="mw-redirect" title="Normal sinus rhythm">normal sinus rhythm</a> (NSR). Normal sinus rhythm produces the prototypical pattern of P wave, QRS complex, and T wave. Generally, deviation from normal sinus rhythm is considered a <a href="/wiki/Cardiac_arrhythmia" class="mw-redirect" title="Cardiac arrhythmia">cardiac arrhythmia</a>. Thus, the first question in interpreting an ECG is whether or not there is a sinus rhythm. A criterion for sinus rhythm is that P waves and QRS complexes appear 1-to-1, thus implying that the P wave causes the QRS complex.<sup id="cite_ref-Conquering_the_ECG_52-1" class="reference"><a href="#cite_note-Conquering_the_ECG-52"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> </p><p>Once sinus rhythm is established, or not, the second question is the rate. For a sinus rhythm, this is either the rate of P waves or QRS complexes since they are 1-to-1. If the rate is too fast, then it is <a href="/wiki/Sinus_tachycardia" title="Sinus tachycardia">sinus tachycardia</a>, and if it is too slow, then it is <a href="/wiki/Sinus_bradycardia" title="Sinus bradycardia">sinus bradycardia</a>. </p><p>If it is not a sinus rhythm, then determining the rhythm is necessary before proceeding with further interpretation. Some arrhythmias with characteristic findings: </p> <ul><li>Absent P waves with "irregularly irregular" QRS complexes are the hallmark of <a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">atrial fibrillation</a>.</li> <li>A "saw tooth" pattern with QRS complexes is the hallmark of <a href="/wiki/Atrial_flutter" title="Atrial flutter">atrial flutter</a>.</li> <li>A <a href="/wiki/Sine_wave" title="Sine wave">sine wave</a> pattern is the hallmark of <a href="/wiki/Ventricular_flutter" title="Ventricular flutter">ventricular flutter</a>.</li> <li>Absent P waves with wide QRS complexes and a fast heart rate are <a href="/wiki/Ventricular_tachycardia" title="Ventricular tachycardia">ventricular tachycardia</a>.</li></ul> <p>Determination of rate and rhythm is necessary in order to make sense of further interpretation. </p> <div class="mw-heading mw-heading3"><h3 id="Axis">Axis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=19" title="Edit section: Axis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Rapid_Axis_Vector.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/7c/Rapid_Axis_Vector.svg/250px-Rapid_Axis_Vector.svg.png" decoding="async" width="220" height="86" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/7c/Rapid_Axis_Vector.svg/330px-Rapid_Axis_Vector.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/7c/Rapid_Axis_Vector.svg/500px-Rapid_Axis_Vector.svg.png 2x" data-file-width="512" data-file-height="201" /></a><figcaption>Diagram showing how the polarity of the QRS complex in leads I, II, and III can be used to estimate the heart's electrical axis in the frontal plane.</figcaption></figure> <p>The heart has several axes, but the most common by far is the axis of the QRS complex (references to "the axis" imply the QRS axis). Each axis can be computationally determined to result in a number representing degrees of deviation from zero, or it can be categorized into a few types.<sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup> </p><p>The QRS axis is the general direction of the ventricular depolarization wavefront (or mean electrical vector) in the frontal plane. It is often sufficient to classify the axis as one of three types: normal, left deviated, or right deviated. Population data shows that a normal QRS axis is from −30° to 105°, with 0° being along lead I and positive being inferior and negative being superior (best understood graphically as the <a href="/wiki/Hexaxial_reference_system" title="Hexaxial reference system">hexaxial reference system</a>).<sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup> Beyond +105° is <a href="/wiki/Right_axis_deviation" title="Right axis deviation">right axis deviation</a> and beyond −30° is <a href="/wiki/Left_axis_deviation" title="Left axis deviation">left axis deviation</a> (the third quadrant of −90° to −180° is very rare and is an indeterminate axis). A shortcut for determining if the QRS axis is normal is if the QRS complex is mostly positive in lead I and lead II (or lead I and aVF if +90° is the upper limit of normal).<sup id="cite_ref-61" class="reference"><a href="#cite_note-61"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup> </p><p>The normal QRS axis is generally <i>down and to the left</i>, following the anatomical orientation of the heart within the chest. An abnormal axis suggests a change in the physical shape and orientation of the heart or a defect in its conduction system that causes the ventricles to depolarize in an abnormal way.<sup id="cite_ref-Conquering_the_ECG_52-2" class="reference"><a href="#cite_note-Conquering_the_ECG-52"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> </p> <table class="wikitable"> <tbody><tr> <th>Classification </th> <th>Angle </th> <th>Notes </th></tr> <tr> <td>Normal </td> <td>−30° to 105° </td> <td>Normal </td></tr> <tr> <td><a href="/wiki/Left_axis_deviation" title="Left axis deviation">Left axis deviation</a> </td> <td>−30° to −90° </td> <td>May indicate <a href="/wiki/Left_ventricular_hypertrophy" title="Left ventricular hypertrophy">left ventricular hypertrophy</a>, <a href="/wiki/Left_anterior_fascicular_block" title="Left anterior fascicular block">left anterior fascicular block</a>, or an old inferior STEMI </td></tr> <tr> <td><a href="/wiki/Right_axis_deviation" title="Right axis deviation">Right axis deviation</a> </td> <td>+105° to +180° </td> <td>May indicate <a href="/wiki/Right_ventricular_hypertrophy" title="Right ventricular hypertrophy">right ventricular hypertrophy</a>, <a href="/wiki/Left_posterior_fascicular_block" title="Left posterior fascicular block">left posterior fascicular block</a>, or an old lateral STEMI </td></tr> <tr> <td><i>Indeterminate axis</i> </td> <td>+180° to −90° </td> <td>Rarely seen; considered an 'electrical no-man's land' </td></tr></tbody></table> <p>The extent of a normal axis can be +90° or 105° depending on the source. </p> <div class="mw-heading mw-heading3"><h3 id="Amplitudes_and_intervals">Amplitudes and intervals</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=20" title="Edit section: Amplitudes and intervals"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:ECG_principle_slow.gif" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e5/ECG_principle_slow.gif/250px-ECG_principle_slow.gif" decoding="async" width="220" height="251" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e5/ECG_principle_slow.gif/330px-ECG_principle_slow.gif 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e5/ECG_principle_slow.gif/500px-ECG_principle_slow.gif 2x" data-file-width="700" data-file-height="800" /></a><figcaption>Animation of a normal ECG wave</figcaption></figure> <figure typeof="mw:File/Thumb"><a href="/wiki/File:EKG_Complex_en.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/34/EKG_Complex_en.svg/250px-EKG_Complex_en.svg.png" decoding="async" width="210" height="164" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/34/EKG_Complex_en.svg/330px-EKG_Complex_en.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/34/EKG_Complex_en.svg/500px-EKG_Complex_en.svg.png 2x" data-file-width="581" data-file-height="455" /></a><figcaption>Schematic representation of a normal ECG</figcaption></figure> <p>All of the waves on an ECG tracing and the intervals between them have a predictable time duration, a range of acceptable amplitudes (<a href="/wiki/Voltage" title="Voltage">voltages</a>), and a typical morphology. Any deviation from the normal tracing is potentially pathological and therefore of clinical significance.<sup id="cite_ref-62" class="reference"><a href="#cite_note-62"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup> </p><p>For ease of measuring the amplitudes and intervals, an ECG is printed on graph paper at a standard scale: each 1 mm (one small box on the standard 25mm/s ECG paper) represents 40 milliseconds of time on the x-axis, and 0.1 millivolts on the y-axis.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> </p> <table class="wikitable"> <tbody><tr> <th>Feature </th> <th>Description </th> <th>Pathology </th> <th>Duration </th></tr> <tr> <td><a href="/wiki/P_wave_(electrocardiography)" title="P wave (electrocardiography)">P wave</a> </td> <td>The P wave represents depolarization of the atria. Atrial depolarization spreads from the SA node towards the AV node, and from the right <a href="/wiki/Atrium_(anatomy)" class="mw-redirect" title="Atrium (anatomy)">atrium</a> to the left <a href="/wiki/Atrium_(anatomy)" class="mw-redirect" title="Atrium (anatomy)">atrium</a>. </td> <td>The P wave is typically upright in most leads except for aVR; an unusual P wave axis (inverted in other leads) can indicate an <a href="/wiki/Ectopic_pacemaker" title="Ectopic pacemaker">ectopic atrial pacemaker</a>. If the P wave is of unusually long duration, it may represent atrial enlargement. Typically a large <i>right atrium</i> gives a tall, peaked P wave while a large <i>left atrium</i> gives a two-humped bifid P wave. </td> <td><80 ms </td></tr> <tr> <td><a href="/wiki/PR_interval" title="PR interval">PR interval</a> </td> <td>The PR interval is measured from the beginning of the P wave to the beginning of the QRS complex. This interval reflects the time the electrical impulse takes to travel from the sinus node through the AV node. </td> <td>A PR interval shorter than 120 ms suggests that the electrical impulse is bypassing the AV node, as in <a href="/wiki/Wolff-Parkinson-White_syndrome" class="mw-redirect" title="Wolff-Parkinson-White syndrome">Wolff-Parkinson-White syndrome</a>. A PR interval consistently longer than 200 ms diagnoses <a href="/wiki/First_degree_atrioventricular_block" class="mw-redirect" title="First degree atrioventricular block">first degree atrioventricular block</a>. The PR segment (the portion of the tracing after the P wave and before the QRS complex) is typically completely flat, but may be depressed in <a href="/wiki/Pericarditis" title="Pericarditis">pericarditis</a>. </td> <td>120 to 200 ms </td></tr> <tr> <td><a href="/wiki/QRS_complex" title="QRS complex">QRS complex</a> </td> <td>The QRS complex represents the rapid depolarization of the right and left ventricles. The ventricles have a greater muscle mass proportion compared to the atria, hence the QRS complex usually has a much larger amplitude than the P wave. </td> <td>If the QRS complex is wide (longer than 120 ms) it suggests disruption of the heart's conduction system, such as in <a href="/wiki/LBBB" class="mw-redirect" title="LBBB">LBBB</a>, <a href="/wiki/RBBB" class="mw-redirect" title="RBBB">RBBB</a>, or ventricular rhythms such as <a href="/wiki/Ventricular_tachycardia" title="Ventricular tachycardia">ventricular tachycardia</a>. Metabolic issues such as severe <a href="/wiki/Hyperkalemia" title="Hyperkalemia">hyperkalemia</a>, or <a href="/wiki/Tricyclic_antidepressant_overdose" title="Tricyclic antidepressant overdose">tricyclic antidepressant overdose</a> can also widen the QRS complex. An unusually tall QRS complex may represent <a href="/wiki/Left_ventricular_hypertrophy" title="Left ventricular hypertrophy">left ventricular hypertrophy</a> while a very low-amplitude QRS complex may represent a <a href="/wiki/Pericardial_effusion" title="Pericardial effusion">pericardial effusion</a> or <a href="/wiki/Restrictive_cardiomyopathy" title="Restrictive cardiomyopathy">infiltrative myocardial disease</a>. </td> <td>80 to 100 ms </td></tr> <tr> <td><a href="/wiki/J-point" class="mw-redirect" title="J-point">J-point</a> </td> <td>The J-point is the point at which the QRS complex finishes and the ST segment begins. </td> <td>The J-point may be elevated as a normal variant. The appearance of a separate <i><a href="/wiki/Osborn_wave" class="mw-redirect" title="Osborn wave">J wave</a></i> or <i>Osborn wave</i> at the J-point is <a href="/wiki/Pathognomonic" title="Pathognomonic">pathognomonic</a> of <a href="/wiki/Hypothermia" title="Hypothermia">hypothermia</a> or <a href="/wiki/Hypercalcemia" class="mw-redirect" title="Hypercalcemia">hypercalcemia</a>.<sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup> </td> <td> </td></tr> <tr> <td><a href="/wiki/ST_segment" title="ST segment">ST segment</a> </td> <td>The ST segment connects the QRS complex and the T wave; it represents the period when the ventricles are depolarized. </td> <td>It is usually isoelectric, but may be depressed or elevated with <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">myocardial infarction</a> or ischemia. <a href="/wiki/ST_depression" title="ST depression">ST depression</a> can also be caused by <a href="/wiki/LVH" class="mw-redirect" title="LVH">LVH</a> or <a href="/wiki/Digoxin" title="Digoxin">digoxin</a>. <a href="/wiki/ST_elevation" title="ST elevation">ST elevation</a> can also be caused by <a href="/wiki/Pericarditis" title="Pericarditis">pericarditis</a>, <a href="/wiki/Brugada_syndrome" title="Brugada syndrome">Brugada syndrome</a>, or can be a normal variant (J-point elevation). </td> <td> </td></tr> <tr> <td><a href="/wiki/T_wave" title="T wave">T wave</a> </td> <td>The T wave represents the repolarization of the ventricles. It is generally upright in all leads except aVR and lead V1. </td> <td>Inverted T waves can be a sign of myocardial ischemia, <a href="/wiki/LVH" class="mw-redirect" title="LVH">left ventricular hypertrophy</a>, high <a href="/wiki/Intracranial_pressure" title="Intracranial pressure">intracranial pressure</a>, or metabolic abnormalities. Peaked T waves can be a sign of <a href="/wiki/Hyperkalemia" title="Hyperkalemia">hyperkalemia</a> or very early <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">myocardial infarction</a>. </td> <td>160 ms </td></tr> <tr> <td><a href="/wiki/Corrected_QT_interval" class="mw-redirect" title="Corrected QT interval">Corrected QT interval</a> (QTc) </td> <td>The QT interval is measured from the beginning of the QRS complex to the end of the T wave. Acceptable ranges vary with heart rate, so it must be <i>corrected</i> to the QTc by dividing by the square root of the RR interval. </td> <td>A prolonged QTc interval is a risk factor for ventricular tachyarrhythmias and sudden death. Long QT can arise as a <a href="/wiki/Long_QT_syndrome" title="Long QT syndrome">genetic syndrome</a>, or as a side effect of certain medications. An unusually short QTc can be seen in severe hypercalcemia. </td> <td><440 ms </td></tr> <tr> <td><a href="/wiki/U_wave" title="U wave">U wave</a> </td> <td>The U wave is hypothesized to be caused by the repolarization of the interventricular septum. It normally has a low amplitude, and even more often is completely absent. </td> <td>A very prominent U wave can be a sign of hypokalemia, hypercalcemia or hyperthyroidism.<sup id="cite_ref-65" class="reference"><a href="#cite_note-65"><span class="cite-bracket">[</span>64<span class="cite-bracket">]</span></a></sup> </td> <td> </td></tr> </tbody></table> <div class="mw-heading mw-heading3"><h3 id="Time-Frequency_Analysis_in_ECG_Signal_Processing">Time-Frequency Analysis in ECG Signal Processing</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=21" title="Edit section: Time-Frequency Analysis in ECG Signal Processing"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In electrocardiogram (ECG) signal processing, Time-Frequency Analysis (TFA) is an important technique used to reveal how the frequency characteristics of ECG signals change over time, especially in non-stationary signals such as arrhythmias or transient cardiac events. </p><p><b>Common Methods for Time-Frequency Analysis</b> </p> <table class="wikitable"> <tbody><tr> <th>Method </th> <th>Advantage </th> <th>Disadvantage </th> <th>Example </th></tr> <tr> <td><a href="/wiki/Short-time_Fourier_transform" title="Short-time Fourier transform">Short-time Fourier transform</a> </td> <td>Simple to implement, suitable for analyzing steady or near-steady heart rhythms and easy to perform using Fast Fourier Transform (FFT). </td> <td>Time and frequency resolution are affected by window length, making it difficult to efficiently capture both short-term and long-term variations simultaneously. </td> <td>Monitoring short-term heart rate variability. </td></tr> <tr> <td><a href="/wiki/Wavelet_transform" title="Wavelet transform">Wavelet transform</a> </td> <td>Provides multi-resolution analysis, making it suitable for processing non-stationary signals. </td> <td>Computationally intensive. </td> <td>Local feature extraction of P-wave or T-wave and frequency analysis of atrial fibrillation signals. </td></tr> <tr> <td><a href="/wiki/Hilbert%E2%80%93Huang_transform" title="Hilbert–Huang transform">Hilbert–Huang transform</a> </td> <td>Suitable for fully non-stationary and nonlinear signals. <p>Provides instantaneous frequency distribution. </p> </td> <td>Susceptible to mode mixing issues. </td> <td>Detection of transient heart rate variability. </td></tr> </tbody></table> <p><b>Steps for Time-Frequency Analysis</b> </p><p>Step1: Preprocessing </p> <ul><li>Signal Denoising: Use wavelet denoising, band-pass filtering (0.5–50 Hz), or Principal Component Analysis (PCA) to remove electromyographic (EMG) noise.</li> <li>Signal Segmentation: Segment the signal based on heartbeat cycles (e.g., R-wave detection).</li></ul> <p>Step2: Select an Appropriate TFA Method </p> <ul><li>Choose methods such as STFT, WT, or HHT based on the application requirements.</li></ul> <p>Step3: Compute the Time-Frequency Spectrum </p> <ul><li>Calculate the time-frequency distribution using the selected method to generate a time-frequency representation.</li></ul> <p>Step4: Feature Extraction </p> <ul><li>Extract power features from specific frequency bands, such as low-frequency (LF: 0.04–0.15 Hz) and high-frequency (HF: 0.15–0.4 Hz) components.</li></ul> <p>Step5: Pattern Recognition or Diagnosis </p> <ul><li>Apply machine learning or deep learning models to detect or classify cardiac events based on the time-frequency features.</li></ul> <p><br /> <b>Application Scenarios</b> </p><p>Heart Rate Variability Analysis (HRV): </p> <ul><li>Time-frequency analysis helps to separate sympathetic and parasympathetic nervous system activity.</li></ul> <p>Atrial Fibrillation Detection: </p> <ul><li>Analyze the time-frequency characteristics of atrial activity.</li></ul> <p>Ventricular Fibrillation Analysis: </p> <ul><li>Detect time-frequency changes in high-frequency abnormal components.</li></ul> <p><br /> </p> <div class="mw-heading mw-heading3"><h3 id="Limb_leads_and_electrical_conduction_through_the_heart">Limb leads and electrical conduction through the heart <span id="How_the_Electrical_Conduction_Through_the_Heart_Creates_the_ECG"></span></h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=22" title="Edit section: Limb leads and electrical conduction through the heart"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Animation_of_ECG_Limb_Leads.gif" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/82/Animation_of_ECG_Limb_Leads.gif/960px-Animation_of_ECG_Limb_Leads.gif" decoding="async" width="530" height="292" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/82/Animation_of_ECG_Limb_Leads.gif/1060px-Animation_of_ECG_Limb_Leads.gif 2x" data-file-width="1910" data-file-height="1052" /></a><figcaption>Formation of limb waveforms during a pulse</figcaption></figure> <p>The animation shown to the right illustrates how the path of electrical conduction gives rise to the ECG waves in the limb leads. What is green zone ? Recall that a positive current (as created by depolarization of cardiac cells) traveling towards the positive electrode and away from the negative electrode creates a positive deflection on the ECG. Likewise, a positive current traveling away from the positive electrode and towards the negative electrode creates a negative deflection on the ECG.<sup id="cite_ref-66" class="reference"><a href="#cite_note-66"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> The red arrow represents the overall direction of travel of the depolarization. The magnitude of the red arrow is proportional to the amount of tissue being depolarized at that instance. The red arrow is simultaneously shown on the axis of each of the 3 limb leads. Both the direction and the magnitude of the red arrow's projection onto the axis of each limb lead is shown with blue arrows. Then, the direction and magnitude of the blue arrows are what theoretically determine the deflections on the ECG. For example, as a blue arrow on the axis for Lead I moves from the negative electrode, to the right, towards the positive electrode, the ECG line rises, creating an upward wave. As the blue arrow on the axis for Lead I moves to the left, a downward wave is created. The greater the magnitude of the blue arrow, the greater the deflection on the ECG for that particular limb lead.<sup id="cite_ref-68" class="reference"><a href="#cite_note-68"><span class="cite-bracket">[</span>67<span class="cite-bracket">]</span></a></sup> </p><p>Frames 1–3 depict the depolarization being generated in and spreading through the <a href="/wiki/Sinoatrial_node" title="Sinoatrial node">sinoatrial node</a>. The SA node is too small for its depolarization to be detected on most ECGs. Frames 4–10 depict the depolarization traveling through the atria, towards the <a href="/wiki/Atrioventricular_node" title="Atrioventricular node">atrioventricular node</a>. During frame 7, the depolarization is traveling through the largest amount of tissue in the atria, which creates the highest point in the P wave. Frames 11–12 depict the depolarization traveling through the AV node. Like the SA node, the AV node is too small for the depolarization of its tissue to be detected on most ECGs. This creates the flat PR segment.<sup id="cite_ref-69" class="reference"><a href="#cite_note-69"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup> </p><p>Frame 13 depicts an interesting phenomenon in an over-simplified fashion. It depicts the depolarization as it starts to travel down the interventricular septum, through the <a href="/wiki/Bundle_of_His" title="Bundle of His">bundle of His</a> and <a href="/wiki/Bundle_branches" title="Bundle branches">bundle branches</a>. After the Bundle of His, the conduction system splits into the left bundle branch and the right bundle branch. Both branches conduct action potentials at about 1 m/s. However, the action potential starts traveling down the left bundle branch about 5 milliseconds before it starts traveling down the right bundle branch, as depicted by frame 13. This causes the depolarization of the interventricular septum tissue to spread from left to right, as depicted by the red arrow in frame 14. In some cases, this gives rise to a negative deflection after the PR interval, creating a Q wave such as the one seen in lead I in the animation to the right. Depending on the mean electrical axis of the heart, this phenomenon can result in a Q wave in lead II as well.<sup id="cite_ref-70" class="reference"><a href="#cite_note-70"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-71" class="reference"><a href="#cite_note-71"><span class="cite-bracket">[</span>70<span class="cite-bracket">]</span></a></sup> </p><p>Following depolarization of the interventricular septum, the depolarization travels towards the apex of the heart. This is depicted by frames 15–17 and results in a positive deflection on all three limb leads, which creates the R wave. Frames 18–21 then depict the depolarization as it travels throughout both ventricles from the apex of the heart, following the action potential in the <a href="/wiki/Purkinje_fibers" title="Purkinje fibers">Purkinje fibers</a>. This phenomenon creates a negative deflection in all three limb leads, forming the S wave on the ECG. Repolarization of the atria occurs at the same time as the generation of the QRS complex, but it is not detected by the ECG since the tissue mass of the ventricles is so much larger than that of the atria. Ventricular contraction occurs between ventricular depolarization and repolarization. During this time, there is no movement of charge, so no deflection is created on the ECG. This results in the flat ST segment after the S wave.<sup id="cite_ref-72" class="reference"><a href="#cite_note-72"><span class="cite-bracket">[</span>71<span class="cite-bracket">]</span></a></sup> </p><p>Frames 24–28 in the animation depict repolarization of the ventricles. The epicardium is the first layer of the ventricles to repolarize, followed by the myocardium. The endocardium is the last layer to repolarize. The plateau phase of depolarization has been shown to last longer in endocardial cells than in epicardial cells. This causes repolarization to start from the apex of the heart and move upwards. Since repolarization is the spread of negative current as membrane potentials decrease back down to the resting membrane potential, the red arrow in the animation is pointing in the direction opposite of the repolarization. This therefore creates a positive deflection in the ECG, and creates the T wave.<sup id="cite_ref-73" class="reference"><a href="#cite_note-73"><span class="cite-bracket">[</span>72<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Ischemia_and_infarction">Ischemia and infarction</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=23" title="Edit section: Ischemia and infarction"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Electrocardiography_in_myocardial_infarction" title="Electrocardiography in myocardial infarction">Electrocardiography in myocardial infarction</a></div> <p>Ischemia or <a href="/wiki/NSTEMI" class="mw-redirect" title="NSTEMI">non-ST elevation myocardial infarctions</a> (non-STEMIs) may manifest as <a href="/wiki/ST_depression" title="ST depression">ST depression</a> or inversion of <a href="/wiki/T_wave" title="T wave">T waves</a>. It may also affect the <a href="/wiki/HFQRS" class="mw-redirect" title="HFQRS">high frequency band of the QRS</a>. </p><p><a href="/wiki/STEMI" class="mw-redirect" title="STEMI">ST elevation myocardial infarctions</a> (STEMIs) have different characteristic ECG findings based on the amount of time elapsed since the MI first occurred. The earliest sign is <i>hyperacute T waves,</i> peaked T waves due to local <a href="/wiki/Hyperkalemia" title="Hyperkalemia">hyperkalemia</a> in ischemic myocardium. This then progresses over a period of minutes to elevations of the <a href="/wiki/ST_segment" title="ST segment">ST segment</a> by at least 1 mm. Over a period of hours, a pathologic <a href="/wiki/QRS_complex#Q_wave" title="QRS complex">Q wave</a> may appear and the T wave will invert. Over a period of days the ST elevation will resolve. Pathologic Q waves generally will remain permanently.<sup id="cite_ref-Alpert-2000_74-0" class="reference"><a href="#cite_note-Alpert-2000-74"><span class="cite-bracket">[</span>73<span class="cite-bracket">]</span></a></sup> </p><p>The <a href="/wiki/Coronary_artery" class="mw-redirect" title="Coronary artery">coronary artery</a> that has been occluded can be identified in an STEMI based on the location of ST elevation. The <a href="/wiki/Anterior_interventricular_branch_of_left_coronary_artery" class="mw-redirect" title="Anterior interventricular branch of left coronary artery">left anterior descending</a> (LAD) artery supplies the anterior wall of the heart, and therefore causes ST elevations in anterior leads (V<sub>1</sub> and V<sub>2</sub>). The <a href="/wiki/Circumflex_branch_of_left_coronary_artery" title="Circumflex branch of left coronary artery">LCx</a> supplies the lateral aspect of the heart and therefore causes ST elevations in lateral leads (I, aVL and V<sub>6</sub>). The <a href="/wiki/Right_coronary_artery" title="Right coronary artery">right coronary artery</a> (RCA) usually supplies the inferior aspect of the heart, and therefore causes ST elevations in inferior leads (II, III and aVF).<sup id="cite_ref-75" class="reference"><a href="#cite_note-75"><span class="cite-bracket">[</span>74<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Artifacts">Artifacts</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=24" title="Edit section: Artifacts"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>An ECG tracing is affected by patient motion. Some rhythmic motions (such as shivering or <a href="/wiki/Tremor" title="Tremor">tremors</a>) can create the illusion of cardiac arrhythmia.<sup id="cite_ref-76" class="reference"><a href="#cite_note-76"><span class="cite-bracket">[</span>75<span class="cite-bracket">]</span></a></sup> Artifacts are distorted signals caused by a secondary internal or external sources, such as muscle movement or interference from an electrical device.<sup id="cite_ref-Takla_77-0" class="reference"><a href="#cite_note-Takla-77"><span class="cite-bracket">[</span>76<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-78" class="reference"><a href="#cite_note-78"><span class="cite-bracket">[</span>77<span class="cite-bracket">]</span></a></sup> </p><p>Distortion poses significant challenges to healthcare providers,<sup id="cite_ref-Takla_77-1" class="reference"><a href="#cite_note-Takla-77"><span class="cite-bracket">[</span>76<span class="cite-bracket">]</span></a></sup> who employ various techniques<sup id="cite_ref-79" class="reference"><a href="#cite_note-79"><span class="cite-bracket">[</span>78<span class="cite-bracket">]</span></a></sup> and strategies to safely recognize<sup id="cite_ref-Fahim_H_Jafary_80-0" class="reference"><a href="#cite_note-Fahim_H_Jafary-80"><span class="cite-bracket">[</span>79<span class="cite-bracket">]</span></a></sup> these false signals.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (August 2015)">medical citation needed</span></a></i>]</sup> Accurately separating the ECG artifact from the true ECG signal can have a significant impact on patient outcomes and <a href="/wiki/Legal_liability" title="Legal liability">legal liabilities</a>.<sup id="cite_ref-81" class="reference"><a href="#cite_note-81"><span class="cite-bracket">[</span>80<span class="cite-bracket">]</span></a></sup><sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag may rely on an unreliable or less reliable medical source. (August 2015)">unreliable medical source?</span></a></i>]</sup> </p><p>Improper lead placement (for example, reversing two of the limb leads) has been estimated to occur in 0.4% to 4% of all ECG recordings,<sup id="cite_ref-82" class="reference"><a href="#cite_note-82"><span class="cite-bracket">[</span>81<span class="cite-bracket">]</span></a></sup> and has resulted in improper diagnosis and treatment including unnecessary use of <a href="/wiki/Thrombolytic" class="mw-redirect" title="Thrombolytic">thrombolytic</a> therapy.<sup id="cite_ref-83" class="reference"><a href="#cite_note-83"><span class="cite-bracket">[</span>82<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-84" class="reference"><a href="#cite_note-84"><span class="cite-bracket">[</span>83<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="A_Method_for_Interpretation">A Method for Interpretation</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=25" title="Edit section: A Method for Interpretation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Whitbread, consultant nurse and paramedic, suggests ten rules of the normal ECG, deviation from which is likely to indicate pathology.<sup id="cite_ref-85" class="reference"><a href="#cite_note-85"><span class="cite-bracket">[</span>84<span class="cite-bracket">]</span></a></sup> These have been added to, creating the 15 rules for 12-lead (and 15- or 18-lead) interpretation.<sup id="cite_ref-86" class="reference"><a href="#cite_note-86"><span class="cite-bracket">[</span>85<span class="cite-bracket">]</span></a></sup> </p><p>Rule 1: All waves in aVR are negative. </p><p>Rule 2: The ST segment (J point) starts on the isoelectric line (except in V1 & V2 where it may be elevated by not greater than 1 mm). </p><p>Rule 3: The PR interval should be 0.12–0.2 seconds long. </p><p>Rule 4: The QRS complex should not exceed 0.11–0.12 seconds. </p><p>Rule 5: The QRS and T waves tend to have the same general direction in the limb leads. </p><p>Rule 6: The R wave in the precordial (chest) leads grows from V1 to at least V4 where it may or may not decline again. </p><p>Rule 7: The QRS is mainly upright in I and II. </p><p>Rule 8: The P wave is upright in I II and V2 to V6. </p><p>Rule 9: There is no Q wave or only a small q (<0.04 seconds in width) in I, II and V2 to V6. </p><p>Rule 10: The T wave is upright in I II and V2 to V6. The end of the T wave should not drop below the isoelectric baseline. </p><p>Rule 11: Does the deepest S wave in V1 plus the tallest R wave in V5 or V6 equal >35 mm? </p><p>Rule 12: Is there an <a href="/wiki/Epsilon_wave" class="mw-redirect" title="Epsilon wave">Epsilon wave</a>? </p><p>Rule 13: Is there an J wave? </p><p>Rule 14: Is there a <a href="/wiki/Wolff%E2%80%93Parkinson%E2%80%93White_syndrome" title="Wolff–Parkinson–White syndrome">Delta wave</a>? </p><p>Rule 15: Are there any patterns representing an <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">occlusive myocardial infarction</a> (OMI)? </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=26" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Numerous diagnoses and findings can be made based upon electrocardiography, and many are discussed above. Overall, the diagnoses are made based on the patterns. For example, an "irregularly irregular" QRS complex without P waves is the hallmark of <a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">atrial fibrillation</a>; however, other findings can be present as well, such as a <a href="/wiki/Bundle_branch_block" title="Bundle branch block">bundle branch block</a> that alters the shape of the QRS complexes. ECGs can be interpreted in isolation but should be applied – like all <a href="/wiki/Diagnostic_tests" class="mw-redirect" title="Diagnostic tests">diagnostic tests</a> – in the context of the patient. For example, an observation of peaked T waves is not sufficient to diagnose hyperkalemia; such a diagnosis should be verified by measuring the blood potassium level. Conversely, a discovery of hyperkalemia should be followed by an ECG for manifestations such as peaked T waves, widened QRS complexes, and loss of P waves. The following is an organized list of possible ECG-based diagnoses.<sup id="cite_ref-87" class="reference"><a href="#cite_note-87"><span class="cite-bracket">[</span>86<span class="cite-bracket">]</span></a></sup> </p><p>Rhythm disturbances or arrhythmias:<sup id="cite_ref-88" class="reference"><a href="#cite_note-88"><span class="cite-bracket">[</span>87<span class="cite-bracket">]</span></a></sup> </p> <ul><li><a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">Atrial fibrillation</a> and <a href="/wiki/Atrial_flutter" title="Atrial flutter">atrial flutter</a> without rapid ventricular response</li> <li><a href="/wiki/Premature_atrial_contraction" title="Premature atrial contraction">Premature atrial contraction</a> (PACs) and <a href="/wiki/Premature_ventricular_contraction" title="Premature ventricular contraction">premature ventricular contraction</a> (PVCs)</li> <li><a href="/wiki/Sinus_arrhythmia" title="Sinus arrhythmia">Sinus arrhythmia</a></li> <li><a href="/wiki/Sinus_bradycardia" title="Sinus bradycardia">Sinus bradycardia</a> and <a href="/wiki/Sinus_tachycardia" title="Sinus tachycardia">sinus tachycardia</a></li> <li><a href="/wiki/Sinus_pause" class="mw-redirect" title="Sinus pause">Sinus pause</a> and <a href="/wiki/Sinoatrial_arrest" title="Sinoatrial arrest">sinoatrial arrest</a></li> <li><a href="/wiki/Sinus_node_dysfunction" title="Sinus node dysfunction">Sinus node dysfunction</a> and <a href="/wiki/Bradycardia-tachycardia_syndrome" class="mw-redirect" title="Bradycardia-tachycardia syndrome">bradycardia-tachycardia syndrome</a></li> <li><a href="/wiki/Supraventricular_tachycardia" title="Supraventricular tachycardia">Supraventricular tachycardia</a> <ul><li><a href="/wiki/Atrial_fibrillation" title="Atrial fibrillation">Atrial fibrillation</a> with rapid ventricular response</li> <li><a href="/wiki/Atrial_flutter" title="Atrial flutter">Atrial flutter</a> with rapid ventricular response</li> <li><a href="/wiki/AV_nodal_reentrant_tachycardia" title="AV nodal reentrant tachycardia">AV nodal reentrant tachycardia</a></li> <li><a href="/wiki/Atrioventricular_reentrant_tachycardia" title="Atrioventricular reentrant tachycardia">Atrioventricular reentrant tachycardia</a></li> <li><a href="/wiki/Junctional_ectopic_tachycardia" title="Junctional ectopic tachycardia">Junctional ectopic tachycardia</a></li> <li><a href="/wiki/Atrial_tachycardia" title="Atrial tachycardia">Atrial tachycardia</a> <ul><li><a href="/wiki/Ectopic_atrial_tachycardia" class="mw-redirect" title="Ectopic atrial tachycardia">Ectopic atrial tachycardia</a> (unicentric)</li> <li><a href="/wiki/Multifocal_atrial_tachycardia" title="Multifocal atrial tachycardia">Multifocal atrial tachycardia</a></li> <li><a href="/wiki/Paroxysmal_atrial_tachycardia" class="mw-redirect" title="Paroxysmal atrial tachycardia">Paroxysmal atrial tachycardia</a></li></ul></li> <li>Sinoatrial nodal reentrant tachycardia</li></ul></li> <li><a href="/wiki/Wide_complex_tachycardia" class="mw-redirect" title="Wide complex tachycardia">Wide complex tachycardia</a> <ul><li><a href="/wiki/Ventricular_flutter" title="Ventricular flutter">Ventricular flutter</a></li> <li><a href="/wiki/Ventricular_fibrillation" title="Ventricular fibrillation">Ventricular fibrillation</a></li> <li><a href="/wiki/Ventricular_tachycardia" title="Ventricular tachycardia">Ventricular tachycardia</a> (monomorphic ventricular tachycardia)</li> <li><a href="/wiki/Torsades_de_pointes" title="Torsades de pointes">Torsades de pointes</a> (polymorphic ventricular tachycardia)</li></ul></li> <li><a href="/wiki/Pre-excitation_syndrome" title="Pre-excitation syndrome">Pre-excitation syndrome</a> <ul><li><a href="/wiki/Lown%E2%80%93Ganong%E2%80%93Levine_syndrome" title="Lown–Ganong–Levine syndrome">Lown–Ganong–Levine syndrome</a></li> <li><a href="/wiki/Wolff%E2%80%93Parkinson%E2%80%93White_syndrome" title="Wolff–Parkinson–White syndrome">Wolff–Parkinson–White syndrome</a></li></ul></li> <li><a href="/wiki/J_wave" title="J wave">J wave</a> (Osborn wave)</li></ul> <p><a href="/wiki/Heart_block" title="Heart block">Heart block</a> and conduction problems: </p> <ul><li><a href="/wiki/Sinoatrial_block" title="Sinoatrial block">Sinoatrial block</a>: first, second, and third-degree</li> <li>AV node <ul><li><a href="/wiki/First-degree_AV_block" class="mw-redirect" title="First-degree AV block">First-degree AV block</a></li> <li><a href="/wiki/Second-degree_AV_block" class="mw-redirect" title="Second-degree AV block">Second-degree AV block</a> (Mobitz [Wenckebach] I and II)</li> <li><a href="/wiki/Third-degree_AV_block" class="mw-redirect" title="Third-degree AV block">Third-degree AV block</a> or complete AV block</li></ul></li> <li>Right bundle <ul><li><a href="/wiki/Right_bundle_branch_block#Incomplete_right_bundle_branch_block" title="Right bundle branch block">Incomplete right bundle branch block</a> (IRBBB)</li> <li>Complete <a href="/wiki/Right_bundle_branch_block" title="Right bundle branch block">right bundle branch block</a> (RBBB)</li></ul></li> <li>Left bundle <ul><li>Incomplete left bundle branch block (ILBBB)</li> <li>Complete <a href="/wiki/Left_bundle_branch_block" title="Left bundle branch block">left bundle branch block</a> (LBBB)</li> <li><a href="/wiki/Left_anterior_fascicular_block" title="Left anterior fascicular block">Left anterior fascicular block</a> (LAFB)</li> <li><a href="/wiki/Left_posterior_fascicular_block" title="Left posterior fascicular block">Left posterior fascicular block</a> (LPFB)</li> <li><a href="/wiki/Bifascicular_block" title="Bifascicular block">Bifascicular block</a> (LAFB plus LPFB)</li> <li><a href="/wiki/Trifascicular_block" title="Trifascicular block">Trifascicular block</a> (LAFP plus FPFB plus RBBB)</li></ul></li> <li>QT syndromes <ul><li><a href="/wiki/Brugada_syndrome" title="Brugada syndrome">Brugada syndrome</a></li> <li><a href="/wiki/Short_QT_syndrome" title="Short QT syndrome">Short QT syndrome</a></li> <li><a href="/wiki/Long_QT_syndrome" title="Long QT syndrome">Long QT syndromes</a>, genetic and drug-induced</li></ul></li> <li>Right and left atrial abnormality</li></ul> <p>Electrolytes disturbances and intoxication: </p> <ul><li><a href="/wiki/Digoxin_poisoning" class="mw-redirect" title="Digoxin poisoning">Digitalis intoxication</a></li> <li>Calcium: <a href="/wiki/Hypocalcemia" title="Hypocalcemia">hypocalcemia</a> and <a href="/wiki/Hypercalcemia" class="mw-redirect" title="Hypercalcemia">hypercalcemia</a></li> <li>Potassium: <a href="/wiki/Hypokalemia" title="Hypokalemia">hypokalemia</a> and <a href="/wiki/Hyperkalemia" title="Hyperkalemia">hyperkalemia</a></li> <li><a href="/wiki/Serotonin_Syndrome" class="mw-redirect" title="Serotonin Syndrome">Serotonin toxicity</a></li></ul> <p>Ischemia and infarction: </p> <ul><li><a href="/wiki/Wellens%27_syndrome" title="Wellens' syndrome">Wellens' syndrome</a> (LAD occlusion)</li> <li>de Winter T waves (LAD occlusion) <sup id="cite_ref-89" class="reference"><a href="#cite_note-89"><span class="cite-bracket">[</span>88<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/ST_elevation" title="ST elevation">ST elevation</a> and <a href="/wiki/ST_depression" title="ST depression">ST depression</a></li> <li><a href="/wiki/High_frequency_QRS" title="High frequency QRS">High frequency QRS</a> changes</li> <li><a href="/wiki/Myocardial_infarction" title="Myocardial infarction">Myocardial infarction</a> (heart attack) <ul><li>Non-Q wave myocardial infarction</li> <li><a href="/wiki/NSTEMI" class="mw-redirect" title="NSTEMI">NSTEMI</a></li> <li><a href="/wiki/STEMI" class="mw-redirect" title="STEMI">STEMI</a></li> <li><a href="/wiki/Sgarbossa%27s_criteria" title="Sgarbossa's criteria">Sgarbossa's criteria</a> for ischemia with a <a href="/wiki/Left_bundle_branch_block" title="Left bundle branch block">LBBB</a></li></ul></li></ul> <p>Structural: </p> <ul><li><a href="/wiki/Acute_pericarditis" title="Acute pericarditis">Acute pericarditis</a></li> <li><a href="/wiki/Right_ventricular_hypertrophy" title="Right ventricular hypertrophy">Right</a> and <a href="/wiki/Left_ventricular_hypertrophy" title="Left ventricular hypertrophy">left ventricular hypertrophy</a></li> <li><a href="/wiki/Right_ventricular_strain" class="mw-redirect" title="Right ventricular strain">Right ventricular strain</a> or S1Q3T3 (can be seen in <a href="/wiki/Pulmonary_embolism" title="Pulmonary embolism">pulmonary embolism</a>)</li></ul> <p>Other phenomena: </p> <ul><li><a href="/wiki/Cardiac_aberrancy" title="Cardiac aberrancy">Cardiac aberrancy</a> <ul><li><a href="/wiki/Ashman_phenomenon" title="Ashman phenomenon">Ashman phenomenon</a></li></ul></li> <li><a href="/wiki/Concealed_conduction" title="Concealed conduction">Concealed conduction</a></li> <li><a href="/wiki/Electrical_alternans" title="Electrical alternans">Electrical alternans</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=27" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Willem_Einthoven_ECG.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/1c/Willem_Einthoven_ECG.jpg/250px-Willem_Einthoven_ECG.jpg" decoding="async" width="220" height="180" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/1c/Willem_Einthoven_ECG.jpg/330px-Willem_Einthoven_ECG.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/1c/Willem_Einthoven_ECG.jpg/500px-Willem_Einthoven_ECG.jpg 2x" data-file-width="652" data-file-height="533" /></a><figcaption>An early commercial ECG device (1911)</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:BASA-532K-1-2-15-Ran_Bosilek.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b7/BASA-532K-1-2-15-Ran_Bosilek.jpg/250px-BASA-532K-1-2-15-Ran_Bosilek.jpg" decoding="async" width="220" height="36" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b7/BASA-532K-1-2-15-Ran_Bosilek.jpg/330px-BASA-532K-1-2-15-Ran_Bosilek.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b7/BASA-532K-1-2-15-Ran_Bosilek.jpg/500px-BASA-532K-1-2-15-Ran_Bosilek.jpg 2x" data-file-width="10502" data-file-height="1732" /></a><figcaption>ECG from 1957</figcaption></figure> <ul><li>In 1872, <a href="/wiki/Alexander_Muirhead" title="Alexander Muirhead">Alexander Muirhead</a> is reported to have attached wires to the wrist of a patient with fever to obtain an electronic record of their heartbeat.<sup id="cite_ref-90" class="reference"><a href="#cite_note-90"><span class="cite-bracket">[</span>89<span class="cite-bracket">]</span></a></sup></li> <li>In 1882, <a href="/wiki/John_Burdon-Sanderson" title="John Burdon-Sanderson">John Burdon-Sanderson</a> working with frogs, was the first to appreciate that the interval between variations in potential was not electrically quiescent and coined the term "isoelectric interval" for this period.<sup id="cite_ref-91" class="reference"><a href="#cite_note-91"><span class="cite-bracket">[</span>90<span class="cite-bracket">]</span></a></sup></li> <li>In 1887, <a href="/wiki/Augustus_Desir%C3%A9_Waller" title="Augustus Desiré Waller">Augustus Waller</a><sup id="cite_ref-Waller_1887_92-0" class="reference"><a href="#cite_note-Waller_1887-92"><span class="cite-bracket">[</span>91<span class="cite-bracket">]</span></a></sup> invented an ECG machine consisting of a <a href="/wiki/Lippmann_electrometer" title="Lippmann electrometer">Lippmann capillary electrometer</a> fixed to a projector. The trace from the heartbeat was projected onto a photographic plate that was itself fixed to a toy train. This allowed a heartbeat to be recorded in real time.</li> <li>In 1895, <a href="/wiki/Willem_Einthoven" title="Willem Einthoven">Willem Einthoven</a> assigned the letters P, Q, R, S, and T to the deflections in the theoretical waveform he created using equations which corrected the actual waveform obtained by the capillary electrometer to compensate for the imprecision of that instrument. Using letters different from A, B, C, and D (the letters used for the capillary electrometer's waveform) facilitated comparison when the uncorrected and corrected lines were drawn on the same graph.<sup id="cite_ref-naming_93-0" class="reference"><a href="#cite_note-naming-93"><span class="cite-bracket">[</span>92<span class="cite-bracket">]</span></a></sup> Einthoven probably chose the initial letter P to follow the example set by <a href="/wiki/Descartes" class="mw-redirect" title="Descartes">Descartes</a> in <a href="/wiki/Geometry" title="Geometry">geometry</a>.<sup id="cite_ref-naming_93-1" class="reference"><a href="#cite_note-naming-93"><span class="cite-bracket">[</span>92<span class="cite-bracket">]</span></a></sup> When a more precise waveform was obtained using the string galvanometer, which matched the corrected capillary electrometer waveform, he continued to use the letters P, Q, R, S, and T,<sup id="cite_ref-naming_93-2" class="reference"><a href="#cite_note-naming-93"><span class="cite-bracket">[</span>92<span class="cite-bracket">]</span></a></sup> and these letters are still in use today. Einthoven also described the electrocardiographic features of a number of cardiovascular disorders.</li> <li>In 1897, the string galvanometer was invented by the French engineer <a href="/wiki/Cl%C3%A9ment_Ader" title="Clément Ader">Clément Ader</a>.<sup id="cite_ref-94" class="reference"><a href="#cite_note-94"><span class="cite-bracket">[</span>93<span class="cite-bracket">]</span></a></sup></li> <li>In 1901, Einthoven, working in <a href="/wiki/Leiden" title="Leiden">Leiden</a>, the <a href="/wiki/Netherlands" title="Netherlands">Netherlands</a>, used the <a href="/wiki/String_galvanometer" title="String galvanometer">string galvanometer</a>: the first practical ECG.<sup id="cite_ref-95" class="reference"><a href="#cite_note-95"><span class="cite-bracket">[</span>94<span class="cite-bracket">]</span></a></sup> This device was much more sensitive than the capillary electrometer Waller used.</li> <li>In 1924, Einthoven was awarded the <a href="/wiki/Nobel_Prize_in_Medicine" class="mw-redirect" title="Nobel Prize in Medicine">Nobel Prize in Medicine</a> for his pioneering work in developing the ECG.<sup id="cite_ref-Cooper_1986_96-0" class="reference"><a href="#cite_note-Cooper_1986-96"><span class="cite-bracket">[</span>95<span class="cite-bracket">]</span></a></sup></li> <li>By 1927, General Electric had developed a portable apparatus that could produce electrocardiograms without the use of the string galvanometer. This device instead combined amplifier tubes similar to those used in a radio with an internal lamp and a moving mirror that directed the tracing of the electric pulses onto film.<sup id="cite_ref-97" class="reference"><a href="#cite_note-97"><span class="cite-bracket">[</span>96<span class="cite-bracket">]</span></a></sup></li> <li>In 1937, <a href="/wiki/Taro_Takemi" title="Taro Takemi">Taro Takemi</a> invented a new portable electrocardiograph machine.<sup id="cite_ref-98" class="reference"><a href="#cite_note-98"><span class="cite-bracket">[</span>97<span class="cite-bracket">]</span></a></sup></li> <li>In 1942, Emanuel Goldberger increases the voltage of Wilson's unipolar leads by 50% and creates the augmented limb leads aVR, aVL and aVF. When added to Einthoven's three limb leads and the six chest leads we arrive at the 12-lead electrocardiogram that is used today.<sup id="cite_ref-nicehist_99-0" class="reference"><a href="#cite_note-nicehist-99"><span class="cite-bracket">[</span>98<span class="cite-bracket">]</span></a></sup></li> <li>In the late 1940s, <a href="/wiki/Rune_Elmqvist" title="Rune Elmqvist">Rune Elmqvist</a> invented an inkjet printer involving thin jets of ink deflected by electrical potentials from the heart, with good frequency response and direct recording of ECG on paper. The device, called the Mingograf, was sold by Siemens Elema until the 1990s.<sup id="cite_ref-100" class="reference"><a href="#cite_note-100"><span class="cite-bracket">[</span>99<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading3"><h3 id="Etymology">Etymology</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=28" title="Edit section: Etymology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The word is derived from the <a href="/wiki/Greek_language" title="Greek language">Greek</a> <i>electro</i>, meaning related to electrical activity; <i>kardia</i>, meaning heart; and <i>graph</i>, meaning "to write".<sup id="cite_ref-101" class="reference"><a href="#cite_note-101"><span class="cite-bracket">[</span>100<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=29" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Signal-averaged_electrocardiogram" title="Signal-averaged electrocardiogram">Signal-averaged electrocardiogram</a></li> <li><a href="/wiki/Electrical_conduction_system_of_the_heart" class="mw-redirect" title="Electrical conduction system of the heart">Electrical conduction system of the heart</a></li> <li><a href="/wiki/Electroencephalography" title="Electroencephalography">Electroencephalography</a></li> <li><a href="/wiki/Electrogastrogram" title="Electrogastrogram">Electrogastrogram</a></li> <li><a href="/wiki/Electropalatography" title="Electropalatography">Electropalatography</a></li> <li><a href="/wiki/Electroretinography" title="Electroretinography">Electroretinography</a></li> <li><a href="/wiki/Emergency_medicine" title="Emergency medicine">Emergency medicine</a></li> <li><a href="/wiki/Forward_problem_of_electrocardiology" title="Forward problem of electrocardiology">Forward problem of electrocardiology</a></li> <li><a href="/wiki/Heart_rate" title="Heart rate">Heart rate</a></li> <li><a href="/wiki/Heart_rate_monitor" title="Heart rate monitor">Heart rate monitor</a></li> <li><a href="/wiki/Wireless_ambulatory_ECG" title="Wireless ambulatory ECG">Wireless ambulatory ECG</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="Notes">Notes</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=30" title="Edit section: Notes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-lower-alpha"> <div class="mw-references-wrap"><ol class="references"> <li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text">The version with '-K-', more commonly used in <a href="/wiki/American_English" title="American English">American English</a> than in <a href="/wiki/British_English" title="British English">British English</a>, is an early-20th-century <a href="/wiki/Loanword" title="Loanword">loanword</a> from the German acronym EKG for <span title="German-language text"><i lang="de">Elektrokardiogramm</i></span> (electrocardiogram),<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> which reflects that German physicians were pioneers in the field at the time. Today, <a href="/wiki/AMA_Manual_of_Style" title="AMA Manual of Style">AMA style</a> and–under its stylistic influence–most American medical publications use ECG instead of EKG.<sup id="cite_ref-AMA_MOS_2-0" class="reference"><a href="#cite_note-AMA_MOS-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The German term <span title="German-language text"><i lang="de">Elektrokardiogramm</i></span> as well as the English equivalent, electrocardiogram, consist of the <a href="/wiki/Neo-Latin" title="Neo-Latin">Neo-Latin</a>/<a href="/wiki/International_scientific_vocabulary" title="International scientific vocabulary">international scientific vocabulary</a> elements <span title="German-language text"><i lang="de"><a href="https://en.wiktionary.org/wiki/elektro-#German" class="extiw" title="wikt:elektro-">elektro-</a></i></span> (cognate <span title="German-language text"><i lang="de"><a href="https://en.wiktionary.org/wiki/electro-#English" class="extiw" title="wikt:electro-">electro-</a></i></span>) and <span title="German-language text"><i lang="de">kardi-</i></span> (cognate 'cardi-'), the latter from Greek <span title="Greek-language text"><i lang="el">kardia</i></span> (heart).<sup id="cite_ref-MW_Collegiate_3-0" class="reference"><a href="#cite_note-MW_Collegiate-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> The '-K-' version is more often retained under circumstances where there may be verbal confusion between ECG and EEG (<a href="/wiki/Electroencephalography" title="Electroencephalography">electroencephalography</a>) due to similar pronunciation.</span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Electrocardiography&action=edit&section=31" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239543626" /><div class="reflist reflist-columns references-column-width" style="column-width: 30em;"> <ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20200215123359/https://www.lexico.com/en/definition/ekg">"Definition of EKG"</a>. <i>Lexico Dictionaries</i>. Archived from <a rel="nofollow" class="external text" href="https://www.lexico.com/en/definition/ekg">the original</a> on 15 February 2020<span class="reference-accessdate">. Retrieved <span class="nowrap">20 January</span> 2020</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Lexico+Dictionaries&rft.atitle=Definition+of+EKG&rft_id=https%3A%2F%2Fwww.lexico.com%2Fen%2Fdefinition%2Fekg&rfr_id=info%3Asid%2Fen.wikipedia.org%3AElectrocardiography" class="Z3988"></span></span> </li> <li id="cite_note-AMA_MOS-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-AMA_MOS_2-0">^</a></b></span> <span class="reference-text"> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation cs2">"15.3.1 Electrocardiographic Terms", <a rel="nofollow" class="external text" href="https://www.amamanualofstyle.com/"><i>AMA Manual of Style</i></a>, <a href="/wiki/American_Medical_Association" title="American Medical Association">American Medical Association</a></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=15.3.1+Electrocardiographic+Terms&rft.btitle=AMA+Manual+of+Style&rft.pub=American+Medical+Association&rft_id=https%3A%2F%2Fwww.amamanualofstyle.com%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AElectrocardiography" class="Z3988"></span></span> </li> <li id="cite_note-MW_Collegiate-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-MW_Collegiate_3-0">^</a></b></span> <span class="reference-text"> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation encyclopaedia cs1"><span class="id-lock-subscription" title="Paid subscription required"><a rel="nofollow" class="external text" href="https://unabridged.merriam-webster.com/collegiate/">"Merriam-Webster's Collegiate Dictionary"</a></span>. <i><a href="/wiki/Merriam-Webster" title="Merriam-Webster">Merriam-Webster</a></i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Merriam-Webster%27s+Collegiate+Dictionary&rft.btitle=Merriam-Webster&rft_id=https%3A%2F%2Funabridged.merriam-webster.com%2Fcollegiate%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AElectrocardiography" class="Z3988"></span></span> </li> <li id="cite_note-Kumar2020-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-Kumar2020_5-0">^</a></b></span> <span class="reference-text"> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFBunceRayPatel2020" class="citation book cs1">Bunce, Nicholas H.; Ray, Robin; Patel, Hitesh (2020). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=sl3sDwAAQBAJ&pg=PA1033">"30. Cardiology"</a>. In Feather, Adam; Randall, David; Waterhouse, Mona (eds.). <i>Kumar and Clark's Clinical Medicine</i> (10th ed.). Elsevier. pp. <span class="nowrap">1033–</span>1038. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-7020-7870-5" title="Special:BookSources/978-0-7020-7870-5"><bdi>978-0-7020-7870-5</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=30.+Cardiology&rft.btitle=Kumar+and+Clark%27s+Clinical+Medicine&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1033-%3C%2Fspan%3E1038&rft.edition=10th&rft.pub=Elsevier&rft.date=2020&rft.isbn=978-0-7020-7870-5&rft.aulast=Bunce&rft.aufirst=Nicholas+H.&rft.au=Ray%2C+Robin&rft.au=Patel%2C+Hitesh&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3Dsl3sDwAAQBAJ%26pg%3DPA1033&rfr_id=info%3Asid%2Fen.wikipedia.org%3AElectrocardiography" class="Z3988"></span></span> </li> <li id="cite_note-Lilly_2016-6"><span class="mw-cite-backlink"><b><a href="#cite_ref-Lilly_2016_6-0">^</a></b></span> <span class="reference-text"> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFLilly2016" class="citation book cs1">Lilly, Leonard S. 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template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Emergency_medicine" title="Template talk:Emergency medicine"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Emergency_medicine" title="Special:EditPage/Template:Emergency medicine"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Emergency_medicine519" style="font-size:114%;margin:0 4em"><a href="/wiki/Emergency_medicine" title="Emergency medicine">Emergency medicine</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Emergency medicine</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Emergency_department" title="Emergency department">Emergency department</a></li> <li><a href="/wiki/Emergency_medical_services" title="Emergency medical services">Emergency medical services</a></li> <li><a href="/wiki/Emergency_nursing" title="Emergency nursing">Emergency nursing</a></li> <li><a href="/wiki/Emergency_psychiatry" title="Emergency psychiatry">Emergency psychiatry</a></li> <li><a href="/wiki/Golden_hour_(medicine)" title="Golden hour (medicine)">Golden hour</a></li> <li><a href="/wiki/Medical_emergency" title="Medical emergency">Medical emergency</a></li> <li><a href="/wiki/International_emergency_medicine" title="International emergency medicine">International emergency medicine</a></li> <li><a href="/wiki/Pediatric_emergency_medicine" title="Pediatric emergency medicine">Pediatric emergency medicine</a></li> <li><a href="/wiki/Pre-hospital_emergency_medicine" title="Pre-hospital emergency medicine">Pre-hospital emergency medicine</a></li> <li><a href="/wiki/Major_trauma" title="Major trauma">Major trauma</a></li> <li><a href="/wiki/Trauma_center" title="Trauma center">Trauma center</a></li> <li><a href="/wiki/Triage" title="Triage">Triage</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Category:Emergency_medical_equipment" title="Category:Emergency medical equipment">Equipment</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bag_valve_mask" title="Bag valve mask">Bag valve mask</a> (BVM)</li> <li><a href="/wiki/Chest_tube" title="Chest tube">Chest tube</a></li> <li><a href="/wiki/Defibrillation" title="Defibrillation">Defibrillation</a> (<a href="/wiki/Automated_external_defibrillator" title="Automated external defibrillator">AED</a></li> <li><a href="/wiki/Implantable_cardioverter-defibrillator" title="Implantable cardioverter-defibrillator">ICD</a>)</li> <li><a class="mw-selflink selflink">Electrocardiogram</a> (ECG/EKG)</li> <li><a href="/wiki/Intraosseous_infusion" title="Intraosseous infusion">Intraosseous infusion</a> (IO)</li> <li><a href="/wiki/Intravenous_therapy" title="Intravenous therapy">Intravenous therapy</a> (IV)</li> <li><a href="/wiki/Tracheal_intubation" title="Tracheal intubation">Tracheal intubation</a></li> <li><a href="/wiki/Laryngeal_tube" title="Laryngeal tube">Laryngeal tube</a></li> <li><a href="/wiki/Combitube" title="Combitube">Combitube</a></li> <li><a href="/wiki/Nasopharyngeal_airway" title="Nasopharyngeal airway">Nasopharyngeal airway</a> (NPA)</li> <li><a href="/wiki/Oropharyngeal_airway" title="Oropharyngeal airway">Oropharyngeal airway</a> (OPA)</li> <li><a href="/wiki/Pocket_mask" title="Pocket mask">Pocket mask</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Drugs</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adenosine" title="Adenosine">Adenosine</a></li> <li><a href="/wiki/Amiodarone" title="Amiodarone">Amiodarone</a></li> <li><a href="/wiki/Atropine" title="Atropine">Atropine</a></li> <li><a href="/wiki/Dopamine" title="Dopamine">Dopamine</a></li> <li><a href="/wiki/Epinephrine" class="mw-redirect" title="Epinephrine">Epinephrine / Adrenaline</a></li> <li><a href="/wiki/Naloxone" title="Naloxone">Naloxone</a></li> <li><a href="/wiki/Magnesium_sulfate" title="Magnesium sulfate">Magnesium sulfate</a></li> <li><a href="/wiki/Sodium_bicarbonate" title="Sodium bicarbonate">Sodium bicarbonate</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Category:Emergency_medicine_organisations" title="Category:Emergency medicine organisations">Organisations</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/International_Federation_for_Emergency_Medicine" title="International Federation for Emergency Medicine">International Federation for Emergency Medicine</a> (<a href="/wiki/International_Conference_on_Emergency_Medicine" title="International Conference on Emergency Medicine">International Conference on Emergency Medicine</a>)</li> <li><a href="/wiki/American_College_of_Emergency_Physicians" title="American College of Emergency Physicians">American College of Emergency Physicians</a></li> <li><a href="/wiki/Australasian_College_for_Emergency_Medicine" title="Australasian College for Emergency Medicine">Australasian College for Emergency Medicine</a></li> <li><a href="/wiki/Canadian_Association_of_Emergency_Physicians" title="Canadian Association of Emergency Physicians">Canadian Association of Emergency Physicians</a></li> <li><a href="/wiki/Royal_College_of_Emergency_Medicine" title="Royal College of Emergency Medicine">Royal College of Emergency Medicine</a></li> <li><a href="/wiki/European_Society_for_Emergency_Medicine" title="European Society for Emergency Medicine">European Society for Emergency Medicine</a></li> <li><a href="/wiki/Asian_Society_for_Emergency_Medicine" class="mw-redirect" title="Asian Society for Emergency Medicine">Asian Society for Emergency Medicine</a></li> <li><a href="/wiki/American_Academy_of_Emergency_Medicine" title="American Academy of Emergency Medicine">American Academy of Emergency Medicine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Category:Emergency_medicine_courses" title="Category:Emergency medicine courses">Courses</a> / <a href="/wiki/Category:Emergency_life_support" title="Category:Emergency life support">Life support</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/First_aid" title="First aid">First aid</a></li> <li><a href="/wiki/Cardiopulmonary_resuscitation" title="Cardiopulmonary resuscitation">Cardiopulmonary resuscitation</a> (CPR)</li> <li><a href="/wiki/Mouth-to-mouth_resuscitation" title="Mouth-to-mouth resuscitation">Mouth-to-mouth resuscitation</a></li> <li><a href="/wiki/Basic_life_support" title="Basic life support">Basic life support</a> (BLS)</li> <li><a href="/wiki/Advanced_cardiac_life_support" title="Advanced cardiac life support">Advanced cardiac life support</a> (ACLS)</li> <li><a href="/wiki/Advanced_trauma_life_support" title="Advanced trauma life support">Advanced trauma life support</a> (ATLS)</li> <li><a href="/wiki/Neonatal_Resuscitation_Program" title="Neonatal Resuscitation Program">Neonatal Resuscitation Program</a> (NRP)</li> <li><a href="/wiki/Acute_Care_of_at-Risk_Newborns" title="Acute Care of at-Risk Newborns">Acute Care of at-Risk Newborns</a> (ACoRN)</li> <li><a href="/wiki/Pediatric_basic_life_support" title="Pediatric basic life support">Pediatric basic life support</a> (PBLS)</li> <li><a href="/wiki/Pediatric_Advanced_Life_Support" class="mw-redirect" title="Pediatric Advanced Life Support">Pediatric Advanced Life Support</a> (PALS)</li> <li><a href="/wiki/Advanced_Life_Support_in_Obstetrics" title="Advanced Life Support in Obstetrics">Advanced Life Support in Obstetrics</a> (ALSO)</li> <li><a href="/wiki/Care_of_the_Critically_Ill_Surgical_Patient" title="Care of the Critically Ill Surgical Patient">Care of the Critically Ill Surgical Patient</a> (CCrISP)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Scoring systems</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/NACA_score" title="NACA score">NACA score</a></li> <li><a href="/wiki/Injury_Severity_Score" title="Injury Severity Score">Injury Severity Score</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div> <ul><li><b><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /></span></span> <a href="/wiki/Category:Emergency_medicine" title="Category:Emergency medicine">Category</a></b></li> <li><b><span class="noviewer" typeof="mw:File"><span title="Outline"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/41/Global_thinking.svg/20px-Global_thinking.svg.png" decoding="async" width="10" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/41/Global_thinking.svg/40px-Global_thinking.svg.png 2x" data-file-width="130" data-file-height="200" /></span></span> <a href="/wiki/Outline_of_emergency_medicine" title="Outline of emergency medicine">Outline</a></b></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /><style data-mw-deduplicate="TemplateStyles:r886047488">.mw-parser-output .nobold{font-weight:normal}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r886047488" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r886047488" /></div><div role="navigation" class="navbox" aria-labelledby="Tests_and_procedures_involving_the_heart388" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231" /><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Cardiac_procedures" title="Template:Cardiac procedures"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Cardiac_procedures" title="Template talk:Cardiac procedures"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Cardiac_procedures" title="Special:EditPage/Template:Cardiac procedures"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Tests_and_procedures_involving_the_heart388" style="font-size:114%;margin:0 4em">Tests and <a href="/wiki/Medical_procedure" title="Medical procedure">procedures</a> involving the <a href="/wiki/Heart" title="Heart">heart</a></div></th></tr><tr><td class="navbox-abovebelow hlist" colspan="2"><div> <ul><li><a href="/wiki/Cardiac_surgery" title="Cardiac surgery">Cardiac surgery</a></li> <li><a href="/wiki/Interventional_cardiology" title="Interventional cardiology">Interventional cardiology</a></li> <li><a href="/wiki/Cardiology_diagnostic_tests_and_procedures" title="Cardiology diagnostic tests and procedures">Cardiology diagnostic tests and procedures</a></li> <li><a href="/wiki/Cardiac_imaging" title="Cardiac imaging">Cardiac imaging</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Surgery</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Heart_valve" title="Heart valve">Heart valves</a><br />and septa</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Heart_valve_repair" title="Heart valve repair">Valve repair</a></li> <li><a href="/wiki/Valvulotomy" title="Valvulotomy">Valvulotomy</a></li> <li><a href="/wiki/Mitral_valve_repair" title="Mitral valve repair">Mitral valve repair</a></li> <li><a href="/wiki/Valvuloplasty" class="mw-redirect" title="Valvuloplasty">Valvuloplasty</a> <ul><li><a href="/wiki/Aortic_valvuloplasty" title="Aortic valvuloplasty">aortic</a></li> <li><a href="/wiki/Mitral_valvuloplasty" class="mw-redirect" title="Mitral valvuloplasty">mitral</a></li></ul></li> <li><a href="/wiki/Valve_replacement" title="Valve replacement">Valve replacement</a></li> <li><a href="/wiki/Aortic_valve_repair" title="Aortic valve repair">Aortic valve repair</a></li> <li><a href="/wiki/Aortic_valve_replacement" title="Aortic valve replacement">Aortic valve replacement</a> <ul><li><a href="/wiki/Ross_procedure" title="Ross procedure">Ross procedure</a></li> <li><a href="/wiki/Transcatheter_aortic_valve_replacement" title="Transcatheter aortic valve replacement">Transcatheter</a></li></ul></li> <li><a href="/wiki/Mitral_valve_replacement" title="Mitral valve replacement">Mitral valve replacement</a></li> <li><a href="/wiki/Transcatheter_pulmonary_valve_replacement" title="Transcatheter pulmonary valve replacement">Transcatheter pulmonary valve replacement</a></li></ul> <dl><dt><span class="nobold">production of septal defect in heart</span></dt> <dd><i>enlargement of existing septal defect</i> <dl><dd><a href="/wiki/Atrial_septostomy" title="Atrial septostomy">Atrial septostomy</a></dd> <dd><a href="/wiki/Balloon_septostomy" title="Balloon septostomy">Balloon septostomy</a></dd></dl></dd> <dd><i>creation of septal defect in heart</i> <dl><dd><a href="/wiki/Blalock%E2%80%93Hanlon_procedure" title="Blalock–Hanlon procedure">Blalock–Hanlon procedure</a></dd></dl></dd></dl> <dl><dt><span class="nobold">shunt from heart chamber to blood vessel</span></dt> <dd><a href="/wiki/Atrium_(heart)" title="Atrium (heart)">atrium</a> to <a href="/wiki/Pulmonary_artery" title="Pulmonary artery">pulmonary artery</a> <dl><dd><a href="/wiki/Fontan_procedure" title="Fontan procedure">Fontan procedure</a></dd></dl></dd> <dd><a href="/wiki/Left_ventricle" class="mw-redirect" title="Left ventricle">left ventricle</a> to <a href="/wiki/Aorta" title="Aorta">aorta</a> <dl><dd><a href="/wiki/Rastelli_procedure" title="Rastelli procedure">Rastelli procedure</a></dd></dl></dd> <dd><a href="/wiki/Right_ventricle" class="mw-redirect" title="Right ventricle">right ventricle</a> to <a href="/wiki/Pulmonary_artery" title="Pulmonary artery">pulmonary artery</a> <dl><dd><a href="/wiki/Sano_shunt" title="Sano shunt">Sano shunt</a></dd></dl></dd></dl> <dl><dt><span class="nobold">compound procedures</span></dt> <dd>for <a href="/wiki/Transposition_of_the_great_vessels" title="Transposition of the great vessels">transposition of the great vessels</a> <dl><dd><a href="/wiki/Arterial_switch_operation" title="Arterial switch operation">Arterial switch operation</a></dd> <dd><a href="/wiki/Mustard_procedure" title="Mustard procedure">Mustard procedure</a></dd> <dd><a href="/wiki/Senning_procedure" title="Senning procedure">Senning procedure</a></dd></dl></dd> <dd>for univentricular defect <dl><dd><a href="/wiki/Norwood_procedure" title="Norwood procedure">Norwood procedure</a></dd> <dd><a href="/wiki/Kawashima_procedure" title="Kawashima procedure">Kawashima procedure</a></dd></dl></dd></dl> <dl><dt><span class="nobold">shunt from blood vessel to blood vessel</span></dt> <dd><a href="/wiki/Systemic_circulation" class="mw-redirect" title="Systemic circulation">systemic circulation</a> to <a href="/wiki/Pulmonary_artery" title="Pulmonary artery">pulmonary artery</a> shunt <dl><dd><a href="/wiki/Blalock%E2%80%93Taussig_shunt" class="mw-redirect" title="Blalock–Taussig shunt">Blalock–Taussig shunt</a></dd></dl></dd> <dd><a href="/wiki/Superior_vena_cava" title="Superior vena cava">SVC</a> to the right <a href="/wiki/Pulmonary_artery" title="Pulmonary artery">PA</a> <dl><dd><a href="/wiki/Glenn_procedure" title="Glenn procedure">Glenn procedure</a></dd></dl></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Cardiac vessels</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><span class="nobold"><a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">CHD</a></span></dt> <dd><a href="/wiki/Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">Angioplasty</a></dd> <dd><a href="/wiki/Vascular_bypass" title="Vascular bypass">Bypass</a>/<a href="/wiki/Coronary_artery_bypass_surgery" title="Coronary artery bypass surgery">Coronary artery bypass</a> <dl><dd><a href="/wiki/MIDCAB" class="mw-redirect" title="MIDCAB">MIDCAB</a></dd> <dd><a href="/wiki/Off-pump_coronary_artery_bypass" title="Off-pump coronary artery bypass">Off-pump CAB</a></dd> <dd><a href="/wiki/TECAB" class="mw-redirect" title="TECAB">TECAB</a></dd></dl></dd></dl> <dl><dt><span class="nobold"><a href="/wiki/Coronary_stent" title="Coronary stent">Coronary stent</a></span></dt> <dd><a href="/wiki/Bare-metal_stent" title="Bare-metal stent">Bare-metal stent</a></dd> <dd><a href="/wiki/Drug-eluting_stent" title="Drug-eluting stent">Drug-eluting stent</a></dd></dl> <dl><dt><span class="nobold">Obstacle removal</span></dt> <dd><a href="/wiki/Endarterectomy" title="Endarterectomy">Endarterectomy</a></dd> <dd><a href="/wiki/Atherectomy" title="Atherectomy">Atherectomy</a></dd></dl> <ul><li><a href="/wiki/Bentall_procedure" title="Bentall procedure">Bentall procedure</a></li> <li><a href="/wiki/Valve-sparing_aortic_root_replacement" title="Valve-sparing aortic root replacement">Valve-sparing aortic root replacement</a></li></ul> <ul><li><a href="/wiki/LeCompte_maneuver" title="LeCompte maneuver">LeCompte maneuver</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><span class="nobold"><a href="/wiki/Pericardium" title="Pericardium">Pericardium</a></span></dt> <dd><a href="/wiki/Pericardiocentesis" title="Pericardiocentesis">Pericardiocentesis</a></dd> <dd><a href="/wiki/Pericardial_window" title="Pericardial window">Pericardial window</a></dd> <dd><a href="/wiki/Pericardiectomy" title="Pericardiectomy">Pericardiectomy</a></dd></dl> <dl><dt><span class="nobold"><a href="/wiki/Myocardium" class="mw-redirect" title="Myocardium">Myocardium</a></span></dt> <dd><a href="/wiki/Cardiomyoplasty" title="Cardiomyoplasty">Cardiomyoplasty</a></dd> <dd><a href="/wiki/Dor_procedure" title="Dor procedure">Dor procedure</a></dd> <dd><a href="/wiki/Septal_myectomy" title="Septal myectomy">Septal myectomy</a></dd> <dd><a href="/wiki/Ventricular_reduction" class="mw-redirect" title="Ventricular reduction">Ventricular reduction</a></dd> <dd><a href="/wiki/Alcohol_septal_ablation" title="Alcohol septal ablation">Alcohol septal ablation</a></dd></dl> <dl><dt><span class="nobold"><a href="/wiki/Cardiac_conduction_system" title="Cardiac conduction system">Conduction system</a></span></dt> <dd>Maze procedure (<a href="/wiki/Cox_maze_procedure" title="Cox maze procedure">Cox maze</a> and <a href="/wiki/Minimaze_procedure" title="Minimaze procedure">minimaze</a>)</dd> <dd><a href="/wiki/Catheter_ablation" title="Catheter ablation">Catheter ablation</a></dd> <dd><a href="/wiki/Cryoablation" title="Cryoablation">Cryoablation</a></dd> <dd><a href="/wiki/Radiofrequency_ablation" title="Radiofrequency ablation">Radiofrequency ablation</a></dd> <dd><a href="/wiki/Artificial_cardiac_pacemaker" class="mw-redirect" title="Artificial cardiac pacemaker">Pacemaker insertion</a></dd> <dd><a href="/wiki/S-ICD" class="mw-redirect" title="S-ICD">S-ICD</a> implantation</dd> <dd><a href="/wiki/Implantable_cardioverter-defibrillator" title="Implantable cardioverter-defibrillator">ICD</a> implantation</dd> <dd><a href="/wiki/Cardiac_resynchronization_therapy" title="Cardiac resynchronization therapy">Cardiac resynchronization therapy</a></dd></dl> <ul><li><a href="/wiki/Left_atrial_appendage_occlusion" title="Left atrial appendage occlusion">Left atrial appendage occlusion</a></li> <li><a href="/wiki/Cardiotomy" title="Cardiotomy">Cardiotomy</a></li> <li><a href="/wiki/Heart_transplantation" title="Heart transplantation">Heart transplantation</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Tests</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><span class="nobold"><a href="/wiki/Electrophysiology" title="Electrophysiology">Electrophysiology</a></span></dt> <dd><a class="mw-selflink selflink">Electrocardiography</a> <dl><dd><a href="/wiki/Vectorcardiography" title="Vectorcardiography">Vectorcardiography</a></dd> <dd><a href="/wiki/Magnetocardiography" title="Magnetocardiography">Magnetocardiography</a></dd></dl></dd> <dd><a href="/wiki/Holter_monitor" title="Holter monitor">Holter monitor</a></dd> <dd><a href="/wiki/Implantable_loop_recorder" title="Implantable loop recorder">Implantable loop recorder</a></dd> <dd><a href="/wiki/Cardiac_stress_test" title="Cardiac stress test">Cardiac stress test</a> <dl><dd><a href="/wiki/Bruce_protocol" title="Bruce protocol">Bruce protocol</a></dd></dl></dd> <dd><a href="/wiki/Electrophysiology_study" title="Electrophysiology study">Electrophysiology study</a></dd></dl> <dl><dt><span class="nobold"><a href="/wiki/Cardiac_imaging" title="Cardiac imaging">Cardiac imaging</a></span></dt> <dd><a href="/wiki/Angiocardiography" class="mw-redirect" title="Angiocardiography">Angiocardiography</a></dd> <dd><a href="/wiki/Echocardiography" title="Echocardiography">Echocardiography</a> <dl><dd><a href="/wiki/Transthoracic_echocardiogram" title="Transthoracic echocardiogram">TTE</a></dd> <dd><a href="/wiki/Transesophageal_echocardiogram" title="Transesophageal echocardiogram">TEE</a></dd></dl></dd> <dd><a href="/wiki/Myocardial_perfusion_imaging" title="Myocardial perfusion imaging">Myocardial perfusion imaging</a></dd> <dd><a href="/wiki/Cardiac_magnetic_resonance_imaging" title="Cardiac magnetic resonance imaging">Cardiovascular MRI</a></dd> <dd><a href="/wiki/Cardiac_ventriculography" title="Cardiac ventriculography">Ventriculography</a> <dl><dd><a href="/wiki/Radionuclide_ventriculography" class="mw-redirect" title="Radionuclide ventriculography">Radionuclide ventriculography</a></dd></dl></dd> <dd><a href="/wiki/Cardiac_catheterization" title="Cardiac catheterization">Cardiac catheterization</a>/<a href="/wiki/Coronary_catheterization" title="Coronary catheterization">Coronary catheterization</a></dd> <dd><a href="/wiki/Cardiac_CT" class="mw-redirect" title="Cardiac CT">Cardiac CT</a></dd> <dd><a href="/wiki/Cardiac_PET" title="Cardiac PET">Cardiac PET</a></dd></dl> <dl><dt><span class="nobold"><a href="/wiki/Sound" title="Sound">sound</a></span></dt> <dd><a href="/wiki/Phonocardiogram" title="Phonocardiogram">Phonocardiogram</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiology_diagnostic_tests_and_procedures" title="Cardiology diagnostic tests and procedures">Function tests</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Impedance_cardiography" title="Impedance cardiography">Impedance cardiography</a></li> <li><a href="/wiki/Ballistocardiography" title="Ballistocardiography">Ballistocardiography</a></li> <li><a href="/wiki/Cardiotocography" title="Cardiotocography">Cardiotocography</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pacing</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cardioversion" title="Cardioversion">Cardioversion</a></li> <li><a href="/wiki/Transcutaneous_pacing" title="Transcutaneous pacing">Transcutaneous pacing</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /></span></span> <a href="/wiki/Category:Cardiac_procedures" title="Category:Cardiac procedures">Category</a></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /></div><div role="navigation" class="navbox" aria-labelledby="Medical_test:_Electrodiagnosis194" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231" /><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Electrodiagnosis" title="Template:Electrodiagnosis"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Electrodiagnosis" title="Template talk:Electrodiagnosis"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Electrodiagnosis" title="Special:EditPage/Template:Electrodiagnosis"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Medical_test:_Electrodiagnosis194" style="font-size:114%;margin:0 4em"><a href="/wiki/Medical_test" title="Medical test">Medical test</a>: <a href="/wiki/Electrodiagnostic_medicine" title="Electrodiagnostic medicine">Electrodiagnosis</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Heart" title="Heart">Heart</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a class="mw-selflink selflink">Electrocardiography</a></li> <li><a href="/wiki/Fasegraphy" title="Fasegraphy">Fasegraphy</a></li> <li><a href="/wiki/Vectorcardiography" title="Vectorcardiography">Vectorcardiography</a></li> <li><a href="/wiki/Magnetocardiography" title="Magnetocardiography">Magnetocardiography</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Central_nervous_system" title="Central nervous system">Central nervous system</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Electroencephalography" title="Electroencephalography">Electroencephalography</a> (<a href="/wiki/Intracranial_EEG" class="mw-redirect" title="Intracranial EEG">Intracranial EEG</a>, <a href="/wiki/Stereoelectroencephalography" title="Stereoelectroencephalography">stereoelectroencephalography</a>)</li> <li><a href="/wiki/Magnetoencephalography" title="Magnetoencephalography">Magnetoencephalography</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peripheral_nervous_system" title="Peripheral nervous system">Peripheral nervous system</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Electromyography" title="Electromyography">Electromyography</a> (<a href="/wiki/Facial_electromyography" title="Facial electromyography">Facial electromyography</a>)</li> <li><a href="/wiki/Magnetomyography" title="Magnetomyography">Magnetomyography</a></li> <li><a href="/wiki/Nerve_conduction_study" title="Nerve conduction study">Nerve conduction study</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Audition" title="Audition">Ears</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Electrocochleography" title="Electrocochleography">Electrocochleography</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_eye" title="Human eye">Eyes</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Electronystagmography" title="Electronystagmography">Electronystagmography</a></li> <li><a href="/wiki/Electrooculography" title="Electrooculography">Electrooculography</a></li> <li><a href="/wiki/Electroretinography" title="Electroretinography">Electroretinography</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Digestion" title="Digestion">Digestive system</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Electrogastrogram" title="Electrogastrogram">Electrogastrogram</a></li> <li><a href="/wiki/Magnetogastrography" title="Magnetogastrography">Magnetogastrography</a></li> <li><a href="/wiki/Electrogustometry" title="Electrogustometry">Electrogustometry</a></li> <li><a href="/wiki/Electro-olfactography" title="Electro-olfactography">Electro-olfactography</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /></div><div role="navigation" class="navbox" aria-labelledby="Physiology_of_the_cardiovascular_system139" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231" /><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Cardiovascular_physiology" title="Template:Cardiovascular physiology"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Cardiovascular_physiology" title="Template talk:Cardiovascular physiology"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Cardiovascular_physiology" title="Special:EditPage/Template:Cardiovascular physiology"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Physiology_of_the_cardiovascular_system139" style="font-size:114%;margin:0 4em"><a href="/wiki/Cardiovascular_physiology" title="Cardiovascular physiology">Physiology of the cardiovascular system</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Heart" title="Heart">Heart</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiac_output" title="Cardiac output">Cardiac output</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cardiac_cycle" title="Cardiac cycle">Cardiac cycle</a></li> <li><a href="/wiki/Cardiac_output" title="Cardiac output">Cardiac output</a> <ul><li><a href="/wiki/Heart_rate" title="Heart rate">Heart rate</a></li> <li><a href="/wiki/Stroke_volume" title="Stroke volume">Stroke volume</a></li></ul></li> <li><a href="/wiki/Stroke_volume" title="Stroke volume">Stroke volume</a> <ul><li><a href="/wiki/End-diastolic_volume" title="End-diastolic volume">End-diastolic volume</a></li> <li><a href="/wiki/End-systolic_volume" title="End-systolic volume">End-systolic volume</a></li></ul></li> <li><a href="/wiki/Afterload" title="Afterload">Afterload</a></li> <li><a href="/wiki/Preload_(cardiology)" title="Preload (cardiology)">Preload</a></li> <li><a href="/wiki/Frank%E2%80%93Starling_law" title="Frank–Starling law">Frank–Starling law</a></li> <li><a href="/wiki/Cardiac_function_curve" title="Cardiac function curve">Cardiac function curve</a></li> <li><a href="/wiki/Venous_return_curve" class="mw-redirect" title="Venous return curve">Venous return curve</a></li> <li><a href="/wiki/Wiggers_diagram" title="Wiggers diagram">Wiggers diagram</a></li> <li><a href="/wiki/Pressure_volume_diagram" class="mw-redirect" title="Pressure volume diagram">Pressure volume diagram</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Echocardiography" title="Echocardiography">Ultrasound</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ventricle_(heart)#Dimensions" title="Ventricle (heart)">Fractional shortening</a> = (<a href="/wiki/End-diastolic_dimension" class="mw-redirect" title="End-diastolic dimension">End-diastolic dimension</a></li> <li><a href="/wiki/End-systolic_dimension" class="mw-redirect" title="End-systolic dimension">End-systolic dimension</a>) / End-diastolic dimension</li> <li><a href="/wiki/Aortic_valve_area_calculation" title="Aortic valve area calculation">Aortic valve area calculation</a></li> <li><a href="/wiki/Ejection_fraction" title="Ejection fraction">Ejection fraction</a></li> <li><a href="/wiki/Cardiac_index" title="Cardiac index">Cardiac index</a></li> <li><a href="/wiki/Left_atrial_volume" title="Left atrial volume">Left atrial volume</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Heart_rate" title="Heart rate">Heart rate</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cardiac_pacemaker" title="Cardiac pacemaker">Cardiac pacemaker</a></li> <li><a href="/wiki/Chronotropic" title="Chronotropic">Chronotropic</a> (<a href="/wiki/Heart_rate" title="Heart rate">Heart rate</a>)</li> <li><a href="/wiki/Dromotropic" title="Dromotropic">Dromotropic</a> (<a href="/wiki/Nerve_conduction_velocity" title="Nerve conduction velocity">Conduction velocity</a>)</li> <li><a href="/wiki/Inotrope" title="Inotrope">Inotropic</a> (Contractility)</li> <li><a href="/wiki/Bathmotropic" title="Bathmotropic">Bathmotropic</a> (Excitability)</li> <li><a href="/wiki/Lusitropy" title="Lusitropy">Lusitropic</a> (Relaxation)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Conduction</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Electrical_conduction_system_of_the_heart" class="mw-redirect" title="Electrical conduction system of the heart">Conduction system</a></li> <li><a href="/wiki/Cardiac_electrophysiology" title="Cardiac electrophysiology">Cardiac electrophysiology</a></li> <li>Action potential <ul><li><a href="/wiki/Cardiac_action_potential" title="Cardiac action potential">cardiac </a></li> <li><a href="/wiki/Atrial_action_potential" title="Atrial action potential">atrial</a></li> <li><a href="/wiki/Ventricular_action_potential" title="Ventricular action potential">ventricular</a></li></ul></li> <li><a href="/wiki/Effective_refractory_period" title="Effective refractory period">Effective refractory period</a></li> <li><a href="/wiki/Pacemaker_potential" title="Pacemaker potential">Pacemaker potential</a></li> <li><a class="mw-selflink selflink">Electrocardiography</a> <ul><li><a href="/wiki/P_wave_(electrocardiography)" title="P wave (electrocardiography)">P wave</a></li> <li><a href="/wiki/PR_interval" title="PR interval">PR interval</a></li> <li><a href="/wiki/QRS_complex" title="QRS complex">QRS complex</a></li> <li><a href="/wiki/QT_interval" title="QT interval">QT interval</a></li> <li><a href="/wiki/ST_segment" title="ST segment">ST segment</a></li> <li><a href="/wiki/T_wave" title="T wave">T wave</a></li> <li><a href="/wiki/U_wave" title="U wave">U wave</a></li></ul></li> <li><a href="/wiki/Hexaxial_reference_system" title="Hexaxial reference system">Hexaxial reference system</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Chamber pressure</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Central_venous_pressure" title="Central venous pressure">Central venous</a></li> <li>Right <ul><li><a href="/wiki/Right_atrial_pressure" title="Right atrial pressure">atrial</a></li> <li><a href="/wiki/Right_ventricular_pressure" class="mw-redirect" title="Right ventricular pressure">ventricular</a></li></ul></li> <li><a href="/wiki/Pulmonary_artery_pressure" class="mw-redirect" title="Pulmonary artery pressure">pulmonary artery</a> <ul><li><a href="/wiki/Pulmonary_wedge_pressure" title="Pulmonary wedge pressure">wedge</a></li></ul></li> <li>Left <ul><li><a href="/wiki/Pulmonary_wedge_pressure" title="Pulmonary wedge pressure">atrial</a></li> <li><a href="/wiki/Left_ventricular_pressure" class="mw-redirect" title="Left ventricular pressure">ventricular</a></li></ul></li> <li><a href="/wiki/Aortic_pressure" title="Aortic pressure">Aortic</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ventricular_remodeling" title="Ventricular remodeling">Ventricular remodeling</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Circulatory_system" title="Circulatory system">Vascular system</a>/<br /><a href="/wiki/Hemodynamics" title="Hemodynamics">hemodynamics</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hemodynamics" title="Hemodynamics">Blood flow</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Compliance_(physiology)" title="Compliance (physiology)">Compliance</a></li> <li><a href="/wiki/Vascular_resistance" title="Vascular resistance">Vascular resistance</a></li> <li><a href="/wiki/Pulse" title="Pulse">Pulse</a></li> <li><a href="/wiki/Perfusion" title="Perfusion">Perfusion</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Blood_pressure" title="Blood pressure">Blood pressure</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pulse_pressure" title="Pulse pressure">Pulse pressure</a> <ul><li><a href="/wiki/Systole" title="Systole">Systolic</a></li> <li><a href="/wiki/Diastole" title="Diastole">Diastolic</a></li></ul></li> <li><a href="/wiki/Mean_arterial_pressure" title="Mean arterial pressure">Mean arterial pressure</a></li> <li><a href="/wiki/Jugular_venous_pressure" title="Jugular venous pressure">Jugular venous pressure</a></li> <li><a href="/wiki/Portal_venous_pressure" title="Portal venous pressure">Portal venous pressure</a></li> <li><a href="/wiki/Critical_closing_pressure" title="Critical closing pressure">Critical closing pressure</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiovascular_physiology#Regulation_of_blood_pressure" title="Cardiovascular physiology">Regulation of BP</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Baroreflex" title="Baroreflex">Baroreflex</a></li> <li><a href="/wiki/Kinin%E2%80%93kallikrein_system" title="Kinin–kallikrein system">Kinin–kallikrein system</a></li> <li><a href="/wiki/Renin%E2%80%93angiotensin_system" title="Renin–angiotensin system">Renin–angiotensin system</a></li> <li><a href="/wiki/Vasoconstriction" title="Vasoconstriction">Vasoconstrictors</a></li> <li><a href="/wiki/Vasodilation" title="Vasodilation">Vasodilators</a></li> <li><a href="/wiki/Autoregulation" title="Autoregulation">Autoregulation</a> <ul><li><a href="/wiki/Myogenic_mechanism" title="Myogenic mechanism">Myogenic mechanism</a></li> <li><a href="/wiki/Tubuloglomerular_feedback" title="Tubuloglomerular feedback">Tubuloglomerular feedback</a></li> <li><a href="/wiki/Cerebral_autoregulation" title="Cerebral autoregulation">Cerebral autoregulation</a></li></ul></li> <li><a href="/wiki/Paraganglion" title="Paraganglion">Paraganglia</a> <ul><li><a href="/wiki/Aortic_body" title="Aortic body">Aortic body</a></li> <li><a href="/wiki/Carotid_body" title="Carotid body">Carotid body</a></li> <li><a href="/wiki/Glomus_cell" title="Glomus cell">Glomus cell</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319" /></div><div role="navigation" class="navbox authority-control" aria-labelledby="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q79785#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata1694" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q79785#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata1694" style="font-size:114%;margin:0 4em"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q79785#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">National</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://d-nb.info/gnd/4014280-2">Germany</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Electrocardiography"><a rel="nofollow" class="external text" href="https://id.loc.gov/authorities/sh85042098">United States</a></span></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Électrocardiographie"><a rel="nofollow" class="external text" href="https://catalogue.bnf.fr/ark:/12148/cb119441316">France</a></span></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Électrocardiographie"><a rel="nofollow" class="external text" href="https://data.bnf.fr/ark:/12148/cb119441316">BnF data</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://id.ndl.go.jp/auth/ndlna/00571014">Japan</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="elektrokardiografie"><a rel="nofollow" class="external text" href="https://aleph.nkp.cz/F/?func=find-c&local_base=aut&ccl_term=ica=ph134770&CON_LNG=ENG">Czech Republic</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://www.nli.org.il/en/authorities/987007538292305171">Israel</a></span></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="http://esu.com.ua/search_articles.php?id=17744">Encyclopedia of Modern Ukraine</a></span></li></ul></div></td></tr></tbody></table></div>    </div><noscript><img src="https://auth.wikimedia.org/loginwiki/wiki/Special:CentralAutoLogin/start?useformat=desktop&type=1x1&usesul3=1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Electrocardiography&oldid=1280160354">https://en.wikipedia.org/w/index.php?title=Electrocardiography&oldid=1280160354</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" title="Help:Category">Categories</a>: <ul><li><a href="/wiki/Category:Cardiac_electrophysiology" title="Category:Cardiac electrophysiology">Cardiac electrophysiology</a></li><li><a href="/wiki/Category:Diagnostic_cardiology" title="Category:Diagnostic cardiology">Diagnostic cardiology</a></li><li><a href="/wiki/Category:Electrodiagnosis" 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[\"CITEREFCorradoBassoSchiavonThiene1998\"] = 1,\n [\"CITEREFDrewCaliffFunkKaufman2004\"] = 2,\n [\"CITEREFEwy1984\"] = 1,\n [\"CITEREFFlemingThompsonStevensHeneghan2011\"] = 1,\n [\"CITEREFGalliAmbrosiniLombardi2016\"] = 1,\n [\"CITEREFGargiulo2015\"] = 1,\n [\"CITEREFGuijarro-Morales_A.,_Gil-Extremera_B.,_Maldonado-Martín_A.1991\"] = 1,\n [\"CITEREFHoughton,_Andrew_RGray,_David2012\"] = 1,\n [\"CITEREFHoylandHammacheBattagliaOster2020\"] = 1,\n [\"CITEREFHurst_JW1998\"] = 1,\n [\"CITEREFInterwoven_W1901\"] = 1,\n [\"CITEREFJafary2007\"] = 1,\n [\"CITEREFJinWulffWiddicombeZheng2012\"] = 1,\n [\"CITEREFJowettTurnerColeJones2005\"] = 1,\n [\"CITEREFKashouBasitChhabra2022\"] = 1,\n [\"CITEREFKashouBasitMalik2022\"] = 1,\n [\"CITEREFKavuruVesselleThomas1987\"] = 1,\n [\"CITEREFKligfieldGettesBaileyChilders2007\"] = 2,\n [\"CITEREFKlingfieldGettesBaileyChilders2007\"] = 1,\n [\"CITEREFLilly2016\"] = 1,\n [\"CITEREFLukas2016\"] = 1,\n [\"CITEREFLyakhovKiladzeLyakhova2021\"] = 1,\n [\"CITEREFMacfarlaneColeman1995\"] = 1,\n [\"CITEREFMadias2008\"] = 1,\n [\"CITEREFMallinson2023\"] = 1,\n [\"CITEREFMangalmurtiSeaburyChandraLakdawalla2014\"] = 1,\n [\"CITEREFMastersBowdenMartinChandler2003\"] = 1,\n [\"CITEREFMc_Loughlin2020\"] = 1,\n [\"CITEREFMeek2002\"] = 1,\n [\"CITEREFMeigasKaikAnier2008\"] = 1,\n [\"CITEREFMontagueOuelletteBuller2008\"] = 1,\n [\"CITEREFMoyer_VA2012\"] = 1,\n [\"CITEREFNobleHillisRothbaum1990\"] = 1,\n [\"CITEREFOteroLenihan2000\"] = 1,\n [\"CITEREFPehrsonBlomströ-LundqvistLjungströBlomströ1994\"] = 1,\n [\"CITEREFPennoyerBykhovskySohinkiMallard2020\"] = 1,\n [\"CITEREFPrabhakararaoDandapat2020\"] = 1,\n [\"CITEREFPublishing2015\"] = 1,\n [\"CITEREFRivera-RuizCajavilcaVaron1927\"] = 1,\n [\"CITEREFRogers1969\"] = 1,\n [\"CITEREFSattarChhabra2022\"] = 1,\n [\"CITEREFScherYoungMalmgrenErickson1955\"] = 1,\n [\"CITEREFSchläpferWellens2017\"] = 1,\n [\"CITEREFSchrepelAmickSayedChipman2021\"] = 1,\n [\"CITEREFSegura-SampedroParra-LópezSampedro-AbascalMuñoz-Rodríguez2015\"] = 1,\n [\"CITEREFSurawiczKnillans2008\"] = 1,\n [\"CITEREFTaklaPetreDoyleHoribe2006\"] = 1,\n [\"CITEREFTsukadaTokitaMurataHirasawa2019\"] = 1,\n [\"CITEREFUS_Preventive_Services_TaskCurryKristOwens2018\"] = 1,\n [\"CITEREFWaller_AD1887\"] = 1,\n [\"CITEREFWalraven2011\"] = 1,\n [\"CITEREFWarnerTivakaran2022\"] = 1,\n [\"CITEREFWhitbread2006\"] = 1,\n [\"CITEREFZhangBantaFuJohn2022\"] = 1,\n [\"CITEREFde_Winter2008\"] = 1,\n [\"Lead_groups\"] = 1,\n}\ntemplate_list = table#1 {\n [\"Anchor\"] = 1,\n [\"Authority control\"] = 1,\n [\"Cardiac procedures\"] = 1,\n [\"Cardiovascular physiology\"] = 1,\n [\"Citation\"] = 7,\n [\"Cite ODNB\"] = 1,\n [\"Cite book\"] = 10,\n [\"Cite encyclopedia\"] = 1,\n [\"Cite journal\"] = 53,\n [\"Cite news\"] = 5,\n [\"Cite web\"] = 22,\n [\"Clear\"] = 1,\n [\"Commons category\"] = 1,\n [\"Distinguish\"] = 1,\n [\"Efn\"] = 1,\n [\"Electrodiagnosis\"] = 1,\n [\"Emergency medicine\"] = 1,\n [\"Fact\"] = 2,\n [\"Infobox medical intervention\"] = 1,\n [\"Lang\"] = 6,\n [\"Main\"] = 2,\n [\"Medical citation needed\"] = 1,\n [\"Notelist\"] = 1,\n [\"Redirect2\"] = 1,\n [\"Reflist\"] = 1,\n [\"Sfn\"] = 2,\n [\"Short description\"] = 1,\n [\"UNMED\"] = 1,\n [\"Use dmy dates\"] = 1,\n}\narticle_whitelist = table#1 {\n}\nciteref_patterns = table#1 {\n}\n"},"cachereport":{"origin":"mw-web.codfw.main-7dbbdd594f-nkv7x","timestamp":"20250405211306","ttl":2592000,"transientcontent":false}}});});</script> <script type="application/ld+json">{"@context":"https:\/\/schema.org","@type":"Article","name":"Electrocardiography","url":"https:\/\/en.wikipedia.org\/wiki\/Electrocardiography","sameAs":"http:\/\/www.wikidata.org\/entity\/Q79785","mainEntity":"http:\/\/www.wikidata.org\/entity\/Q79785","author":{"@type":"Organization","name":"Contributors to Wikimedia projects"},"publisher":{"@type":"Organization","name":"Wikimedia Foundation, Inc.","logo":{"@type":"ImageObject","url":"https:\/\/www.wikimedia.org\/static\/images\/wmf-hor-googpub.png"}},"datePublished":"2002-08-28T08:59:21Z","dateModified":"2025-03-12T22:13:19Z","image":"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/9\/9e\/SinusRhythmLabels.svg","headline":"method to record the electrical activity of the heart through passive electrodes placed over the skin."}</script> </body> </html>