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Table Of Contents
1. Acknowledgements.
2. Certificate
4. Basics of ECG
5. Circuit diagram
6. Working of ECG
7. Matlab Basics
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
ACKNOWLEDGEMENT
Sunil Kumar
80405103010
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
Certificate
This is certified that the report file on ECG (electro cardio
graph) has been completed by
Sunil Kumar
80405103010
Mr. A.C.MONGRA
H.O.D. (BME Deptt.)
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
Introduction
The electrocardiogram (ECG or EKG) is a diagnostic tool that measures and
records the electrical activity of the heart in exquisite detail. Interpretation of these
details allows diagnosis of a wide range of heart conditions. These conditions can
meeting of the Dutch Medical Society. In 1924, Einthoven received the Nobel
• The standard 12-lead ECG that is used throughout the world was
introduced in 1942.
is, the structure) and physiology (that is, the function) of the heart.
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
the body.
• The heart is really 2 "half hearts," the right heart and the left heart, which
beat simultaneously.
• Each of these 2 sides has 2 chambers: a smaller upper chamber called the
atrium (together, the 2 are called atria), and a larger lower chamber called
the ventricle.
• Thus, the 4 chambers of the heart are called the right atrium, right ventricle,
This sequence also represents the direction of blood flow through the heart.
• The right atrium receives blood that has completed a tour around the body
and is depleted of oxygen and other nutrients. This blood returns via 2 large
veins: the superior vena cava returning blood from the head, neck, arms,
and upper portions of the chest, and the inferior vena cava returning blood
• The right atrium pumps this blood into the right ventricle, which, a fraction
of a second later, pumps the blood into the blood vessels of the lungs.
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
• The lungs serve 2 functions: to oxygenate the blood by exposing it to the air
you breathe in (which is 20% oxygen), and to eliminate the carbon dioxide
that has accumulated in the blood as a result of the body's many metabolic
functions.
• Having passed through the lungs, the blood enters the left atrium, which
• The left ventricle then pumps the blood back into the circulatory system of
blood vessels (arteries and veins). The blood leaves the left ventricle via the
aorta, the largest artery in the body. Because the left ventricle has to exert
enough pressure to keep the blood moving throughout all the blood vessels
ventricle that gets measured when you have your blood pressure checked.
The heart, like all tissues in the body, requires oxygen to function. Indeed, it is the
only muscle in the body that never rests. Thus, the heart has reserved for itself its
• This blood flows to the heart muscle through a group of arteries that begins
less than one-half inch from where the aorta begins. These are known as the
coronary arteries. These arteries deliver oxygen to both the heart muscle
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
artery gets interrupted, then the part of the heart muscle supplied by that
artery begins to die. This is called coronary heart disease, or coronary artery
disease. If this condition is not stopped, the heart itself starts to lose its
• When the interruption of coronary blood flow lasts only a few minutes, the
symptoms are called angina, and there is no permanent damage to the heart.
When the interruption lasts longer, that part of the heart muscle dies. This is
Nerves of the heart: The heart's function is so important to the body that it has its
own electrical system to keep it running independently of the rest of the body's
nervous system.
• Even in cases of severe brain damage, the heart often beats normally.
contract with perfectly synchronized timing much like the distributor and
spark plugs of a car make sure that an engine's pistons fire in the right
sequence.
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
• The ECG records this electrical activity and depicts it as a series of graph-
like tracings, or waves. The shapes and frequencies of these tracings reveal
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
Basics of ECG
ECG Electrodes
Skin Preparation:
Clean with an alcohol wipe if necessary. If the patients are very hairy – shave the
electrode areas.
Lead I: is between the right arm and left arm electrodes, the left arm being positive.
Lead II: is between the right arm and left leg electrodes, the left leg being positive.
Lead III: is between the left arm and left leg electrodes, the left leg
V6: Level with V5 at left midaxillary line. (Directly under the midpoint of the armpit)
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
The ECG records the electrical activity that results when the heart muscle cells in the
• The third and last common wave in an ECG is the T wave. This is the electrical
activity produced when the ventricles are recharging for the next contraction
(repolarizing).
• Interestingly, the letters P, Q, R, S, and T are not abbreviations for any actual
words but were chosen many years ago for their position in the middle of the
alphabet.
• The electrical activity results in P, QRS, and T waves that are of different sizes
and shapes. When viewed from different leads, these waves can show a wide
range of abnormalities of both the electrical conduction system and the muscle
ECG Interpretation
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
The graph paper that the ECG records on is standardised to run at 25mm/second, and is
marked at 1 second intervals on the top and bottom. The horizontal axis correlates the
length of each electrical event with its duration in time. Each small block (defined by
lighter lines) on the horizontal axis represents 0.04 seconds. Five small blocks (shown by
P-Wave: represents atrial depolarization - the time necessary for an electrical impulse
from the sinoatrial (SA) node to spread throughout the atrial musculature.
seconds
P-R Interval: represents the time it takes an impulse to travel from the atria through the
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
• Location: Extends from the beginning of the P wave to the beginning of the QRS
complex
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
Q-T Interval: represents the time necessary for ventricular depolarization and
repolarization.
• Location: Extends from the beginning of the QRS complex to the end of the T
wave
T Wave: represents the repolarization of the ventricles. On rare occasions, a U wave can
be seen following the T wave. The U wave reflects the repolarization of the His-Purkinje
fibres.
Amplitude: 5mm or less in standard leads I, II, and III; 10mm or less in precordial
leads V1-V6.
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
S-T Segment: represents the end of the ventricular depolarization and the beginning of
ventricular repolarization.
• Location: Extends from the end of the S wave to the beginning of the T wave
During an MI, the ECG goes through a series of abnormalities. The initial abnormality is
called a hyperacute T wave. This is a T wave that is taller and more pointed than the
normal T wave.
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
Hyperacute T Wave
The abnormality lasts for a very short time, and then elevation of the ST segment occurs.
This is the hallmark abnormality of an acute MI. It occurs when the heart muscle is being
injured by a lack of blood flow and oxygen and is also called a current of injury.
An ECG can not only tell you if an MI is present but can also show the approximate
location of the heart attack, and often which artery is involved. When the ECG
abnormalities mentioned above occur, then the MI can be localized to a certain region of
Circuit Diagram
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
Design Considerations
TI's new ADS1298 provides eight channels of PGA plus separate 24-bit delta-sigma
ADCs, a Wilson center terminal, the augmented Goldberger terminals and their
amplifiers, provide for a full, standard 12-lead ECG integrated analog front end. The
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
Basic functions of an ECG machine include ECG waveform display, either through LCD
screen or printed paper media, and heart rhythm indication as well as simple user
interface through buttons. More features, such as patient record storage through
convenient media, wireless/wired transfer and 2D/3D display on large LCD screen with
touch screen capabilities, are required in more and more ECG products. Multiple levels
of diagnostic capabilities are also assisting doctors and people without specific ECG
trainings to understand ECG patterns and their indication of a certain heart condition.
After the ECG signal is captured and digitized, it will be sent for display and analysis,
• Measurement of the ECG signal gets challenging due to the presence of the large
DC offset and various interference signals. This potential can be up to 300mV for
from the power supplies, motion artifacts due to patient movement, radio
• Some of the 50Hz/60Hz common mode interference can be cancelled with a high-
noise common to both inputs. To further reject line power noise, the signal is
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
inverted and driven back into the patient through the right leg by an amplifier.
Only a few micro amps or less are required to achieve significant CMR
improvement and stay within the UL544 limit. In addition, 50/60Hz digital notch
• Optimizing the power consumption and the PCB area of the analog front end is
critical for portable ECG's. Due to technological advancements, there are now
no DC offset)
• When a low resolution (16 bit) ADC is used, the signal needs to be gained up
high resolution (24bit) sigma delta ADC is used, the signal needs a modest gain of
4 - 5x. Hence the second gain stage and the circuitry needed to eliminate the DC
offset can be removed. This leads to an overall reduction in area and cost. Also
the delta sigma approach preserves the entire frequency content of the signal and
• With a sequential approach the individual channels creating the leads of an ECG
are multiplexed to one ADC. This way there is a definite skew between adjacent
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
channels. With the simultaneous sampling approach, a dedicated ADC is used for
Working of ECG
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
The ECG works mostly by detecting and amplifying the tiny electrical changes on the
skin that are caused when the heart muscle "depolarises" during each heart beat. At rest,
each heart muscle cell has a charge across its outer wall, or cell membrane. Reducing this
charge towards zero is called de-polarisation, which activates the mechanisms in the cell
that cause it to contract. During each heartbeat a healthy heart will have an orderly
node, spreads out through the atrium, passes through "intrinsic conduction pathways" and
then spreads all over the ventricles. This is detected as tiny rises and falls in the voltage
between two electrodes placed either side of the heart which is displayed as a wavy line
either on a screen or on paper. This display indicates the overall rhythm of the heart and
Usually more than 2 electrodes are used and they can be combined into a number of pairs
(For example: Left arm (LA), right arm (RA) and left leg (LL) electrodes form the pairs:
LA+RA, LA+LL, RA+LL). The output from each pair is known as a lead. Each lead is
said to look at the heart from a different angle. Different types of ECGs can be referred to
by the number of leads that are recorded, for example 3-lead, 5-lead or 12-lead ECGs
(sometimes simply "a 12-lead"). A 12-lead ECG is one in which 12 different electrical
signals are recorded at approximately the same time and will often be used as a one-off
recording of an ECG, typically printed out as a paper copy. 3- and 5-lead ECGs tend to
There may, or may not be any permanent record of a 3- or 5-lead ECG depending on the
equipment used.
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
It is the best way to measure and diagnose abnormal rhythms of the heart, [2] particularly
abnormal rhythms caused by damage to the conductive tissue that carries electrical
infarction (MI), the ECG can identify if the heart muscle has been damaged in specific
areas, though not all areas of the heart are covered.[4] The ECG cannot reliably measure
nuclear medicine tests are used. It is possible to be in cardiac arrest with a normal ECG
Sunil Kumar
80405103010
Cardea Biomedical Labs New Delhi
Sunil Kumar
80405103010