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In 1905 Einthoven recorded the first 'telecardiogram' from the hospital to his laboratoy 1.5 km away. | In 1905 Einthoven recorded the first 'telecardiogram' from the hospital to his laboratoy 1.5 km away. | ||
In 1906 | In 1906 Einthoven published the first article in which he described a series of abnormal ECGs: left- and right bundlebranchblock, left- and right atrialdilatation, the U wave, notching of the QRS complex, ventricular extrasystoles, bigemini, atrialflutter and total AV block. ''Einthoven W. Le telecardiogramme. Arch Int de Physiol 1906;4:132-164'' | ||
{{clr}} | {{clr}} | ||
=The ECG electrodes= | =The ECG electrodes= | ||
[[Image:ECGelectrodes.jpg|thumb|click on the Image for an enlargement]] | [[Image:ECGelectrodes.jpg|thumb|click on the Image for an enlargement]] | ||
Electric activity | Electric activity going through the heart, can be measured by external (skin)electrodes. The electrocardiogram (ECG) registers these activities from these electrodes which have been attached on diffrent places on the body. In total, twelve leads are calculated using ten electrodes. | ||
The ten electrodes are: | The ten electrodes are: | ||
Line 110: | Line 110: | ||
** N - neutral, on the right leg (= electrisch aarde of nulpunt ten opzichte waarvan de electrische spanning wordt gemeten) | ** N - neutral, on the right leg (= electrisch aarde of nulpunt ten opzichte waarvan de electrische spanning wordt gemeten) | ||
** F - foot, on the left leg | ** F - foot, on the left leg | ||
It makes no | It makes no difference whether the electrodes are attached proximal or distal on the extremities. ''However'', it is best to be uniform in this. (eg. do not attach an electrode on the left shoulder and one on the right wrist). | ||
* '''the chest leads:''' | * '''the chest leads:''' | ||
** V1 - | ** V1 - placed in the 4th intercostal space, right of the sternum | ||
** V2 - | ** V2 - placed in the 4th intercostal space, left of the sternum | ||
** V3 - | ** V3 - placed between V2 and V4 | ||
** V4 - | ** V4 - placed 5th intercostal space in the nippleline | ||
** V5 - | ** V5 - placed between V4 ann V6 | ||
** V6 - | ** V6 - placed in the axillar line on the same height as V4 | ||
{{clr}} | {{clr}} | ||
Using these 10 electrodes, 12 leads can be derived. There are 6 extremity leads and 6 precordial leads. | |||
==The extremity leads== | ==The extremity leads== | ||
[[Image:ECGafleidingen.jpg|thumb]] | [[Image:ECGafleidingen.jpg|thumb]] | ||
The extremity leads are: | |||
*'''I''' | *'''I''' from the right ot the left arm | ||
*'''II''' | *'''II''' from the right arm to the left leg | ||
*'''III''' | *'''III''' from the left arm to the left leg | ||
An easy rule to remember: lead '''I''' + lead '''III''' = lead '''II''' | |||
Hierbij wordt gebruik gemaakt van de hoogten en/of diepten, onafhankelijk van de golf (QRS, P of T). | Hierbij wordt gebruik gemaakt van de hoogten en/of diepten, onafhankelijk van de golf (QRS, P of T). | ||
Voorbeeld: is in Afleiding I het QRS complex 3mm hoog, in Afleiding III 9mm, dan zal de hoogte van het QRS-complex in afleiding II 12mm bedragen. | Voorbeeld: is in Afleiding I het QRS complex 3mm hoog, in Afleiding III 9mm, dan zal de hoogte van het QRS-complex in afleiding II 12mm bedragen. |