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Basics: Difference between revisions
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→The electric discharge of the heart
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| caption1 = A patient with atrial fibrillation with a 'Lewis Lead' | | caption1 = A patient with atrial fibrillation with a 'Lewis Lead' positioning of the leads. Compared with the normal lead configuration, the atrial signal is enlarged. Although some parts have a 'sawtooth' appearance consistent with atrial flutter, the rhythm is atrial fibrillation as there is a changing pattern in the atrial activity. | ||
| image2 = E000557.jpg | | image2 = E000557.jpg | ||
| caption2 = The same patient with a normal lead configuration | | caption2 = The same patient with a normal lead configuration. The rhythm is atrial fibrillation. The atrial activity in lead V1 is organized probably due to a organisation of electrical activity after it enters the right atrial appendage, close to lead V1. | ||
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Throughout history extra lead positions have been tried. Most are rarely used in practice, but they can deliver very valuable diagnostic clues in specific cases. | Throughout history extra lead positions have been tried. Most are rarely used in practice, but they can deliver very valuable diagnostic clues in specific cases. | ||
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*Leads to improve detection of '''atrial | *Leads to improve detection of '''atrial rhythm''': | ||
::In wide complex tachycardia, good detection of atrial rhythm and atrio-ventricular dissociation can be very helpful in the diagnosis process. An esophagal ECG electrode placed close to the atria can be helpful. Another, less invasive, method is the '''Lewis Lead'''. This is recorded by changing the limb electrodes, placing the right arm electrode in the second intercostal space and the left arm electrode in the fourth intercostal space, both to the right of the sternum. Furthermore gain is increased to 20mm/mV and paper speed to 50mm/sec.<cite>Lewis1</cite>ß | ::In wide complex tachycardia, good detection of atrial rhythm and atrio-ventricular dissociation can be very helpful in the diagnosis process. An esophagal ECG electrode placed close to the atria can be helpful. Another, less invasive, method is the '''Lewis Lead'''. This is recorded by changing the limb electrodes, placing the right arm electrode in the second intercostal space and the left arm electrode in the fourth intercostal space, both to the right of the sternum. Furthermore gain is increased to 20mm/mV and paper speed to 50mm/sec.<cite>Lewis1</cite>ß | ||