Basics: Difference between revisions

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#Leads V7-V8-V9 can be used to diagnose a posteriorinfarct. It is means that after V6, leads are pkaced towards the back. See the chapter[[Ischemia]] for other ways of diagnosing posterior infarction.
#Leads V7-V8-V9 can be used to diagnose a posteriorinfarct. It is means that after V6, leads are pkaced towards the back. See the chapter[[Ischemia]] for other ways of diagnosing posterior infarction.


=Technical problems with the ECG=
=Technical problems=
==Lead reversals==
==Lead reversals==
[[Image:cableReversal1.png|thumb]]
[[Image:cableReversal1.png|thumb]]
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**reversal of leads aVR and aVF
**reversal of leads aVR and aVF


It is possible to distinguish lead reversal and[[wikipedia:Dextrocardia|dextrocardia]] to check the precordial leads. Dextrocardia will show an R wave inversion, wheras lead reversal will not.
It is possible to distinguish lead reversal and[[wikipedia:Dextrocardia|dextrocardia]] by watching the precordial leads. Dextrocardia will show an R wave inversion, wheras lead reversal will not.


==Disturbances==
==Artefacts==
[[Image:Noise_move.png|thumb| Storing doordat de patient beweegt]]
[[Image:Noise_move.png|thumb| Movement artefacts]]
[[Image:ECG_Parkinson.png|thumb| Toenemende storing bij een patiënt met Parkinson. Onderliggend sinusritme! (niet te zien op dit strookje)]]
[[Image:ECG_Parkinson.png|thumb| Increasing movement artefacts in a Parkinson patient. The patient was in sinus rhythm! (which doesn't show on this short recording)]]
[[Image:BaselineDrift.png|thumb| Basislijnzwaai. De versterker van het ECG apparaat moet 'het midden vinden'. Te zien direct na aansluiten van het apparaat en na electrische cardioversie.]]
[[Image:BaselineDrift.png|thumb| Baseline drift. The amplifier in the ECG machine has to re-find the 'mean'. This often occurs right after lead connection and after electric cardioversion.]]
[[Image:electric_noise_ecg.png|thumb| Storing door radiogolven van een electrisch apparaat. Eent typisch voorbeeld is TL verlichting die vaak storing geeft met een frequentie van 100 Hz. Niet te verwarren met boezemfibrilleren.]]
[[Image:electric_noise_ecg.png|thumb| Radiographic artefacts by a nearby electrical appliance. A typical example is a 100 Hz background distortion from fluorescent lights. Not to be confused with [[arrhythmias#atrial fibrillation|atrial fibrillation]].]]
[[Image:electric_noise_ecg2.jpg|thumb| Storing door invloed van buiten (ik weet niet wat voor apparaat). Het eigen ritme is regulair. Er staan 10 QRS complexen op dit ECG.]]
[[Image:electric_noise_ecg2.jpg|thumb| Another example of an artefact caused by an electrical appliance. The patients rhythm is regular. This strip shows 10 QRS complexes.]]


*Movement artefacts
Artefacts (disturbances) can have many causes. Common causes are:
*Movement  
*Electrical interference
*Electrical interference
*Wrong filter setting
 
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