Please meet outside Hippocrates room of DSO building. To get there, go to level 2 of MD9 and cross the link bridge between MD9 and the DSO building. DO NOT come through the main entrance of the DSO building building.
Assistant Professor TRAN Thai Lung Disease Research Laboratory Department of Physiology, MD9, level 4 National University of Singapore (phstt@nus.edu.sg) ( h tt@ d )
Objectives Objecti es
Understand the relationship between heart rate response and exercise intensity intensity. B able t d t Be bl to determine common ECG waves and i d intervals. Be able to calculate heart rate using ECG recordings. Experience placing leads for 12-lead ECG.
Assessment
Mini Quiz constitutes 5% of overall year mark
Exercise protocol used is dependent on purpose of the test and profile of test population. Clinical cases are done under medical supervision
Lab Activity 1:
H k Hook-up ECG leads t l d to monitor. Record heart rate at rest, exercise and recovery recovery.
Exercise 1
Calculation of Maximum Heart Rate (MHR)
MHR = 220 - Age %MHR = MHR
%MHR =
220 - Age
Age 20; Exercise HR at 75W = 95 b A 20 E i t bpm Example MHR = 220 20 = 200bpm 95 X 100% = 47.5% %MHR = 200
HR
( (
HR
X 100%
X 100%
Electrocardiogram = ECG
The ECG is a graphical representation of the hearts electrical activity.
QRS complex
Q S
Atrial At i l depolarization
Ventricle V ti l repolarization
Exercise 2
Calculation of Heart Rate from ECG tracings C l l ti fH tR t f t i
RR interval
1mV V 0.1mV
P Q S
P Q S
V Voltage (mV V)
0.04sec
Time (sec)
Speed of recording = 25 mm/sec (or 1mm/0.04sec)
300
Number of 5mm squares in an RR interval
Eg: if there are 2.5 (5mm) squares between 2 R waves, then the HR would be HR = 300/2.5 = 120bpm
Lab Activity 2: y
There are 12 such leads in a regular 12 lead ECG, each of which analyze a different plane of the heart and are therefore useful in diagnosing different conditions and localizing disease. BIPOLAR l d leads: Have a single (+) and a single (-) electrode between which electrical potentials are measured
TWO electrodes are used to record a lead
Three types of ECG leads: 1) Limb leads (Bipolar) 2) Augmented limb leads (Unipolar) 3) Chest leads (Unipolar)
UNIPOLAR leads: Have a single (+) electrode and uses a combination of the other electrodes to serve as a composite (-) electrode. Each lead records from a different angle (viewpoint) diff t l ( i i t) provides different view of the same cardiac activity
ONE electrode is used to record
RA
LA
RL
LL
Records the potential reaching one p g electrode (+) in comparison to the rest of the body
Leads: CHEST
These 6 chest l d may be Th h leads b visualized as lying in the HORIZONTAL plane (the plane cuts the body into top and bottom halves)
Leads V1 &V2 orient over the RIGHT side of the heart Leads V5 & V6 orient over the LEFT side of the heart Leads V3 &V4 orient over the INTERVENTRICULAR SEPTUM (the right and left branches course through the i t th interventricular septum) ti l t )
Each lead records from a different angle (viewpoint) provides different view of the same cardiac activity