UNIT-5

ELECTROCARDIOGRAM
ELECTROCARDIOGRAM

- It deals with the study of electrical activity of the heart muscles.

- potentials originated in the individual fibers of heart muscle are
added to produce the ECG waveform.

- Shape,time interval and amplitude of ECG give details of the

state of the heart.
-disturbances in the heart rhythm can be easily diagnosed using
electrocardiogram.
INFORMATION ON THE ECG

• Heart rate and measurements

• Speed ECG is recorded

• Voltage ECG is recorded

3
ECG wave
ECG wave
DURATION
0.12-0.22sec

0.07-0.1 sec

0.05-0.15 sec
 ECG WAVE

PR Interval is more than 0.22 sec

First degree-heart attacks

QR Interval is more than 0.1 sec

SEVERE heart attacks
 ECG lead configuration
• Surface electrodes are used with jelly as electrolyte between skin
and electrodes.
• Potentials generated in the heart are conducted to the body
surface.
• Potential distribution changes in a regular and complex manner
during each cardiac cycle.
• To record ECG,we must choose standardized electrode positions.

Three types:

1. Augmented unipolar limb leads 2. unipolar chest leads 3.Bipolar

leads
 ECG WAVE
• Heart has four chambers.

• Two top chambers –right atria

• Lower chambers-ventricles.

• Right atria-receives blood from veins and pumps into right

ventricle.
• right ventricle-pumps the blood into lungs where it is purified

and enters into left atria and then pumped into left ventricle .
PROCESS
 
LIMB LEADS

• Bipolar leads
I II III

• Augment
leads
Avr Avl Avf

10
 ECG lead configuration
1.Augmented unipolar limb leads :

- ECG is recorder between a single exploratory electrode and the central terminal which

has a potential corresponding to centre of the body.

-Exploring electrodes is placed on the body surface of any one of the positions at

Augmented voltage Right arm(RA or VR) or Augmented voltage left arm (LA or VL)

or Augmented voltage foot.

-Two equal large resistors are connected to a pair of limb electrodes and the centre of

their resistive network act as a central terminal and the remaining limb electrode act

as exploratory electrode.

-Using unipolar lead connections, a small increase in the ECG voltage can be realized.
 ECG lead configuration
2.Unipolar chest leads:

-Exploring electrode on chest is called percordial leads.

-Chest electrodes are placed on six different points on the chest closed to
the heart.

-Connecting three equal large resistances to the left arm, right arm and
left leg a reference electrode is obtained.
- Lead V1 and V2 – right ventricular activity (or) Right side of the heart

- Lead V5 and V6 – left ventricular activity (or) Left side of the heart
• Lead V3 and V4 - Intraventricular septum(seperates left and right
ventricle)
 CHEST LEADS
• 6 UNIPOLAR LEADS
• V1
• V2
• V3
• V4
• V5
• V6

13
ECG lead configuration

Fig: Placement of chest leads

 ECG lead configuration
3.Bipolar leads

-Leads are connected to right arm(VR) ,left arm(VL),left leg(VF)

and right leg.

-Lead 1- gives voltage V1 ,voltage drop between left arm to right

arm.

-Lead 2- gives voltage V2 ,voltage drop between left leg to right

arm.

-Lead 3- gives voltage V3 ,voltage drop between left leg to left

arm
 ECG lead configuration
From different leads R wave amplitude is given by

Lead 1 –V1 0.53 mV.

Lead 2 –V2 0.71 mV.

Lead 3 –V3 0.38 mV.

-ECG are recorded from these 12 lead selections( 3
from bipolar leads,3 from augmented unipolar leads
and 6 chest leads).
 ECG Recording set up
The main parts of ECG recorder are

1.Patient cable

2. Defibrillator protection circuit

3.ECG Recorder switch

4.Calibrator

5.Pre-amplifier or Bio –amplifier

6.Output unit
7.Power switch
ECG Recording set up
 ECG Recording set up
1.Patient cable:

- It connects the different leads from the limbs and chest to the
defibrillator protection circuit.

2. Defibrillator protection circuit

- It consists of buffer amplifiers and overvoltage protection circuit.

- Leads are connected with the buffer amplifiers such that one
buffer amplifier for each patient lead.

-it provides proper matching impedance between the electrode and

ECG recorder switch.
 ECG Recording set up

2. Defibrillator protection circuit

- Overvoltage protection circuit is necessary to avoid any damage to pre-

amplifiers in the recorder.

-Overvoltage of the order of 1000v may occur when ECG is used during

surgery for cutting and coagulation or during the treatment of ventricular

fibrillation using defibrillators..

-It consists of resistors, capacitors and neon lamps.

-When a pulse from defibrillator is present, neon lamps gets fired during

this condition there is no input to the pre-amplifier of the recorder.

-Capacitors c1,c2,c3,c4 are used for high frequency grounding.

 ECG Recording set up

3.ECG Recorder switch

-It is used to feed the input voltage from appropriate

electrode to the preamplifier.

-Pen control circuit is coupled with ECG recorder

switch and for each position of the recorder switch
the pen is deflected from its original position to
make available more than one channels.
 ECG Recording set up

4. Calibrator
- It allows standardization voltage of 1 mV to
the pre-amplifier.
- This enables the technician to observe the
output on the display unit and adjust the scale
so that a known deflection corresponds to
1mV input signal.
 ECG Recording set up

5.Pre-amplifier or Bio –amplifier

-Pre-amplifier is a AC coupled differential amplifier

with high common mode rejection ratio (CMRR) to
eliminate the DC common mode signal.

-The gain of the amplifier is changed by a switch.

 ECG Recording set up
6.Output unit

-Output unit is a paper chart recorder.

-Pen amplifier supplies the required power to drive pen

motor.

-Pen motor records the ECG trace on wax coated heat

sensitive paper.

-Position control on the pen amplifier is used to

position the pen at the centre on the recording paper.
 ECG Recording set up
6.Output unit

-Stylus pen is heated electrically and the temperature of

the stylus pen can be adjusted with stylus heat control.

-Stylus marker which is controlled by a push button and

allow the technician to mark a coded indication of the
lead being recorded.

-Paper speed varies from 20 mm/sec to 50mm/sec.

-Faster speed provide better resolution of QRS complex

wave at very high rates.
 ECG Recording set up
7.Power switch

-Power switch of the recorder has three positions.

-In ON position the power to the amplifier is turned on

but motor drive does not get supply.

-In RUN position the motor drive is on and the paper

moves.

-The 1 mv standard switch in ECG recorder supplies a

standard voltage for positioning of the pen of the paper.
 ECG Recording set up
ECG recorders are of different types.

-single channel or three channel recorders are used.

-Lead selection and switching between leads is

much easier with the introduction of computer
processing of electro-cardiograms.

- Computer processing provides more leads to be

monitored at same time.
 X -RAY INSTRUMENTATION
X-rays –electromagnetic waves widely used in
medicine field and industries for operation for
inspection of human body or anything.

Production of X-Rays.
 X -RAY INSTRUMENTATION
Production of X-Rays

-It can be produced with the help of high vacuum tube with a heater,
cathode and anode.

-Vacuum tube operate at high voltage.

-Heater is on, very high anode and cathode voltage is applied the electrons
emits from cathode and travel towards anode with high velocity.

-Beam of electrons strike the metal anode.

- These x-rays seem to bounce outside to well of the tube.

 X -RAY INSTRUMENTATION
The basic components of X-Ray machine are

1.High voltage source & H.V Transformer

2.High voltage rectifier

3.X-Ray tube

4.Aluminium filters

5.Collimator

6.Bucky grid
X -RAY INSTRUMENTATION
 X -RAY INSTRUMENTATION
• Various components are used to improve the quality
of the image, increase the contrast between different
tissues, improve size resolution and minimize the
dose of x-rays used on the patient.
• X-ray image is created with high density, high
contrast and high sharpness on flim.
• Density or darkness - of the image is proportional to
amount of x-rays that penetrate the flim.
 X -RAY INSTRUMENTATION

• Contrast is a measure of the darkness of a desired

image compared to its surroundings.
• Sharpness or clarity of the image is reduced due to
distortions in x-ray beam as it passes from x-ray tube

to the patient.
 X -RAY INSTRUMENTATION
1.High voltage source & H.V Transformer
- High voltage source-responsible for providing high voltage to H.V

transformer for a decided time.

- Timer which controls the exposure time (the amount of light per unit
area reaching a photographic film) so that the patient does not
receive an excessive dose.
- Further the exposure time should be limited to avoid the overheat of the
X-ray tube and to avoid overexposure in the film.
-H.V Transformer produces high voltages 20 to 200 KV in the X-ray machine.

-These voltages are used to determine the contrast of the image.

 X -RAY INSTRUMENTATION

1.High voltage source

- TO avoid overheating of the tube there is a
temperature monitor. If it exceeds a specified value,
the high voltage supply will be turned off
automatically.
- Another high voltage transformer is used to step up
the voltage further.
 X -RAY INSTRUMENTATION
2.High Voltage Rectifier
• X-ray tube requires a high d.c. voltage, due to practical

difficulties a high d.c. voltage with small a.c. ripples is used.

• Figure shows the full-wave rectifier which gives almost

constant beam current with a limited a.c. ripple. But it is not

suited because it cannot handle power in an efficient manner.

• A much better power output is provided by three phase

rectifiers in which the voltage does not drop between the half

cycles.
 X -RAY INSTRUMENTATION

2.High Voltage Rectifier

- A three phase rectifier provides better rectification with

14% ripple. A three phase supply consists of 3 separate
single phase voltages which are one third of a cycle out of
phase with respect to each other.

- Rectifies the high voltage produced by H.V.T and supplies

them to the anode of the x-ray tube.
 X -RAY INSTRUMENTATION
3.POWER SUPPLU UNIT

• Figure 7.22 shows the high voltage power supply

arrangements in the X-ray machine.

• The mains voltage is stepped up by high voltage transformer

which is normally an auto-transformer.

• The kV control gives the necessary input to the X-ray tube to

produce the required wavelength of X-rays.

• There is a contractor linked with the timer. This arrangements

is used to deliver the X-ray output in the required time

 X -RAY INSTRUMENTATION
• After that it is given to another high voltage transformer

followed by the high voltage rectifier. Its output is applied

across the anode and cathode of the X-ray tube.

• There is also another circuit, with mA control and tube

filament transformer, drawn from the auto-transformer at the

entrance end. This will provide the necessary current for the

filament of the cathode.

X -RAY INSTRUMENTATION
 X -RAY INSTRUMENTATION
THERMAL OVERLOAD DETECTOR

-Heat of the x-ray tube (should not be increased by

specific range).

-If heat is exceed from a specified value, then thermal

overload detector is used to turn of the system.

ROTOR CONTROL

-X-Ray tube is rotated by induction motor and helps to

cool the anode.
 X -RAY INSTRUMENTATION

4.Aluminum Filters
• The emitted X-ray contain a broad range of frequencies.

• The unwanted frequencies in the X-ray abased creates side

effects such as increase the patient dose and decrease the
image contrast.
• To eliminate this aluminum filters is used.

• Further aluminum filters confine the X-rays to the region of

interest on the body along with the collimator.
X -RAY INSTRUMENTATION
 X -RAY INSTRUMENTATION
5.Collimator
• Between the patient and aluminum the collimator is placed.

• It is an aperture diaphragm which restricts the beam falling on the patient. The

necessary shaping of the X-ray beam is done by it.

• It consists of a shutter made form a heavy metal like lead with a rectangular or

circular hole of suitable size or of four adjustable lead strips which can be moved

relative to each other.

• A lamp and reflective mirror make a visible pattern on the patient so that the medical

attendant can tell where the X-rays will strike and this arrangement is used to align

or positioning the beam on the patient.

 X -RAY INSTRUMENTATION
6.Bucky Grid or Diaphragm

-To reduce scattered radiation, which may produce poor sharpness

in the image, it is important to compress the region of the patient

being examined.

- Bucky grid is introduced between the patient and the film cassette

to improve the sharpness of image.

- To absorb the scattered X-ray and eliminate the burning of an

image a lead grid is used called diaphragm.

 X -RAY INSTRUMENTATION
7.Lead shield

-x-rays passed from the desired region of the patient body are

made to strike on the flim where they produce an image of

the body .

-Lead shield is used to collect the X-Rays after striking on flim.

-Finally produced image of the body is examined in laboratory.

X -RAY INSTRUMENTATION