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Serira Soltani (40124404) Group member: Elyse Benest (40093471) EXCI 259 Group 1, Tuesday Lab 1: Electrocardiography Analysis Lab 1 Homework Measuring the values on the ECG: This would often be done on second lead of the 6 lead ECG, because most of the times lead 2 has the largest upward (positive) deflections. Using the 5-step analysis for detecting arrhythmias: Step 1) Determining the R wave rhythm: In order to regulate the R wave, the distance between every two R wave is measured (in millimeters) in the designated 6 second duration. In my ECG, I got 7 R wave intervals in a 6 second duration. The average of all 7 values were calculated and converted in milliseconds unit. On my ECG, this value (the average of R-R intervals) is 762.86 milliseconds. In order to determine whether the values are within the normal range, each of the values should be between 642.86 milliseconds and 882.86 milliseconds. (the average-120= 642.86, and the average+120= 882.86). The majority of my values were within that range, except for one which was 900 milliseconds. However, this doesn’t necessarily indicate a cardiac malfunction, because

of a breathing artefact that is known to exist and affect the R wave rhythm, named “accordion effect”. This artefact is seen in 40 percent of population, and simply states that taking a deep breath in, will result in increase of R-R interval; and breathing out results in decrease of interval. Step 2) calculation the heart rate: Measuring the heart rate is basically measuring the sinus rhythms, which is the heart contractions driven by the SA node. The normal range of heart rate would be between 60 to 100 bpm (beats per minute). However, athletes (especially the ones that do a lot of endurance training) might have a lower rate. (about 55 bpm). any abnormality in the heart rate, would indicate SA node arrhythmia. If the heart rate of an individual (who is not an athlete) is lower than the normal range (less than 60 bpm), it would be considered bradycardia. While if that individual’s value is higher than the normal range (higher than 100 pm), it would be considered tachycardia. According to my average R-R interval form step one, my heart rate is about 76 bpm which falls into the normal range. Step 3) P wave consistency: For assessing the P wave, there are 4 main components that should be checked: the size, direction, position of the P wave through the ECG, and whether the P wave is followed by a QRS complex or not. (if there is not a QRS following each P wave, it indicates abnormality).

Also, on each lead, the P wave and the R wave must have the same direction in ordered to be considered normal. Abnormality in size and direction of the P waves is a sign of atrial arrhythmia, which could be cause by either an ectopic or a wandering pacemaker in the heart. In my ECG, P waves follow all the regulations to be classified as normal. Step 4) P-R interval: For assessing a P-R interval duration, the distance between the beginning of P wave up to the beginning of the Q wave right after should be measured and turned into milliseconds. If the Q wave isn’t present, the distance can be measured up to the beginning of the next R wave. The average of all P-R intervals measured in that 6 second time frame should be between 120 milliseconds and 200 milliseconds. Otherwise, it would be considered abnormal which could be due to AV node arrhythmia. My value for this is about 126, which shows that I fall into the normal range and I don’t have AV node arrhythmia. Step 5) QRS complex duration: The QRS duration is measured by the distance (millimeters) between the start point and end point of QRS complex (beginning of Q wave up to the end of the following S wave. The end point of S wave is also known as J point.) This distance should be converted into milliseconds, and averaged. The average value should not be greater than 120 milliseconds. If the value exceeds 120 milliseconds, the QRS complex duration is

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