Description of ECG

We describe the standard twelve-lead ECG according to the so-called ECG of ten. We systematically measure the individual parameters of the ECG recording. From the values obtained in this way, a relatively accurate diagnosis can be determined, i.e. whether it is a o pathology of the electrical activity of the heart, or a o physiological finding. It is important to always clarify the units and their ratio in the ECG recording before measuring ! This can be determined from the so-called standard, which is equal to 1 mV, and   speed of the paper advance. Usually 1 mm on the  y- axis is equal to 0,1 mV. At a displacement of 25 mm/s, 1 mm on the  x-axis is equal to 0.04 s, at a displacement of 50 mm/s, 1 mm = 0.02 s.

Summary of ECG ten
By following a uniform and clear procedure confusion and  mistakes can be avoided even during a later inspection. Therefore, we immediately compare the measured values with the physiologigal ones, and we will visibly mark the pathologies found (to faciliate orientation). In the  end, it is necessary to merge the data found and   establish a diagnosis only from them.
 * ECG ten:


 * 1) ,
 * 2) heart rhythm,
 * 3) heart rate,
 * 4) P vlna,
 * 5) PQ interval,
 * 6) QRS complex,
 * 7) ST section,
 * 8) T wave,
 * 9) QT interval,
 * 10) electrial cardiac axis.

Heart action
In the first point, we examine the regularity of heart action. We measure the distances between the selected point of the ventricular complex (most often the R wave) in each cycle in the entire ECG. We calculate the average from the measured values and  measure the same distances again.


 * if the difference between the RR distances and the average is less than 0.16 s, we mark the action as regular = within the norm,
 * if this is not the case, we mark the action as irregular = pathology,
 * if there is only one extrasystole in the record and the other distances are normal, we write  the action is regular with one extrasystole.

Srdeční rytmus
Rytmus je určení místa, kde v srdci vzniká akční potenciál (řídící vzruch), který vede k depolarizaci komor. Sledujeme přítomnost vlny P a její vztah ke komorovému QRS komplexu.

Heart rhythm Rhythm is the determination of the place where an action potential (controlling impulse) arises in the heart, which leads to depolarization of the ventricles. We monitor the presence of the P wave and its relationship to the ventricular QRS complex.

Sinus rhythm

Physiologically the excitation originates in the sino-atrial node  (SA)  and then spreads to the ventricular musculature via the atria,  atrio-ventricular  (AV) and budle of His. This is reflected in the ECG recording by a P wave, which is: a) positive in leads I and II (the impulse spreads through the atria from right down to left), and b) the QRS comples is preceded by a P wave in aconstant PQ interval (the exception is the lenghtening PQ interval in the Wnkebach period - see there). The fulfillment of these condition is evidence that the depolarization of the ventricles is controlled from the sinus node and therefor the ECG recording shows a '''sinus rhythm. '''

If the rhythm originates outside the SA noe (atrial muscle, AV node, transmission system/ventricular muscle), it is always a pathology and we are talking about a  non-sinus rhythm, which can be determined more closely: