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HIS Bundle ECG: Procedure, Waves, Intervals, and More

Learn about HIS bundle ECG, including definition, procedure, waves (A wave, H wave, V wave), intervals (PA interval, AH interval, HV interval), and common heart blocks and arrhythmias. Explore details on Hexaxial reference system, electrical axis of the heart, and myocardial infarction types.

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HIS Bundle ECG: Procedure, Waves, Intervals, and More

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  1. HIS Bundle ECG (HBE) • Definition – • Procedure – • Waves – A wave H wave V wave • Intervals – PA interval AH interval HV interval

  2. R P T Q S A H Contd: PA AH HV HIS bundle ECG V

  3. Standard lead triaxial reference system: I I III II III II 60

  4. Unipolar lead triaxial reference system: aVL aVL aVR aVR I III II aVF aVF 60

  5. F II III aVL aVR R 90 60 120 I 30 I 150 0 L 180 150 30 III II aVF 120 60 90 Hexaxial reference(Superimposed triaxial)system:

  6. 15 10 5 + 14 mm 0 15 10 mm 5 + 10 mm 0 -5 ELECTRICAL AXIS OF HEART: + 14 Lead I - 0 mm Lead III + 14 - 04

  7. III I I 550 III Contd: 14 mm 00 10 mm

  8. Heart blocks: 1st degree PR-0.38s P P 2nd degree(2:1) P P P P Missed ‘V’ beat 2nddegree(Wenkebachphenomenon)

  9. Contd: Left bundle branch block: QRS – prolonged & deformed

  10. QRS QRS QRS Contd: Complete Heart block: Atrial rate: 107/min Ventricular rate:43/min P P P P P P P P P

  11. Reentry Normal Circus movement Block (transient)

  12. Arrhythmias: ‘A’ extrasystole ‘A’ tachycardia ‘A’ flutter (200-350/min) ‘A’ fibrillation (300-500/min)

  13. Normal Wolf-Parkinson-White syndrome Lown-Ganong-Levine syndrome

  14. ‘V’ tachycardia ‘V’ fibrillation

  15. Myocardial infarction: 1) Transmural – a) ST elevation – I, aVL, V3 to V6 b) Q wave –I, aVL & V5 to V6 c) T wave inversion 2) Subendocardial – ST depression – II, III & aVF

  16. Myocardial Infarction

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