Experiment No: Aim of the experiment: To study the Acquisition of Limb Lead ECG Requirements: Limb Lead ECG electrodes, connecting cables, ECG acquisition system, Power Supply, PC or Laptop, Cleaning solution, cotton. Theory: An electrocardiograph is a graph recorded by electric potential changes occurring between electrodes placed on a patient's torso to demonstrate cardiac activity. An ECG signal tracks heart rhythm and many cardiac diseases, such as poor blood flow to the heart and structural abnormalities. The action potential created by contractions of the heart wall spreads electrical currents from the heart throughout the body. The spreading electrical currents create different potentials at points in the body, which can be sensed by electrodes placed on the skin. The electrodes are biological transducers made of metals and salts. In practice, 10 electrodes are attached to different points on the body. There is a standard procedure for acquiring and analyzing ECG signals. A typical ECG wave of a healthy individual is as follows, The "P" wave corresponds to atrial contraction, and the "QRS" complex to the contraction of the ventricles. The "QRS' complex is much larger than the "P" wave due to the relative difference in muscle mass of the atria and ventricles, which masks the relaxation of the atria. The relaxation of the ventricles can be seen in the form of the "T" wave. There are three main leads responsible for measuring the electrical potential difference between arms and legs, as shown in Figure 2. In this demonstration, one of the limb leads, lead I, will be examined, and the electrical potential difference between two arms will be recorded. As in all ECG lead measurements, the electrode connected to the right leg is considered the ground node. An ECG signal will be acquired using a biopotential amplifier and then displayed using instrumentation software, where a gain control will be created to adjust its amplitude. Finally, the recorded ECG will be analyzed. The electrocardiograph must be able to detect not only extremely weak signals ranging from 0.5 mV to 5.0 mV, but also a DC component of up to ±300 mV (resulting from the electrode-skin contact) and a common-mode component of up to 1.5 V, which results from the potential between the electrodes and the ground. The useful bandwidth of an ECG signal depends on the application and can range from 0.5-100 Hz, sometimes reaching up to 1 kHz. It is generally around 1 mV peak-to-peak in the presence of much larger external high frequency noise, 50 or 60 Hz interference, and DC electrode offset potential. Other sources of noise include movement that affects the skin-electrode interface, muscle contractions or electromyographic spikes, respiration (which may be rhythmic or sporadic), electromagnetic interference (EMI), and noise from other electronic devices that couple into the input. Einthoven's Triangle Einthoven's triangle is a theoretical equilateral triangle that is used to represent the electrical activity of the heart in a three-lead ECG acquisition system. It is named after Willem Einthoven, who theorized its existence. The triangle is formed by the three limb leads of an ECG machine: Lead I, Lead II, and Lead III. The heart is located at the center of Einthoven's triangle, Figure 3. The electrical activity of the heart is represented by the voltage difference between the two electrodes in each lead. The voltage difference is measured in millivolts (mV). DEPARTMENT OF BIOMEDICAL ENGINEERING NATIONAL INSTITUTE OF TECHNOLOGY, RAIPUR BASIC BIOMEDICAL ENGINEERING LABORATORY (1st SEMESTER)
Figure 1: ECG waveform
Figure 2: ECG Limb Leads
Figure 3: Einthoven’s Triangle
DEPARTMENT OF BIOMEDICAL ENGINEERING NATIONAL INSTITUTE OF TECHNOLOGY, RAIPUR BASIC BIOMEDICAL ENGINEERING LABORATORY (1st SEMESTER)
The three leads provide different views of the electrical activity of the heart. Lead I provides a view of the heart from the left side, Lead II provides a view of the heart from the inferior side, and Lead III provides a view of the heart from the right side. The electrical axis of the heart is a measure of the direction of the heart's electrical activity. The electrical axis is calculated by using the three limb leads. The normal electrical axis is between 0° and 90°. An abnormal electrical axis can be a sign of a heart condition, such as a heart attack or a heart defect. In the explanation of three-lead ECG acquisition system, Einthoven's triangle is used to explain how the three limb leads are positioned on the body. The positive electrode of Lead I is placed on the left arm, the negative electrode of Lead I is placed on the right arm, the positive electrode of Lead II is placed on the left arm, and the negative electrode of Lead II is placed on the left leg. The positive electrode of Lead III is placed on the right arm, and the negative electrode of Lead III is placed on the left leg, Table 1. Einthoven's triangle is a useful tool for understanding the electrical activity of the heart. It is used by cardiologists and other healthcare professionals to diagnose and monitor heart conditions. Table 1: Leads and placement of electrode
Lead Positive Electrode Negative Electrode
I Left Arm (LA) Right Arm (RA)
II Left Leg (LL) Right Arm (RA) III Left Leg (LL) Left Arm (LA)
Procedure
This basic setup can provide useful information about the heart's rhythm and rate. Here's a step-by-step procedure for acquiring an ECG signal through a three-lead ECG system:
1. Gather Equipment
- ECG machine or monitor
- Electrodes (three disposable electrodes with adhesive)
2. Prepare the subject
- Explain the procedure to the patient and ensure they are comfortable and relaxed. - Ensure that the patient's chest is bare and free of any lotions or oils that might interfere with electrode adhesion.
3. Place Electrodes
- Attach the three electrodes to specific locations on the patient's body:
Lead I: Place one electrode on the right arm (RA) and another on the left arm (LA). Lead II: Keep the electrode on the right arm (RA) and place the second electrode on the left leg (LL). Lead III: Position one electrode on the left arm (LA) and the other on the left leg (LL). DEPARTMENT OF BIOMEDICAL ENGINEERING NATIONAL INSTITUTE OF TECHNOLOGY, RAIPUR BASIC BIOMEDICAL ENGINEERING LABORATORY (1st SEMESTER)
Block Diagram
Figure 4 Block Diagram of ECG Aquisition
Expected outcome
Final Outcome DEPARTMENT OF BIOMEDICAL ENGINEERING NATIONAL INSTITUTE OF TECHNOLOGY, RAIPUR BASIC BIOMEDICAL ENGINEERING LABORATORY (1st SEMESTER)
4. Connect Electrodes to ECG Machine
- Connect the electrodes to the appropriate connectors on the ECG machine. There are typically color- coded connectors to match the color of the lead cables.
5. Start Recording:
- Power on the ECG Acquisition system and select the appropriate settings for a three-lead recording. - Ensure that the machine is connected to computer properly.
6. Verify Signal Quality, The setup should display a live waveform for each lead. Verify that the signals are clear and free of interference.
7. Record ECG
- Initiate the recording on computer using appropriate software (biopac).
- Allow the machine to capture a sufficient amount of heartbeats to analyze the heart's electrical activity.
8. Review and Interpret
- After recording, review the ECG waveform on the screen or printout.
- Analyze the waveforms for abnormalities, including the P wave, QRS complex, and T wave patterns.
9. Document and Report, if necessary, document any findings and observations related to the ECG waveform.
10. Gently remove, the electrodes from the subject’s skin, taking care not to cause discomfort or skin irritation.
11. Clean Up, Properly dispose of the used electrodes and any other disposable materials.
Inference:
1. Rhythm Analysis - Compare the P waves, QRS complexes, and T waves in each lead. - Determine if the timing and morphology of these components are consistent across the leads. - Look for regularity or irregularity in the intervals between successive heartbeats.
2. Heart Rate - Calculate the heart rate based on the number of QRS complexes in a specific time period (e.g., one minute). - The heart rate is an important indicator of the heart's overall functioning.
3. Axis Deviation - Analyze the relationship between Lead I, Lead II, and Lead III to assess whether there are any deviations from normal axis orientation. - This information can provide insight into possible heart chamber enlargement or other structural issues.
