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Wiggers diagram with mechanical (echo), electrical (ECG), and aortic pressure (catheter) waveforms, together with an in-ear dynamic pressure waveform measured using a novel infrasonic hemodynography technology, for a patient with severe aortic stenosis.
Schematic representation of a normal sinus rhythm EKG wave. In electrocardiography, the PR interval is the period, measured in milliseconds, that extends from the beginning of the P wave (the onset of atrial depolarization) until the beginning of the QRS complex (the onset of ventricular depolarization); it is normally between 120 and 200 ms in duration.
ECG would be abnormal in 75 to 95% of the patients. Characteristic ECG changes would be large QRS complex associated with giant T wave inversion [4] in lateral leads I, aVL, V5, and V6, together with ST segment depression in left ventricular thickening. For right ventricular thickening, T waves are inverted from V2 to V3 leads.
The QRS complex is the combination of three of the graphical deflections seen on a typical electrocardiogram (ECG or EKG). It is usually the central and most visually obvious part of the tracing. It corresponds to the depolarization of the right and left ventricles of the heart and contraction of the large ventricular muscles.
The ECG will show a terminal R wave in lead V1 and a slurred S wave in lead I. Left bundle branch block widens the entire QRS, and in most cases shifts the heart's electrical axis to the left. The ECG will show a QS or rS complex in lead V1 and a monophasic R wave in lead I.
ECG beat. The Pan–Tompkins algorithm [1] is commonly used to detect QRS complexes in electrocardiographic signals ().The QRS complex represents the ventricular depolarization and the main spike visible in an ECG signal (see figure).
The SA is the angle of deviation between two vectors; the spatial QRS-axis representing all of the electrical forces produced by ventricular depolarization and the spatial T-axis representing all the electrical forces produced by ventricular repolarization. [8]
Exceptions to this include complete heart block and certain ventricular artificial pacemaker rhythms, where the P waves may be completely normal in shape, but ventricular depolarization bears no relation to them; in these cases, the speed of the "sinus rhythm of the atria" and the speed of the ventricular rhythm must be calculated separately. [2]
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