7 stepwise approach in ECG interpretation using cardiac vector theory

Title : 7 stepwise approach in ECG interpretation using cardiac vector theory

Abstract:

Introduction: Electrocardiogram (ECG) interpretation plays an immense clinical role for the diagnosis of coronary heart disease. But its interpretation remains a challenging task for junior medical staffs. Einthoven applied vectors to discuss the cardiac electrical activity even before a century but he never gave a detailed explanation for the same. Many medical scientists attempted to solve this problem but unable to identify that vector and unable to give a detailed explanation using vector physics principle. Cardiac vector theory and its clinical utility for ECG interpretation was proposed and described in detail by Rajini Samuel (current author) in the previous research articles.

Objectives:

• To discuss the derivation and application of  cardiac vector Theory.
• To develop a 7 stepwise approach in ECG interpretation using cardiac vector theory to understand and interpret most of the common cardiac conditions.

Methods: The voltage recorded by the unipolar and bipolar limb lead electrodes are the vertices of an electrical equilateral triangle with Heart at the center of the electric field which it generates. The right arm, left arm and left leg are the extensions of its electrical field. The equilateral triangle can be converted into a circle. The deviation of cardiac vector and representation of resultant cardiac wave vector in the form of circles are applied using the vector physics principle. A stepwise approach in ECG interpretation using cardiac vector concept was formulated.

Results: Each cardiac wave (P, QRS, T) can be represented in the form of circles. Cardiac circles were constructed using MATLAB software using the well-known relationship between Bipolar and Unipolar Limb Leads. The cardiac vector theory helps to clearly analyse and correlate the changes in different ECG leads. The changes in the resultant cardiac vector in various clinical conditions were applied to interpret the ECG findings.

Conclusion: Cardiac Vector Theory serves as an efficient teaching tool for the understanding and interpretation of ECG interpretation. It may help the junior medical staffs   to overcome the arduous task of pattern memorization method. Coronary heart disease continues to remain as a major global burden. These 7 stepwise approaches in ECG interpretation using vector concepts may help in interpreting the ECG findings efficiently, easily and quickly resulting in saving innumerable heart patients.

Keywords: Stepwise Approach, ECG Interpretation, Cardiac Vector Theory.

Audience Take Away Notes:

• Derivation of Cardiac Vector Theory.
• Application of Cardiac Vector Theory.
• Vector Based Novel Approach to Interpret  the ECG findings.
• Development of  a 7 stepwise approach using cardiac vector theory for ECG interpretation.

Biography:

Dr. T Rajini Samuel did MBBS (2004 -2010) in Chengalpattu Government Medical College, Tamil Nadu, India. He worked in Venkateshwara Hospitals, Chennai for two years to complete his ECG research project. He had proposed cardiac vector theory and developed a Novel approach using vector concepts to understand and interpret abnormal ECG findings. He did M.D Biochemistry (2012-2015) in Sree Balaji Medical College and Hospitals, Chennai. He then focused his research on Arterial Blood Gas (ABG) interpretation. He is presently working as the Professor of Biochemistry in Shri Sathya Sai Medical College and Research Institute, Chennai. He had developed a novel pH based ABG interpretation method, constructed a novel four quadrant graphical tool for ABG interpretation and proposed a novel approach to identify and understand hidden and mixed acid base disorders. He had derived novel equations of motion for understanding and interpretation of the Ventilator Graphics. He had published 48 research articles, 3 books and one chapter. He had received High Flyers Global Achievers Award 2022 - The Best Medical Science Researcher, Atmanirbhar Bharath Award 2022 and Indian Achievers Award 2021 for Excellence in Innovation awarded by the Indian Achievers Forum.