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:

T.Rajini Samuel did MBBS (2004 -2010) in Chengalpattu Government Medical College. He started doing research in Electrocardiogram (ECG) interpretation during his undergraduate studies. He worked for two years as a duty doctor in Venkateshwara Hospitals, Nandanam, Chennai to complete the ECG project. He had proposed the cardiac vector theory, developed  a Novel  ECG interpretation using Vector Based approach  and published 7 research articles related to his novel Cardiac Vector theory that helps in the understanding and interpretation of ECG report. Coronary heart disease remains the number one killer disease of the world. The proposed cardiac vector theory has immense clinical value in the teaching and interpretation of abnormal ECG findings. Currently he is involved in the process of  implementing of his novel ECG research findings collaborating with Mobile ECG device manufactures.

He did his post-graduation in Biochemistry and completed M.D in Biochemistry (2012-2015) in Sree Balaji Medical College and Hospitals, Chennai. After completing his post-graduation, he joined as an Assistant Professor of Biochemistry in May 2015 in Shri Sathya Sai Medical College and Research Institute, SBV Chennai Campus. He was promoted as an Associate Professor on 1^st September 2020 and Professor of Biochemistry on 15th November 2023 in the same institute.

He started his research on Arterial Blood Gas (ABG) interpretation during his post-graduation. He had proposed a novel pH based ABG interpretation method and also developed a novel four quadrant graphical tool for ABG interpretation. He had published 23 research articles, 3 books and one book chapter related to Arterial Blood Gas (ABG) interpretation. During COVID times, he concentrated his research on ventilator. He had derived novel equations of motion for mechanical ventilation and published 4 research articles on Ventilator Graphics Interpretation.

He had developed a Mobile Application for ABG Interpretation using the innovative interpretation and graphical methods developed by him integrating it with already existing ABG interpretation methods. The name of the Mobile App is ccareabg. Currently he is involved in the process of testing of his ccareabg Mobile APP with many hospitals for its successful launch.

He received Atmanirbhar Bharath Award 2022 and Indian Achievers Award 2021 for excellence in innovation awarded by Indian Achievers Forum, High Flyers Global Achievers Award 2022- The best Medical Science Researcher, "International Best Researcher Award" by high society ISSN International Research Awards Congress (IIRAC 2024) and International Best Scientist award awarded by Honourable Education Minister of Tamil Nadu at the conference Scopus Index Conclave 2025.