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Electrophysiology of the Heart
and the Electrocardiogram (ECG)
Visual Depictions
-
Inês Pinto, Ana Fred, Carolina Rodrigues
and Hugo Plácido da Silva
IT-Instituto de Telecomunicações, 2020
Electrophysiology of the Heart Complexes
Electrophysiology of the Heart Features
Heartbeat Waveform Complexes
Acknowledgments 03
06
08
20
Heartbeat Waveform Features 22
INDEX
Electrophysiology of the Heart 04
Heartbeat Waveform 16
Cardiac Anatomy
The depicted anatomical elements build upon the work of Eric Pierce [1]. His heart anatomy
drawings [2] are licensed under the Creative Commons Attribution-Share Alike 3.0 Unported [3],
and this work extends the base drawings with the electrical conduction system of the heart and
related details.
Heartbeat Complexes
The representation of the main complexes found in the cardiac cycle are based on the annotations
by Anthony Atkielski [4], which are a public domain resource [5].
Electrophysiology of the Heart
The details pertaining the electrophysiology of the heart and different waveforms produced by the
specialized cardiac cells are adapted from the book Jaakko Malmivuo & Robert Plonsey:
Bioelectromagnetism - Principles and Applications of Bioelectric and Biomagnetic Fields [6], Oxford
University Press, New York, 1995. All the material of this web edition is free for publishing elsewhere.
[1] https://en.wikipedia.org/wiki/User:Wapcaplet
[2] https://commons.wikimedia.org/wiki/File:Heart_labelled_large.png
[3] https://creativecommons.org/licenses/by-sa/3.0/
[4] https://en.wikipedia.org/wiki/User:Agateller
[5] https://en.wikipedia.org/wiki/Electrocardiography#/media/File:SinusRhythmLabels.svg
[6] http://www.bem.fi/book/
03 Acknowledgments
04 Electrophysiology of the Heart
Sinus Node
A-V Node
Purkinje Fibers
Ventricular Muscle
Bundle Branches
Bundle of His
Atrial Muscle
05 Electrophysiology of the Heart
06 Electrophysiology of the Heart
TIME (ms) 0 100 200 300 400 500 600 700
PT
U
SQ
R
Sinus Node
A-V Node
Purkinje Fibers
Ventricular Muscle
Ventricular Muscle
Bundle Branches
Bundle of His
Atrial Muscle
Complexes
Sinus Node
A-V Node
Purkinje Fibers
Ventricular Muscle
Bundle Branches
Bundle of His
Atrial Muscle
07 Electrophysiology of the Heart
TIME (ms) 0 100 200 300 400 500 600 700
PT
U
SQ
R
Complexes
Sinus Node
A-V Node
Purkinje Fibers
Ventricular Muscle
Ventricular Muscle
Bundle Branches
Bundle of His
Atrial Muscle
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
QT Interval
QRS
Complex
PR
Segment
PR Interval
ST
Segment
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
QT Interval
QRS
Complex
PR
Segment
PR Interval
ST
Segment
08 Electrophysiology of the Heart
Complexes
Sinus Node
A-V Node
Purkinje Fibers
Ventricular Muscle
Ventricular Muscle
Bundle Branches
Bundle of His
Atrial Muscle
TIME (ms) 0 100 200 300 400 500 600 700
PT
U
SQ
R
PR
Segment
PR
Interval
ST
Segment
QT
Interval
RR
Interval
QRS
Complex
09 Electrophysiology of the Heart
Complexes
TIME (ms) 0 100 200 300 400 500 600 700
PT
U
SQ
R
10 Electrophysiology of the Heart
Complexes
11 Electrophysiology of the Heart
Complexes
Sinus Node
A-V Node
Purkinje Fibers
Ventricular Muscle
Ventricular Muscle
Bundle Branches
Bundle of His
Atrial Muscle
P
T
U
SQ
R
P Slope
P Amplitude
QRS Amplitude
R Slope
T Slope
T Amplitude
QRS Interval
QT Interval
ST Interval
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
QT Interval
QRS
Complex
PR
Segment
PR Interval
ST
Segment
RR Interval
QRS Area
Sinus Node
A-V Node
Purkinje Fibers
Ventricular Muscle
Ventricular Muscle
Bundle Branches
Bundle of His
Atrial Muscle
TIME (ms) 0 100 200 300 400 500 600 700
PT
U
SQ
R
Sinus Node
A-V Node
Purkinje Fibers
Ventricular Muscle
Bundle Branches
Bundle of His
Atrial Muscle
1
2
3
4
5
6
PR Segment
1
PR Interval
2
QRS Complex
3
ST Segment
4
QT Interval
5
RR Interval
6
12 Electrophysiology of the Heart
Complexes
13 Electrophysiology of the Heart
Sinus Node
A-V Node
Purkinje Fibers
Ventricular Muscle
Ventricular Muscle
Bundle Branches
Bundle of His
Atrial Muscle
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
1
2
3
4
5
6
7
8
9
10
P Slope
1
P Amplitude
2
QRS Amplitude
3
QRS Interval
4
R Slope
5
QRS Area
6
ST Interval
7
QT Interval
8
T Slope
9
T Amplitude
10
Features
14 Electrophysiology of the Heart
Sinus Node
A-V Node
Purkinje Fibers
Ventricular Muscle
Ventricular Muscle
Bundle Branches
Bundle of His
Atrial Muscle
P
T
U
SQ
R
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
PR Segment
1
PR Interval
2
QRS Complex
3
ST Segment
4
QT Interval
5
RR Interval
6
P Slope
7
P Amplitude
8
QRS Amplitude
9
QRS Interval
10
R Slope
11
QRS Area
12
ST Interval
13
QT Interval
14
T Slope
15
T Amplitude
16
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Features
TIME (ms) 0 100 200 300 400 500 600 700
PT
U
SQ
R
1
2
3
4
5
6
PR Segment
1
PR Interval
2
QRS Complex
3
ST Segment
4
QT Interval
5
RR Interval
6
Sinus Node
A-V Node
Purkinje Fibers
Ventricular Muscle
Ventricular Muscle
Bundle Branches
Bundle of His
Atrial Muscle
15 Electrophysiology of the Heart
Features
TIME (ms) 0 100 200 300 400 500 600 700
Heartbeat Waveform
16
TIME (ms) 0 100 200 300 400 500 600 700
17 Heartbeat Waveform
TIME (ms) 0 100 200 300 400 500 600 700
18 Heartbeat Waveform
TIME (ms) 0 100 200 300 400 500 600 700
19 Heartbeat Waveform
TIME (ms) 0 100 200 300 400 500 600 700
PT
U
SQ
R
20 Heartbeat Waveform
Complexes
TIME (ms) 0 100 200 300 400 500 600 700
PT
U
SQ
R
21 Heartbeat Waveform
Complexes
TIME (ms) 0 100 200 300 400 500 600 700
PT
U
SQ
R
22 Heartbeat Waveform
Complexes
TIME (ms) 0 100 200 300 400 500 600 700
PT
U
SQ
R
23 Heartbeat Waveform
Complexes
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
24 Heartbeat Waveform
Complexes
PR Interval
1
PR Segment
2
QRS Complex
3
ST Segment
4
QT Interval
5
1
2
3
4
5
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
25 Heartbeat Waveform
Complexes
PR Interval
1
PR Segment
2
QRS Complex
3
ST Segment
4
QT Interval
5
1
2
3
4
5
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
26 Heartbeat Waveform
Complexes
PR Interval
PR Segment
QRS Complex
ST Segment
QT Interval
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
27 Heartbeat Waveform
Complexes
28 Heartbeat Waveform
Complexes
P
T
U
SQ
R
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
PR Interval
1
PR Segment
2
QRS Complex
3
ST Segment
4
QT Interval
5
1
2
3
4
5
RR Interval
6
6
29 Heartbeat Waveform
Complexes
PR Interval
1
PR Segment
2
QRS Complex
3
ST Segment
4
QT Interval
5
RR Interval
6
P
T
U
SQ
R
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
1
2
3
4
5
6
30
P
T
U
SQ
R
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
Heartbeat Waveform
Features
1
2
3
4
5
6
7
8
910
11
12 13
14
15
16
PR Interval
1
PR Segment
2
QRS Complex
3
ST Segment
4
QT Interval
5
RR Interval
6
P Slope
7
P Amplitude
8
QRS Amplitude
9
R Slope
10
QRS Area
11
QRS Interval
12
ST Interval
13
QT Interval
14
T Slope
15
T Amplitude
16
31
P
T
U
SQ
R
TIME (ms) 0 100 200 300 400 500 600 700
P
T
U
SQ
R
Heartbeat Waveform
Features