VIETNAM NATIONAL UNIVERSITY HCMC

INTERNATIONAL
VIETNAM UNIVERSITY
NATIONAL UNIVERSITY HCMC
INTERNATIONAL UNIVERSITY
SCHOOL OF MEDICAL ENGINEERING

Lab 1A - Biomedical Instrumentations

REPORT
ELECTROCARDIOGRAM MONITOR

BIOMEDICAL
ENGINEERING
Instructor Dr. Nguyen Thanh Qua
BIOMEDICAL INSTRUMENTATION – LAB 1A

Bùi Hà Đức An BEBEIU22280

Team member Kim Phương Thùy BEBEIU22283
Vũ Quang Huy BEBEIU22279

Ho Chi Minh City

December, 2022
 HCMC International University – School of Biomedical Engineering

TABLE OF CONTENTS
List of Figures .........................................................................................................3
List of Tables ...........................................................................................................4
I. Introduction.......................................................................................................6
1. Application....................................................................................................6
2. How to use.....................................................................................................6
II. Working Principles............................................................................................9
III. Block diagram..................................................................................................11
IV. Disassemble sequence......................................................................................11
V. Experiment.......................................................................................................17
VI. Further information........................................................................................20
VII. References.......................................................................................................21
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List of Figures
Figure 1: Overall view of Electrocardiogram Monitor...........................................5
Figure 2: Position of 6 precordial electrodes..........................................................7
Figure 3: Position of 3 limb electrodes....................................................................8
Figure 4: Block diagram of Electrocardiogram Monitor.....................................10
Figure 5: Overview inside of Electrocardiogram Monitor...................................12
Figure 5.1: Outside of the Electrocardiogram Monitor............................13
Figure 5.2: Disassemble sequence of Electrocardiogram Monitor..........15
Figure 6.1: Placed 6 precordial electrodes onto the patient.................................17
Figure 6.2: Placed 3 limb electrodes onto the patient...........................................17
Figure 6.3: The results and informations from the patient..................................18
Figure 6.3.1: Results from lead I, II, III...................................................19
Figure 6.3.2: Results from lead aVR, aVL, aVF.......................................19
Figure 6.3.3: Results from lead V1, V2, V3...............................................19
Figure 6.3.4: Results from lead V4, V5,V6................................................19
Figure 7: The components of ECG signal............................................................20

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List of Tables
Table 1: List of Equipments (Outside of the Electrocardiogram Monitor).........14
Table 2: List of equipments (Inside of the Electrocardiogram Monitor).............16

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Figure 1: Overall view of Electrocardiogram Monitor

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I. Introduction
1. Application
The goal of an ECG machine is to track the electrical activity of the heart and show it as a
moving line of peaks and valleys. Arrhythmias are one type of heart condition that can be
indicated by specific ECG patterns. If the heart isn't working properly, an electrocardiogram
can reveal why and show whether it is.

2. How to use
- Prepare the skin: It is crucial to properly clean the patient's chest area with skin-cleansing
(alcohol) swabs before applying your electrodes. This gets rid of any oil that may be on your
skin and causing your ECG/EKG signals to drift. Find and mark the locations for the
electrodes once the skin has been cleaned.
- Find and mark the placements for the electrodes:
+ Starting with V1 and V2, locate the proper location for the chest leads.
+ Because the remaining chest leads are positioned in relation to V1 and V2, proper
placement of these leads is very essential.
+ Identifying the patient's sternum's top will help you locate V1 and V2. There is a ridge
about 4 millimeters below this. The second intercostal gap is indicated by this. You will
encounter the third and fourth intercostal gaps when you are down. Mark V2 in the fourth
intercostal space using a skin-safe marker.
+ Mark V1 on the other side of the chest in the reverse position.
+ One intercostal gap below V2, parallel to the middle of the clavicle, is V4. Use your skin-
safe marker to mark V4.
+ Next, locate V6 at mid-auxiliary on the same level as V4 by moving around the torso to the
subject's left. Mark V6.
+ Midway between V4 and V6, V5 can be identified.
+ Mark V3 similarly in the middle of V2 and V4.
+ There should now be 6 points total for marks V1–V6.
- Apply electrodes to the chest at V1 – V6.
- Connect wires from V1 to V6 to the recording device.
- Apply limbs lead:
+ Apply lead 1 to the left arm. To prevent any EMG signal disturbance, we recommend the
front of the left shoulder in a location with little muscle or muscular action.
+ Apply lead number two next to the right arm. Once more, the front of the shoulder is
mentioned, which is a location with little to no muscle activity.
+ Next, connect the left leg. The electrode should be positioned just above the ankle. All of
the enhanced leads are referenced to this electrode.
+ Apply the "common" lastly on the right ankle's side. This attaches to your recording
device's ground input.
- Connect the limb leads to your recording equipment and check to see if a signal is being
received.
- The information (electrical signals that make the heart beat) will be recorded and displayed
as waves on a monitor or on paper via recording equipment.

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Figure 2: Position of 6 precordial electrodes

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Figure 3: Position of 3 limb electrodes

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II. Working Principles

- Certain locations on the chest, arms, and legs are covered with electrodes, which are tiny
plastic patches that adhere to the skin. Lead wires are used to connect the electrodes to the
ECG device. The heart's electrical activity is then recorded, analyzed, and printed out. No
electricity is delivered to the body.
- In order to maintain the blood flowing the way it should, natural electrical impulses
coordinate the contractions of the various heart muscle groups. These electrical impulses are
captured by an ECG to provide information on the heart's rate, rhythm (steady or irregular),
and the strength and timing of the electrical impulses as they pass through the various heart
chambers. ECG variations can indicate a variety of heart-related diseases.

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Figure 4: Block diagram of Electrocardiogram Monitor

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III.Block diagram
Electrodes arranged in different parts of the body (counted as five from the diagram) allow the
recording of electrical currents. Each ECG lead is figured by analyzing the currents detected
from several electrodes.
As each pair of lead carries specific data, the lead selector has advantages in choosing the
correct waveform which can be switched to different lead pairs. The waveform consists of the
data then be transmitted and amplified through a pre-amplifier, after that the waveform is
measured in a permanent magnet moving coil (PMMC) galvanometer, where the hot tip stylus
movements depend on the deflection of the coil and total deflections that decided by the
amplitude and polarity of the ECG waveform.
By mentioned before, a hot tip stylus is a pen-like device that priority for thermal writing. The
stylus remains heated by the power supply. Meanwhile, drive motor and gear train control the
movement and speed of the chart paper roll.

IV.Disassemble sequence

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Figure 5: Overview inside of Electrocardiogram Monitor

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3 4

Figure 5.1: Outside of the Electrocardiogram Monitor

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Number Disassemble Sequence Function

1 Power Button - Powers the device on and off

- Adjust some patient’s specifications
2 Adjustment Button
(Date of Birth, Genders,…)
- Forces the paper in and up against the
3 Pinch Roller
thermal printer
4 LCD Display - Shows the screen and the datas

Table 1: List of Equipments (Outside of the Electrocardiogram Monitor)

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Figure 5.2: Disassemble sequence of the Electrocardiogram Monitor

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Number Disassemble Sequence Function

- Producing datas printed on paper by
1 Thermal Printer
heated printhead
- Increases the voltage, current, or power
Amplifier and Hot stylus of a signal.
2
power supply - Provide the right power that an electrical
component needs

Table 2: List of equipments (Inside of the Electrocardiogram Monitor)

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V. Experiment

Figure 6.1: Placed 6 precordial electrodes onto the patient

Figure 6.2: Placed 3 limb electrodes onto the patient

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Figure 6.3: The results and informations from the patient

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Figure 6.3.1: Results from lead I, II, III Figure 6.3.2: Results from lead aVR, aVL, aVF

Figure 6.3.3: Results from lead V1, V2, V3 Figure 6.3.4: Results from lead V4, V5,V6

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VI.Further information: How to read ECG

- ECG paper is a grid where time is measured along the horizontal axis.

- Each small square is 1 mm in length and represents 0.04 seconds. Each larger square is 5 mm
in length and represents 0.2 seconds. Voltage is measured along the vertical axis. 10 mm is
equal to 1mV in voltage.
- The ECG strip can easily be used to calculate heart rate:
The heart rate is 300 divided by the number of large squares between the QRS complexes
when the rhythm is regular.
The heart rate is 75 (300/4=75) if there are four large squares between regular QRS
complexes.

Figure 7: The components of ECG signal

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VII.References
https://www.researchgate.net/figure/Multi-lead-ECG-block-diagram_fig4_260298449
https://www.mayoclinic.org/tests-procedures/ekg/about/pac-20384983#:~:text=During%20an%20ECG
%20%2C%20up%20to,a%20monitor%20or%20on%20paper.
https://www.adinstruments.com/blog/correctly-place-electrodes-12-lead-ecg
https://litfl.com/ecg-lead-positioning/
https://www.fsp-group.com/en/knowledge-tec-26.html
https://www.gflesch.com/blog/how-does-a-thermal-printer-work
https://www.rnceus.com/ekg/ekghowto.html

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