Cardiac cycle with ecg co relation

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cardiac cycle ECG correlation pressure volume Wiggers diagram

Summary : This figure illustrates the left atrial (LA) pressure-volume relationship during the cardiac cycle, showing both time-course traces and a pressure-volume loop, with key phases of atrial function annotated and correlated with the ECG.

line plot and loop diagram:
# Panel A: LA Pressure and Volume Traces
  • Top trace: LA Pressure (y-axis, arbitrary units) over time.
  • Middle trace: LA Volume (y-axis, arbitrary units) over time.
  • Bottom trace: ECG waveform for temporal reference.
  • X-axis: Cardiac cycle phases, with systole and diastole labeled; diastole further subdivided into E, D, and A phases.
  • Five phases are color-coded and numbered:
    – (1) Atrial filling (red)
    – (2) Passive emptying (green)
    – (3) Diastasis (black)
    – (4) Active emptying (blue)
    – (5) Atrial relaxation (gray)
  • Vertical dashed lines demarcate transitions between phases.

# Panel B: LA Pressure-Volume Loop
  • X-axis: LA Volume (arbitrary units).
  • Y-axis: LA Pressure (arbitrary units).
  • The loop is traced in a counterclockwise direction, with arrows indicating the sequence.
  • The same five phases (1–5) are color-coded as in Panel A.
  • The loop is divided into two segments: A-Loop (phases 1, 3, 4, 5) and V-Loop (phase 2).

# Design Encodings :
  • Distinct colors for each phase (red, green, black, blue, gray).
  • Arrows on the loop indicate the direction of the cardiac cycle.
  • ECG trace provides timing reference for the pressure and volume changes.

# Analysis :
  • The LA pressure and volume traces show cyclical changes corresponding to atrial filling, emptying, and relaxation.
  • The pressure-volume loop visually summarizes the dynamic relationship between LA pressure and volume, with distinct segments for passive and active phases.
  • The figure highlights the temporal coordination between atrial events and the ECG, emphasizing the mechanical and electrical coupling in the cardiac cycle.

Summary : This figure illustrates the left atrial (LA) pressure-volume relationship during the cardiac cycle, showing both time-course traces and a pressure-volume loop, with key phases of atrial function annotated and correlated with the ECG. line plot and loop diagram: # Panel A: LA Pressure and Volume Traces • Top trace: LA Pressure (y-axis, arbitrary units) over time. • Middle trace: LA Volume (y-axis, arbitrary units) over time. • Bottom trace: ECG waveform for temporal reference. • X-axis: Cardiac cycle phases, with systole and diastole labeled; diastole further subdivided into E, D, and A phases. • Five phases are color-coded and numbered: – (1) Atrial filling (red) – (2) Passive emptying (green) – (3) Diastasis (black) – (4) Active emptying (blue) – (5) Atrial relaxation (gray) • Vertical dashed lines demarcate transitions between phases. # Panel B: LA Pressure-Volume Loop • X-axis: LA Volume (arbitrary units). • Y-axis: LA Pressure (arbitrary units). • The loop is traced in a counterclockwise direction, with arrows indicating the sequence. • The same five phases (1–5) are color-coded as in Panel A. • The loop is divided into two segments: A-Loop (phases 1, 3, 4, 5) and V-Loop (phase 2). # Design Encodings : • Distinct colors for each phase (red, green, black, blue, gray). • Arrows on the loop indicate the direction of the cardiac cycle. • ECG trace provides timing reference for the pressure and volume changes. # Analysis : • The LA pressure and volume traces show cyclical changes corresponding to atrial filling, emptying, and relaxation. • The pressure-volume loop visually summarizes the dynamic relationship between LA pressure and volume, with distinct segments for passive and active phases. • The figure highlights the temporal coordination between atrial events and the ECG, emphasizing the mechanical and electrical coupling in the cardiac cycle.

This physiological signal diagram illustrates the temporal correlation between mechanical and electrical cardiac activity over a 5-second interval. The figure consists of four vertically stacked, time-synchronized plots sharing a common horizontal axis (Time in Seconds). From top to bottom, the waveforms represent: 1) Accelerometer data (Accel in m/s²), 2) Gyroscope data (Gyro in degrees/second), 3) Normalized Amplitude (representing the ensemble averaging of the motion sensors), and 4) Electrocardiogram (ECG in mV). A vertical red box highlights a specific epoch around the 1-second mark, demonstrating that the mechanical peaks in the seismocardiogram (SCG) and gyrocardiogram (GCG) signals correspond directly with the R-wave peak of the ECG. This visualization is used to demonstrate the efficacy of multi-axis MEMS sensors in capturing cardiac-induced chest vibrations and their synchronization with the heart's electrical cycle, which is essential for non-invasive heart rate monitoring and hemodynamic assessment.

This physiological signal diagram illustrates the temporal correlation between mechanical and electrical cardiac activity over a 5-second interval. The figure consists of four vertically stacked, time-synchronized plots sharing a common horizontal axis (Time in Seconds). From top to bottom, the waveforms represent: 1) Accelerometer data (Accel in m/s²), 2) Gyroscope data (Gyro in degrees/second), 3) Normalized Amplitude (representing the ensemble averaging of the motion sensors), and 4) Electrocardiogram (ECG in mV). A vertical red box highlights a specific epoch around the 1-second mark, demonstrating that the mechanical peaks in the seismocardiogram (SCG) and gyrocardiogram (GCG) signals correspond directly with the R-wave peak of the ECG. This visualization is used to demonstrate the efficacy of multi-axis MEMS sensors in capturing cardiac-induced chest vibrations and their synchronization with the heart's electrical cycle, which is essential for non-invasive heart rate monitoring and hemodynamic assessment.

A three-panel physiological waveform diagram illustrating the temporal relationship between cardiac hemodynamics and motion sensor signals. The upper panel displays a synchronized Electrocardiogram (ECG), Left Ventricular Pressure (PLV), and Aortic Pressure (PAO). A vertical arrow highlights the P wave, while a vertical line marks the R wave, corresponding to the onset of ventricular systole where PLV rises and eventually equilibrates with PAO. The middle panel shows the total composite accelerometer (Acc Tot) signal, with a dotted ellipse identifying the systolic tension onset signal (STOS) and a dashed ellipse highlighting the diastolic acceleration component. The lower panel displays the total angular velocity (Gyro Tot) signal measured in degrees per second, with a dotted box marking the systolic gyroscopic activity and a dashed box outlining the diastolic phase. These waveforms demonstrate that mechanical motion signals from accelerometers and gyroscopes correlate with specific phases of the cardiac cycle, such as systolic contraction and diastolic filling, as defined by the concurrent pressure and ECG traces.

A three-panel physiological waveform diagram illustrating the temporal relationship between cardiac hemodynamics and motion sensor signals. The upper panel displays a synchronized Electrocardiogram (ECG), Left Ventricular Pressure (PLV), and Aortic Pressure (PAO). A vertical arrow highlights the P wave, while a vertical line marks the R wave, corresponding to the onset of ventricular systole where PLV rises and eventually equilibrates with PAO. The middle panel shows the total composite accelerometer (Acc Tot) signal, with a dotted ellipse identifying the systolic tension onset signal (STOS) and a dashed ellipse highlighting the diastolic acceleration component. The lower panel displays the total angular velocity (Gyro Tot) signal measured in degrees per second, with a dotted box marking the systolic gyroscopic activity and a dashed box outlining the diastolic phase. These waveforms demonstrate that mechanical motion signals from accelerometers and gyroscopes correlate with specific phases of the cardiac cycle, such as systolic contraction and diastolic filling, as defined by the concurrent pressure and ECG traces.

Summary : This figure shows a pressure–volume loop for the left ventricle, illustrating how ventricular volume and pressure change during the cardiac cycle, with key phases and valve events annotated. The isovolumetric relaxation and contraction periods are highlighted, and systolic/diastolic blood pressures are marked.

pressure–volume loop diagram:
  
# Title & Axes :
  • No explicit title on the figure, but the legend describes it as a "Pressure–volume loop demonstrating changes in ventricular volume during filling and ejection with corresponding changes in intracavity pressure."
  • X-axis: "Left ventricular volume (mL)" with tick marks at 0, 20, 40, 60, 80, 100, 120, 140, 160.
  • Y-axis: "Left ventricular pressure (mmHg)" with tick marks at 0, 20, 40, 60, 80, 100, 120, 140.
  • Additional axis labels: "Left ventricular end-diastolic pressure" (blue, left), "End-diastolic volume" (blue, bottom right), "Stroke volume" (black, bottom center).

# Phases & Events :
  • Isovolumetric relaxation: vertical line at low volume, pressure drops, labeled.
  • Diastolic filling: horizontal line at low pressure, volume increases, labeled.
  • Isovolumetric contraction: vertical line at high volume, pressure rises, labeled.
  • Ventricular ejection: curved line, volume decreases as pressure peaks and falls, labeled.
  • Valve events:
    – Mitral valve opens (bottom left corner, low pressure/volume).
    – Mitral valve closes (bottom right corner, high volume/low pressure).
    – Aortic valve opens (top right corner, high volume/high pressure).
    – Aortic valve closes (top left corner, low volume/high pressure).

# Blood Pressure Markers :
  • Systolic BP: horizontal dashed blue line at ~120 mmHg.
  • Diastolic BP: horizontal dashed blue line at ~80 mmHg.

# Design Encodings :
  • Black solid lines for the loop.
  • Blue dashed lines for blood pressure markers.
  • Blue text for end-diastolic volume/pressure.
  • Labeled arrows for direction of phases and valve events.

# Analysis :
  • The loop traces the cardiac cycle, starting at low pressure/volume (end-systolic), filling during diastole, rising sharply during isovolumetric contraction, ejecting blood during ventricular ejection, and dropping pressure during isovolumetric relaxation.
  • Systolic and diastolic blood pressures are marked, showing the pressure range during ejection.
  • The width of the loop (horizontal distance) represents stroke volume.
  • The figure clearly distinguishes the four main phases and the timing of valve openings/closings, providing a comprehensive view of ventricular mechanics during a heartbeat.

Summary : This figure shows a pressure–volume loop for the left ventricle, illustrating how ventricular volume and pressure change during the cardiac cycle, with key phases and valve events annotated. The isovolumetric relaxation and contraction periods are highlighted, and systolic/diastolic blood pressures are marked. pressure–volume loop diagram: # Title & Axes : • No explicit title on the figure, but the legend describes it as a "Pressure–volume loop demonstrating changes in ventricular volume during filling and ejection with corresponding changes in intracavity pressure." • X-axis: "Left ventricular volume (mL)" with tick marks at 0, 20, 40, 60, 80, 100, 120, 140, 160. • Y-axis: "Left ventricular pressure (mmHg)" with tick marks at 0, 20, 40, 60, 80, 100, 120, 140. • Additional axis labels: "Left ventricular end-diastolic pressure" (blue, left), "End-diastolic volume" (blue, bottom right), "Stroke volume" (black, bottom center). # Phases & Events : • Isovolumetric relaxation: vertical line at low volume, pressure drops, labeled. • Diastolic filling: horizontal line at low pressure, volume increases, labeled. • Isovolumetric contraction: vertical line at high volume, pressure rises, labeled. • Ventricular ejection: curved line, volume decreases as pressure peaks and falls, labeled. • Valve events: – Mitral valve opens (bottom left corner, low pressure/volume). – Mitral valve closes (bottom right corner, high volume/low pressure). – Aortic valve opens (top right corner, high volume/high pressure). – Aortic valve closes (top left corner, low volume/high pressure). # Blood Pressure Markers : • Systolic BP: horizontal dashed blue line at ~120 mmHg. • Diastolic BP: horizontal dashed blue line at ~80 mmHg. # Design Encodings : • Black solid lines for the loop. • Blue dashed lines for blood pressure markers. • Blue text for end-diastolic volume/pressure. • Labeled arrows for direction of phases and valve events. # Analysis : • The loop traces the cardiac cycle, starting at low pressure/volume (end-systolic), filling during diastole, rising sharply during isovolumetric contraction, ejecting blood during ventricular ejection, and dropping pressure during isovolumetric relaxation. • Systolic and diastolic blood pressures are marked, showing the pressure range during ejection. • The width of the loop (horizontal distance) represents stroke volume. • The figure clearly distinguishes the four main phases and the timing of valve openings/closings, providing a comprehensive view of ventricular mechanics during a heartbeat.

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Wiggers diagram cardiac cycle phases aortic left ventricular pressure ECG heart sounds

A three-panel physiological waveform diagram illustrating the temporal relationship between cardiac hemodynamics and motion sensor signals. The upper panel displays a synchronized Electrocardiogram (ECG), Left Ventricular Pressure (PLV), and Aortic Pressure (PAO). A vertical arrow highlights the P wave, while a vertical line marks the R wave, corresponding to the onset of ventricular systole where PLV rises and eventually equilibrates with PAO. The middle panel shows the total composite accelerometer (Acc Tot) signal, with a dotted ellipse identifying the systolic tension onset signal (STOS) and a dashed ellipse highlighting the diastolic acceleration component. The lower panel displays the total angular velocity (Gyro Tot) signal measured in degrees per second, with a dotted box marking the systolic gyroscopic activity and a dashed box outlining the diastolic phase. These waveforms demonstrate that mechanical motion signals from accelerometers and gyroscopes correlate with specific phases of the cardiac cycle, such as systolic contraction and diastolic filling, as defined by the concurrent pressure and ECG traces.

A three-panel physiological waveform diagram illustrating the temporal relationship between cardiac hemodynamics and motion sensor signals. The upper panel displays a synchronized Electrocardiogram (ECG), Left Ventricular Pressure (PLV), and Aortic Pressure (PAO). A vertical arrow highlights the P wave, while a vertical line marks the R wave, corresponding to the onset of ventricular systole where PLV rises and eventually equilibrates with PAO. The middle panel shows the total composite accelerometer (Acc Tot) signal, with a dotted ellipse identifying the systolic tension onset signal (STOS) and a dashed ellipse highlighting the diastolic acceleration component. The lower panel displays the total angular velocity (Gyro Tot) signal measured in degrees per second, with a dotted box marking the systolic gyroscopic activity and a dashed box outlining the diastolic phase. These waveforms demonstrate that mechanical motion signals from accelerometers and gyroscopes correlate with specific phases of the cardiac cycle, such as systolic contraction and diastolic filling, as defined by the concurrent pressure and ECG traces.

This physiological signal diagram illustrates the temporal synchronization of cardiac mechanical and electrical events over a single heart cycle. The visualization includes seven aligned waveforms: (a) a standard lead ECG with labeled P-Q-R-S-T complexes; (b) Left Ventricular (LV) rotation mechanics showing apical (purple), basal (brown), and net LV twist (black) in degrees; (c) corresponding rotation rates in degrees per second; (d-e) Seismocardiogram (SCG) representing linear (KLin) and rotational (KRot) kinetic energy in millijoules (mJ); and (f-g) Ballistocardiogram (BCG) also representing KLin and KRot energy. A vertical dashed line indicates Aortic Valve Closure (AVC). The diagram highlights key pathophysiological relationships: SCG energy peaks bimodal, occurring during the ejection phase (pre-AVC) and early diastole (post-AVC), while BCG energy peaks appear almost exclusively during the diastolic phase (post-AVC). This chart serves as an educational tool for understanding the relationship between electrical conduction, myocardial rotational mechanics, and the kinetic energy generated by cardiac micro-accelerations and body displacements.

This physiological signal diagram illustrates the temporal synchronization of cardiac mechanical and electrical events over a single heart cycle. The visualization includes seven aligned waveforms: (a) a standard lead ECG with labeled P-Q-R-S-T complexes; (b) Left Ventricular (LV) rotation mechanics showing apical (purple), basal (brown), and net LV twist (black) in degrees; (c) corresponding rotation rates in degrees per second; (d-e) Seismocardiogram (SCG) representing linear (KLin) and rotational (KRot) kinetic energy in millijoules (mJ); and (f-g) Ballistocardiogram (BCG) also representing KLin and KRot energy. A vertical dashed line indicates Aortic Valve Closure (AVC). The diagram highlights key pathophysiological relationships: SCG energy peaks bimodal, occurring during the ejection phase (pre-AVC) and early diastole (post-AVC), while BCG energy peaks appear almost exclusively during the diastolic phase (post-AVC). This chart serves as an educational tool for understanding the relationship between electrical conduction, myocardial rotational mechanics, and the kinetic energy generated by cardiac micro-accelerations and body displacements.

Summary : This figure shows a pressure–volume loop for the left ventricle, illustrating how ventricular volume and pressure change during the cardiac cycle, with key phases and valve events annotated. The isovolumetric relaxation and contraction periods are highlighted, and systolic/diastolic blood pressures are marked.

pressure–volume loop diagram:
  
# Title & Axes :
  • No explicit title on the figure, but the legend describes it as a "Pressure–volume loop demonstrating changes in ventricular volume during filling and ejection with corresponding changes in intracavity pressure."
  • X-axis: "Left ventricular volume (mL)" with tick marks at 0, 20, 40, 60, 80, 100, 120, 140, 160.
  • Y-axis: "Left ventricular pressure (mmHg)" with tick marks at 0, 20, 40, 60, 80, 100, 120, 140.
  • Additional axis labels: "Left ventricular end-diastolic pressure" (blue, left), "End-diastolic volume" (blue, bottom right), "Stroke volume" (black, bottom center).

# Phases & Events :
  • Isovolumetric relaxation: vertical line at low volume, pressure drops, labeled.
  • Diastolic filling: horizontal line at low pressure, volume increases, labeled.
  • Isovolumetric contraction: vertical line at high volume, pressure rises, labeled.
  • Ventricular ejection: curved line, volume decreases as pressure peaks and falls, labeled.
  • Valve events:
    – Mitral valve opens (bottom left corner, low pressure/volume).
    – Mitral valve closes (bottom right corner, high volume/low pressure).
    – Aortic valve opens (top right corner, high volume/high pressure).
    – Aortic valve closes (top left corner, low volume/high pressure).

# Blood Pressure Markers :
  • Systolic BP: horizontal dashed blue line at ~120 mmHg.
  • Diastolic BP: horizontal dashed blue line at ~80 mmHg.

# Design Encodings :
  • Black solid lines for the loop.
  • Blue dashed lines for blood pressure markers.
  • Blue text for end-diastolic volume/pressure.
  • Labeled arrows for direction of phases and valve events.

# Analysis :
  • The loop traces the cardiac cycle, starting at low pressure/volume (end-systolic), filling during diastole, rising sharply during isovolumetric contraction, ejecting blood during ventricular ejection, and dropping pressure during isovolumetric relaxation.
  • Systolic and diastolic blood pressures are marked, showing the pressure range during ejection.
  • The width of the loop (horizontal distance) represents stroke volume.
  • The figure clearly distinguishes the four main phases and the timing of valve openings/closings, providing a comprehensive view of ventricular mechanics during a heartbeat.

Summary : This figure shows a pressure–volume loop for the left ventricle, illustrating how ventricular volume and pressure change during the cardiac cycle, with key phases and valve events annotated. The isovolumetric relaxation and contraction periods are highlighted, and systolic/diastolic blood pressures are marked. pressure–volume loop diagram: # Title & Axes : • No explicit title on the figure, but the legend describes it as a "Pressure–volume loop demonstrating changes in ventricular volume during filling and ejection with corresponding changes in intracavity pressure." • X-axis: "Left ventricular volume (mL)" with tick marks at 0, 20, 40, 60, 80, 100, 120, 140, 160. • Y-axis: "Left ventricular pressure (mmHg)" with tick marks at 0, 20, 40, 60, 80, 100, 120, 140. • Additional axis labels: "Left ventricular end-diastolic pressure" (blue, left), "End-diastolic volume" (blue, bottom right), "Stroke volume" (black, bottom center). # Phases & Events : • Isovolumetric relaxation: vertical line at low volume, pressure drops, labeled. • Diastolic filling: horizontal line at low pressure, volume increases, labeled. • Isovolumetric contraction: vertical line at high volume, pressure rises, labeled. • Ventricular ejection: curved line, volume decreases as pressure peaks and falls, labeled. • Valve events: – Mitral valve opens (bottom left corner, low pressure/volume). – Mitral valve closes (bottom right corner, high volume/low pressure). – Aortic valve opens (top right corner, high volume/high pressure). – Aortic valve closes (top left corner, low volume/high pressure). # Blood Pressure Markers : • Systolic BP: horizontal dashed blue line at ~120 mmHg. • Diastolic BP: horizontal dashed blue line at ~80 mmHg. # Design Encodings : • Black solid lines for the loop. • Blue dashed lines for blood pressure markers. • Blue text for end-diastolic volume/pressure. • Labeled arrows for direction of phases and valve events. # Analysis : • The loop traces the cardiac cycle, starting at low pressure/volume (end-systolic), filling during diastole, rising sharply during isovolumetric contraction, ejecting blood during ventricular ejection, and dropping pressure during isovolumetric relaxation. • Systolic and diastolic blood pressures are marked, showing the pressure range during ejection. • The width of the loop (horizontal distance) represents stroke volume. • The figure clearly distinguishes the four main phases and the timing of valve openings/closings, providing a comprehensive view of ventricular mechanics during a heartbeat.

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Cardiac Cycle with ECG Correlation

The cardiac cycle encompasses all mechanical and electrical events from the beginning of one heartbeat to the start of the next. At a heart rate of 72 bpm, one complete cycle lasts approximately 0.83 seconds. The ECG serves as the timing backbone - each wave marks the electrical event that triggers the corresponding mechanical response.
The Cardiac Cycle - Costanzo Fig 4.25 showing all 7 phases with ECG, pressures, volumes, heart sounds, and venous pulse
Fig. 4.25 - The cardiac cycle with ECG correlation. Phases A-G are separated by vertical lines. (Costanzo Physiology, 7th Edition)

The 7 Phases - ECG Correlation

Phase A - Atrial Systole

ParameterEvent
ECGP wave (atrial depolarization)
MechanicalAtria contract; final 20-30% of ventricular filling occurs
PressuresLeft atrial pressure rises
ValvesMitral valve open; aortic valve closed
Heart SoundS4 (normally inaudible; heard in stiff/hypertrophied ventricle)
Venous pulsea wave (atrial contraction reflected back to jugular vein)
Key concept: The PR interval represents the AV nodal delay (~0.1 sec), which allows the atria to finish contracting and fill the ventricles before ventricular systole begins.

Phase B - Isovolumetric Ventricular Contraction (IVC)

ParameterEvent
ECGQRS complex (ventricular depolarization)
MechanicalVentricles contract; pressure rises sharply
VolumeConstant - ALL valves are closed
ValvesMitral valve closes (LV pressure > LA pressure)
Heart SoundS1 ("lub") - closure of mitral (then tricuspid) valve
Venous pulsec wave - bulging of tricuspid valve into right atrium
This is the period of maximum pressure build-up with no blood movement. LV pressure rises from ~0 to ~80 mmHg.

Phase C - Rapid Ventricular Ejection

ParameterEvent
ECGST segment
MechanicalMost of stroke volume (~70%) ejected into aorta
VolumeVentricular volume falls sharply (EDV ~130 mL → ESV ~50 mL)
PressuresLV pressure peaks (~120 mmHg); aortic pressure rises to peak
ValvesAortic valve opens (LV pressure > aortic pressure)
Heart SoundNone

Phase D - Reduced Ventricular Ejection

ParameterEvent
ECGT wave begins (ventricular repolarization starts)
MechanicalBlood continues ejecting but at a slower rate
VolumeContinues to fall (slowly)
PressuresAortic pressure begins to fall as "runoff" exceeds ejection
ValvesAortic valve still open

Phase E - Isovolumetric Ventricular Relaxation (IVR)

ParameterEvent
ECGAfter T wave ends (ventricles fully repolarized)
MechanicalVentricles relax; pressure falls dramatically
VolumeConstant - ALL valves are closed again
ValvesAortic valve closes (LV pressure < aortic pressure)
Heart SoundS2 ("dub") - closure of aortic (then pulmonic) valve
Aortic pressureShows dicrotic notch (incisura) at the moment of aortic valve closure
Physiological splitting of S2 occurs on inspiration: increased venous return delays pulmonic valve closure relative to aortic valve closure.

Phase F - Rapid Ventricular Filling

ParameterEvent
ECGElectrically silent (between T wave and next P wave)
MechanicalVentricle fills passively; ~70-80% of filling occurs here
VolumeRises rapidly
PressuresLV pressure remains low (compliant ventricle)
ValvesMitral valve opens (LV pressure < LA pressure)
Heart SoundS3 - normal in children; indicates volume overload (CHF, MR, TR) in adults
Venous pulsev wave (atrial filling while tricuspid is closed) → y descent (when tricuspid opens)

Phase G - Reduced Ventricular Filling (Diastasis)

ParameterEvent
ECGElectrically silent
MechanicalSlow, passive filling continues; atria and ventricles in equilibrium
Heart SoundNone
This phase shortens or disappears as heart rate increases.

ECG-Cardiac Cycle Summary Table

ECG FeatureDurationMechanical Correlation
P wave~80 msAtrial depolarization → atrial contraction
PR interval120-200 msAV nodal delay; ventricular filling completes
QRS complex<120 msVentricular depolarization → IVC begins, S1
ST segmentVariableVentricular plateau; rapid ejection
T wave~160 msVentricular repolarization; reduced ejection → IVR begins
QT interval350-440 msEntire ventricular systole (IVC + ejection)
TP intervalVariableVentricular diastole (IVR + filling)

Pressure-Volume Loop

Left ventricular pressure-volume loop showing the four phases and valve events
The PV loop traces one full cardiac cycle:
  • Bottom right corner → Mitral valve closes (end-diastole; EDV ~130 mL)
  • Left vertical line (rising) → Isovolumetric contraction
  • Top left corner → Aortic valve opens; ejection begins
  • Top right curve → Ventricular ejection (volume falls)
  • Top left corner → Aortic valve closes (end-systole; ESV ~50 mL)
  • Left vertical line (falling) → Isovolumetric relaxation
  • Bottom left corner → Mitral valve opens; filling begins
  • Width of the loop = Stroke Volume (~80 mL)

Jugular Venous Pulse (JVP) Waves - ECG Correlation

WaveCauseECG Timing
a waveAtrial contractionAfter P wave
c waveTricuspid bulging + carotid artefactAt QRS
x descentAtrial relaxation + tricuspid pulled down during systoleST segment
v waveVenous filling while tricuspid is closedT wave
y descentTricuspid opens; blood flows into ventricleAfter T wave

Key Points to Remember

  1. Electrical event always precedes the mechanical event - depolarization triggers contraction; repolarization triggers relaxation.
  2. IVC and IVR are periods when all valves are closed - volume is fixed but pressure is changing.
  3. S1 = mitral/tricuspid closure (start of IVC, at QRS); S2 = aortic/pulmonic closure (start of IVR, after T wave).
  4. At high heart rates, diastole is preferentially shortened - diastasis disappears first, then rapid filling shortens. This is why tachycardia impairs ventricular filling.
  5. The QT interval represents total ventricular systole. A prolonged QT = prolonged action potential = arrhythmia risk.
Sources: Costanzo Physiology, 7th Edition (Table 4.5, Fig. 4.25); Guyton and Hall Textbook of Medical Physiology (Fig. 9.8)
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