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Arrhythmia Recognition The Art of Interpretation

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ISBN-10: 0763722464

ISBN-13: 9780763722463

Edition: 2004

Authors: Tomas B. Garcia, Geoffrey T. Miller

List price: $107.95
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Book details

List price: $107.95
Copyright year: 2004
Publisher: Jones & Bartlett Learning, LLC
Publication date: 11/12/2003
Binding: Paperback
Pages: 633
Size: 9.00" wide x 10.50" long x 0.80" tall
Weight: 3.432
Language: English

Introduction to Arrhythmia Recognition
Gross Anatomy
Anterior View
The Heart in Cross Section
The Heart as a Pump
Pump Function Simplified
Cardiac Output
Passive Pumping
Active Pumping
The Electrical Conduction System
Pacemaker Function
Pacemaker Settings
The Sinoatrial (SA) Node
The Internodal Pathways
The Atrioventricular (AV) Node
The Bundle of His
The Left Bundle Branch (LBB)
The Right Bundle Branch (RBB)
The Left Anterior Fascicle (LAF)
The Left Posterior Fascicle (LPF)
The Purkinje System
Chapter Review
Mechanics of Contraction
Ion Movement and Polarity
Membrane Channels and Action Potential Phases
Introduction to the Nervous System and Cardiac Function
Central Nervous System (CNS)
Peripheral Nervous System (PNS)
Chapter Review
Vectors and the Basic Beat
Adding and Subtracting Vectors
The Electrical Axis of the Heart
Electrodes and Waves
Leads Are Like Pictures of the Heart
Lead Placement (Where to Put the "Cameras")
How the Machine Manipulates the Leads
The Two Lead Systems
The Hexaxial System
The Precordial System
The Basic Beat
Introduction to Basic Components
Wave Nomenclature
R' and S' Waves
Individual Components of the ECG Complex
The P Wave
The Tp Wave
The PR Segment
The PR Interval
The QRS Complex
The ST Segment
The T Wave
The QT Interval
The U Wave
Additional Intervals
Chapter Review
The Rhythm Strip, Tools, and Calculating Rates
Boxes and Sizes
Temporal Relationship of Multiple-Lead Strips
Why is Temporal Spacing Important?
ECG Tools
Calipers: The Clinician's Best Friend
How to Use Your Calipers
Comparing Widths
ECG Rulers
Straight Edge
The Rate
Establishing the Rate
Normal and Fast Rates
Bradycardic Rates
Chapter Review
Basic Concepts in Arrhythmia Recognition
Premature Complexes
Escape Complexes and Rhythms
Ectopic Foci and Their Morphologies
Ectopic Foci in the Ventricles
The Isolated Electrocardiographic Type of Fusion
Actual Fusion
Chapter Review
Relevant Topics in Basic Electrocardiography
Basic Information
Localizing an Area: Inferior Wall
Localizing Other Areas
The Electrical Axis
How to Calculate the Electrical Axis
Bundle Branch Blocks
What Happens if One Side is Blocked?
Right Bundle Branch Block (RBBB)
Left Bundle Branch Block (LBBB)
Chapter Review
Arrhythmias: A Quick Review
Major Concepts
P Waves
QRS Complexes
Individual Rhythms
Supraventricular Rhythms
Ventricular Rhythms
Heart Blocks
Chapter Review
Sinus Rhythms
Normal Sinus Rhythm
Introduction to Sinus Rhythms
Normal Sinus Rhythm
The Formation of the ECG
Regularly Irregular Rhythms
Irregularly Irregular Rhythms
ECG Strips
Chapter Review
Sinus Bradycardia
When is Sinus Bradycardia Considered a Cardiac Emergency?
ECG Strips
Chapter Review
Sinus Tachycardia
A Quick Clinical Word
Clinical Characteristics
ECG Strips
Chapter Review
Sinus Arrhythmia
Respiratory Sinus Arrhythmia
Nonrespiratory or Nonphasic Sinus Arrhythmia
Some Additional Clinical Points
ECG Strips
Chapter Review
Sinus Blocks, Pauses, and Arrests
Sinus Block
Sinus Pause and Sinus Arrest
ECG Strips
Chapter Review
Section 2 Self-Test
Section 2 Self-Test Answers
Atrial Rhythms
Premature Atrial Contraction
The P Wave Axis
PACs and the PR Interval
The Pause
The PAC and Aberrancy
The Hidden PAC
P Falling on a T
Blocked PACs
ECG Strips
Chapter Review
Ectopic Atrial Rhythm
Diagnostic Challenges
Hint #1
Hint #2
ECG Strips
Chapter Review
Ectopic Atrial Tachycardia
ECG Strips
Chapter Review
Ectopic Atrial Tachycardia with Block
Diagnostic Criteria
P Waves in EAT with Block
The Problem with Lead II
ECG Strips
Chapter Review
Wandering Atrial Pacemaker
Wandering Atrial Pacemaker: The Classical Definition
Wandering Atrial Pacemaker: A Clinical Variation
ECG Strips
Chapter Review
Multifocal Atrial Tachycardia
Clinical Scenario
ECG Strips
Chapter Review
Atrial Flutter
General Overview
The Making of the Saw-Tooth Pattern
AV Nodal Conduction Rates
Atrial and Ventricular Rates
Recognizing Atrial Flutter
Atrial Flutter and Wide-Complex Tachycardias
ECG Strips
Chapter Review
Atrial Fibrillation
General Information
How f Waves Are Created
Ventricular Response
Clinical Implications
Regular Ventricular Response in Atrial Fibrillation
The Morphology of the Complexes in Atrial Fibrillation
ST Segments and T Waves
ECG Strips
Chapter Review
Section 3 Self-Test
Section 3 Self-Test Answers
Junctional Rhythms
Introduction to Junctional Rhythms
A Closer Look at the AV Node
The Junction as a Pacemaker
Junctional Rhythms: An Overview
Chapter Review
Junctional Rhythm
Junctional Escape Complexes and Rhythms
ECG Strips
Chapter Review
Premature Junctional Contraction
ECG Strips
Chapter Review
Rapid Junctional Rhythms
Pseudo-S and Pseudo-R' Waves
ECG Strips
Chapter Review
AV Nodal Reentry Tachycardia
General Overview
General Concepts in AV Nodal Reentry
Reentry and AVNRT
Identifying the Arrhythmia
ECG Strips
Chapter Review
AV Reentry Tachycardia
Normal Conduction Through an Accessory Pathway
AVRT Reentry Circuits
Orthodromic AVRT
The P Wave and AVRT
Other Important Clinical Facts
Antidromic AVRT
ECG Strips
Chapter Review
How to Approach a Narrow-Complex Tachycardia
The Hemodynamic Consequences of a Tachycardia
Heart Rate and Hemodynamics
A Few Extra Seconds...
Focused Treatment Requires Focused Identification
What to Look for in an SVT
The P Wave
The P-QRS Relationship
The Company It Keeps
A Final Word
Chapter Review
Section 4 Self-Test
Section 4 Self-Test Answers
Ventricular Rhythms
Introduction to Ventricular Rhythms
The Ventricle as a Pacemaker
The P Wave in Ventricular Rhythms
P Wave Morphology in Ventricular Rhythms
The P:QRS Relationship in Ventricular Rhythms
Ventricular Rhythms: General Overview
Chapter Review
Premature Ventricular Contraction
General Overview
Coupling Interval
Compensatory vs. Noncompensatory Pauses
Unifocal vs. Multifocal PVCs
Bigeminy, Trigeminy, and More
Couplets, Triplets, and Salvos
The P Wave and PVCs
Fusion Complexes
ECG Strips
Chapter Review
Ventricular Escape and Idioventricular Rhythms
General Overview
Ventricular Escape Complexes
Idioventricular Rhythm
Accelerated Idioventricular Rhythm
Capture Beats
ECG Strips
Chapter Review
Ventricular Tachycardia
General Overview
Reentry and Other Possible Mechanisms
The presence of an electrical circuit with at least two pathways
The two pathways must have different properties
An area of slowing in one of the circuits--just enough to allow the rest of the circuit to get over its refractory period
General Characteristics of VTach
Morphology of the Complexes and Arrhythmia Recognition
AV Dissociation
Similar Morphology to PVCs
Nonsustained Monomorphic Ventricular Tachycardia
Sustained Monomorphic Ventricular Tachycardia
Ventricular Flutter
ECG Strips
Chapter Review
Polymorphic Ventricular Tachycardia and Torsade de Pointes
General Overview
Polymorphic Ventricular Tachycardia
Torsade de Pointes
Onset of Torsade de Pointes
The Turning of the Points
Causes of Torsade de Pointes
ECG Strips
Chapter Review
How to Approach a Wide-Complex Tachycardia
General Overview
The Approach
AV Dissociation
Capture Beats
Fusion Complexes
P Waves
Regular or Irregular?
Electrical Axis in the Extreme Right Quadrant
Concordance in the Precordial Leads
Physical Examination
Case Discussion
Physical Examination
What do you think of the patient's history?
What do you think of this patient's physical examination?
What do you think of this patient's rhythm?
How can you put it all together?
Chapter Review
Ventricular Fibrillation and Asystole
Ventricular Fibrillation
ECG Strips
Chapter Review
Section 5 Self-Test
Section 5 Self-Test Answers
Additional Rhythms and Information
Atrioventricular Block
General Overview
First-Degree AV Block
Second-Degree AV Block
Second-Degree AV Block or Wenckebach
Mobitz I Second-Degree AV Block: A Final Word
Second-Degree AV Block
Untypable or 2:1 Second-Degree AV Block
High-Grade or Advanced AV Block
Complete or Third-Degree AV Block
Chapter Review
Artificially Paced Rhythms
General Overview
Pacemaker Code
The Pacemaker Spike
QRS Morphology in a Paced Rhythm
Popular Pacemaker Modes
Atrial Demand Pacemaker
Ventricular Demand Pacemaker
AV Sequential
Automatic Pacemaker
ECG Strips
Chapter Review