Conceptual Electrocardiography

Preface
Acknowledgement
Contents
List of Figures
Introduction
	References
Genesis of Cardiac Voltage Changes
	Cellular Polarity
	Cellular Depolarization and Variation in the Action Potential
	Depolarizing Muscle Tissue
	The P, QRS, T, and U Waves
	Cardiac Activation Sequence
	Standard Recording Technique
	References
Conceptualizing Electrocardiographic Forces
	The Lead System
	Frontal Plane Leads
	Horizontal Plane Leads
	Using the Lead System
	A Basic Approach to EKG Interpretation
	References
Specific Electrocardiographic Abnormalities
	Intraventricular Conduction Problems
		Right Bundle Branch Block (RBBB)
		Left Bundle Branch Block (LBBB)
		Superior Fascicular Block (Anterior Hemiblock)
		Inferior Fascicular Block (Posterior Hemiblock)
		Bifascicular Block
	Chamber Enlargement: Basic Concepts
		Left Atrial Enlargement (LAE) (Formerly Called P Mitrale)
		Right Atrial Enlargement (RAE) (Formerly Called P Pulmonale)
		Fig. 24 RAE and RVE with “strain pattern”
		Left Ventricular Enlargement (LVE)
			Fig. 25 LVE-Rombilt-Estes criteria; Sokolow-Lyon criteria; Cornell criteria
		Right Ventricular Enlargement (RVE)
	Chronic Obstructive Pulmonary Disease (COPD)
	Low Voltage
	Acute Pulmonary Embolus
	Fig. 29 Chaotic atrial rhythm (COPD)
	Electrocardiographic Changes Due to Ischemic Heart Disease
		Ischemic Changes
		Injury Changes
		Wellens’ Syndrome
		Q Wave Infarction
		Location of Q Wave Infarction
		Recognition of Pseudo-Infarction
		Non-Q Wave Infarction
		Tako-Tsubo Syndrome
	Other Common Repolarization Changes
		Pericarditis
		“Normal” Early Polarization
		Digitalis Effect
		Hypothermia
		Diffuse T Wave Inversion
			Apical Variant Hypertrophic Cardiomyopathy
			Intracranial Hemorrhage
		T Wave Alternans
		Arrhythmogenic Right Ventricular Dysplasia (ARVD)
		Hyperkalemia
		Hypokalemia
		Hypercalcemia
		Hypocalcemia
		Hypermagnesemia and Hypomagnesemia
		Lithium
		Tricyclic Antidepressants
	Common Artifacts
		Lead Misplacement
		Motion Artifacts
		Electrical Artifacts
		Pacemakers
	References
Common Arrhythmias
	Conduction Problems Between Atria and Ventricles
		First-Degree (1°) A-V Block
		Second-Degree (2°) Block
		Third-Degree (3°) Block
		A-V Dissociation Due to “Usurpation”
		Pre-Excitation
	Disturbances of Impulse Formation
		Reentry
		Automacity
		Triggered Arrhythmias
	Supraventricular Dysrhythmias
		Sinus Node Reentry
		Postural Orthostatic Tachycardia Syndrome (POTS)
		Premature Atrial Depolarization (PAD)
		Atrial Tachycardia
		Multifocal Atrial Tachycardia
		Atrial Fibrillation
		Atrial Flutter
	Junctional Rhythms
		A-V Nodal Reentrant Tachycardia (AVNRT)
		Wolff-Parkinson-White Syndrome Atrio-Ventricular Reentrant Tachycardia (AVRT)
	Ventricular Dysrhythmias
		Premature Ventricular Depolarizations
		Ventricular Tachycardia
			Non-sustained Ventricular Tachycardia (NSVT)
		Accelerated Idioventricular Rhythm (AIVR)
			Sustained Ventricular Tachycardia
		Torsades de Pointes
		Congenital Long Q-T Syndromes
		Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)
		Idiopathic Sustained Left Ventricular Tachycardia
		Brugada Syndrome
		Wide Complex Tachycardia
		Ventricular Fibrillation
	References
Self-Assessment EKG Tracings
Self-Assessment Tracing Analysis
References
Index