Interpretation of cardiac arrhythmias : self assessment approach /
by Zainul Abedin and Robert Conner.
Boston : Kluwer Academic, c2000.
x, 578 p. : ill.
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added author
Boston : Kluwer Academic, c2000.
catalogue key
Includes bibliographical references and index.
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This item was reviewed in:
SciTech Book News, June 2000
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Main Description
Accurate diagnosis of arrhythmias is the goal of this volume. Before the clinician can accurately classify the multiple permutations of cardiac rhythm encountered in daily practice, several essential preconditions must be met. At the most basic level, the clinician must know the diagnostic criteria for each rhythm. Without a clear understanding of these criteria, an accurate differential diagnosis is impossible, and without accurate diagnosis, correct intervention is a mere matter of chance. A second precondition of accurate rhythm diagnosis is an understanding of the mechanism of arrhythmias. Not uncommonly, two or more arrhythmic mechanisms coexist, confronting the clinician with a baffling mixture of apparently unrelated complexes and intervals. Without an understanding of the various arrhythmic mechanisms, simple and complex, the tangled skein of data can never be unraveled. Finally accurate arrhythmia diagnosis depends on skill attained through practice. The competent electrocardiographer combines the skills of precise measurement and rational application of logic with broad theoretical knowledge. The pleasure of electrocardiography is seeing through the surface appearance to the inner workings. Interpretation of Cardiac Arrhythmias presupposes no prior knowledge of arrhythmias, and progresses from basic to the complex. The didactic sections focus extensively on the mechanism of arrhythmia, using laddergrams and other diagramatic devices to help the student visualize what is happening with the cardiac conduction system. Extensive self-assessment sections enable students to apply critical skills and test their grasp of the diagnostic criteria.
Unpaid Annotation
Progresses from basic to complex to help students works toward accurate arrhythmia diagnosis. Didactic sections focus on the mechanism of arrhythmias, using laddergrams and other diagrammatic devices to help students visualize what is happening within the cardiac conduction system. Self-assessment sections with answer keys enable students to apply critical skills and test their grasp of the diagnostic criteria.
Table of Contents
Prefacep. v
The Electrocardiogramp. 1
Anatomy of the conduction systemp. 1
The electrocardiogramp. 4
ECG paper and rate calculationp. 10
The Sinus Rhythmsp. 11
Normal sinus rhythmp. 11
Sinus arrhythmiap. 12
Accelerated atrioventricular conductionp. 12
Sinus tachycardiap. 12
Sinus bradycardiap. 12
Wandering atrial pacemakerp. 14
Self-assessment section: Chapter 2p. 15
Answer keyp. 22
Axis Determinationp. 23
Lead systemsp. 23
Axis determinationp. 24
Self-assessment section: Chapter 3p. 31
Answer keyp. 42
The Atrial Arrhythmiasp. 43
Premature atrial complexesp. 43
Ectopic atrial rhythmp. 47
Atrial fibrillationp. 47
Atrial flutterp. 50
Atrial tachycardiap. 53
Multifocal atrial tachycardiap. 53
Posttachycardia sinus depressionp. 55
Differential diagnosis of supraventricular tachycardiasp. 55
Referencesp. 55
Self-assessment section: Chapter 4p. 57
Answer keyp. 69
Atrioventricular Blockp. 71
Prolonged PR interval (first-degree AV block)p. 71
Second-degree AV blockp. 73
Type I (Wenckebach) second-degree AV blockp. 73
Skipped P wavesp. 80
First-degree AV block and nonconducted P wavesp. 80
Type II (Mobitz II) second-degree AV blockp. 80
Second-degree AV block with 2:1 and 3:1 conduction ratesp. 82
High-grade (advanced) second-degree blockp. 84
Paroxysmal AV blockp. 87
Third-degree AV blockp. 90
Ventriculophasic sinus arrhythmiap. 93
Block-acceleration dissociationp. 93
Referencesp. 96
Self-assessment section: Chapter 5p. 97
Answer keyp. 115
Multilevel Atrioventricular Blockp. 117
Wenckebach conduction of supraventricular tachycardiap. 117
Maintenance of even conduction ratiosp. 119
Wenckebach periods of alternate beatsp. 122
Wenckebach conduction at successive levelsp. 132
Referencesp. 132
Sick Sinus Syndromep. 133
Sinoatrial exit blockp. 133
Second-degree SA blockp. 134
Sinus arrestp. 140
Tachycardia-bradycardia syndromep. 142
Sinus node suppressionp. 142
Referencesp. 149
Self-assessment section: Chapter 7p. 151
Answer keyp. 160
Intraventricular Conduction Defectsp. 161
Fascicular blockp. 162
Bundle branch blockp. 163
Bifascicular blockp. 165
Bilateral bundle branch blockp. 167
Aberrant ventricular conductionp. 167
Wenckebach periods in bundle branchesp. 170
Self-assessment section: Chapter 8p. 175
Answer keyp. 197
The Junctional Rhythmsp. 199
Junctional extrasystoles and rhythmsp. 201
Idiojunctional rhythmp. 203
Double junctional rhythmp. 203
Self-assessment section: Chapter 9p. 209
Answer keyp. 222
Escape and Capturep. 223
Escape beats and rhythmsp. 223
Capture beatsp. 234
Referencesp. 239
Self-assessment section: Chapter 10p. 241
Answer keyp. 254
The Echo Phenomenon and Dual Pathwaysp. 255
The echo phenomenon (reciprocation)p. 255
Different PR and RP intervals as a manifestation of dual pathwaysp. 259
Dual ventricular response as a manifestation of dual pathwaysp. 264
The Wolff--Parkinson--White Syndromep. 265
Localization of accessory pathway using the surface ECGp. 270
Self-assessment section: Chapter 12p. 277
Answer keyp. 297
Supraventricular Reentrant Tachycardiap. 299
Atrioventricular nodal reentry tachycardia (AVNRT)p. 300
Bypass tract-mediated tachycardia (BTMT)p. 303
Diffential diagnosis: AVNRT versus BTMTp. 304
P:QRS relationship and P wave morphologyp. 304
Initiation of the tachycardiap. 309
Electrical alternansp. 309
Atrioventricular blockp. 309
Decrease of rate with QRS wideningp. 311
Maneuvers and drugsp. 312
ST segment depression during tachycardiap. 313
Multiple coexisting pathwaysp. 313
Permanent junctional reciprocating tachycardia (PJRT)p. 313
Mahaim tachycardiap. 316
Interventionsp. 318
Sinoatrial reentry tachycardiap. 318
Referencesp. 320
Self-assessment section: Chapter 13p. 321
Answer keyp. 356
Concealed Conduction and Concealed Extrasystolesp. 359
Concealed atrioventricuar reentry complicating wenckebach cyclesp. 367
Transseptal concealed conduction perpetuating aberrant ventricular conductionp. 371
Concealed conduction suppressing impulse formationp. 373
Concealed junctional extrasystolesp. 375
Referencesp. 381
The Ventricular Arrhythmiasp. 383
Ventricular extrasystolesp. 384
Thr rule of bigeminyp. 386
Monomorphic ventricular tachycardiap. 386
Differential diagnosis of wide-QRS tachycardiasp. 389
Width of the QRS complexp. 389
QRS axisp. 389
Atrioventricular dissociationp. 390
Ventricular fusion and capture beatsp. 394
QRS morphologyp. 395
Ventricular tachycardia with right bundle branch morphologyp. 398
Ventricular tachycardia with left bundle branch morphologyp. 401
Ventricular tachycardia versus aberrancyp. 403
Polymorphic ventricular tachycardiap. 404
Congenital long QT syndromes (CQTS)p. 405
Catecholaminergic polymorphic VTp. 406
Miscellaneous syndromesp. 406
The Brugada syndromep. 406
Ventricular tachycardia due to bundle branch reentryp. 409
Arrhythmogenic right ventricular dysplasiap. 409
Right ventricular outflow tract (RVOT) ventricular tachycardiap. 410
Idiopathic left ventricular tachycardiap. 410
Bidirectional ventricular tachycardiap. 410
Accelerated idioventricular rhythmp. 412
Ventricular fibrillationp. 413
Etiology of ventricular fibrillationp. 413
Referencesp. 415
Self-assessment section: Chapter 15p. 417
Answer keyp. 456
Exit Blockp. 459
Parasystolep. 465
Self-assessment section: Chapter 17p. 475
Answer keyp. 511
Electronic Pacemakersp. 515
Basic functional parametersp. 516
NBG Pacemaker Codep. 517
Pacemaker intervalsp. 519
Pacemaker malfunctionp. 522
Diagnosis of pacemaker malfunctionp. 523
Altered pacemaker artifact (spike)p. 523
QRS morphology during pacingp. 523
Prolonged spike-to-QRS intervalp. 525
Undersensingp. 525
Oversensingp. 525
Failure to pacep. 526
Loss of capturep. 526
Basic pacemaker timing cyclesp. 527
Dual chamber pacemaking timing cyclesp. 528
Self-assessment section: Chapter 18p. 531
Answer keyp. 567
Indexp. 571
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