ECG analysis

1. ECG INTERPRETATION -3
Dr.Abhishek Singh
Medicine Resident

9. ST Elevation Definition

43. SCN5A Channelopathy
• Defect in RT ventricular epicardium
• Creates Voltage gradient btw epicardium
• Triggers VT/TDP
• ECG changes in V1&V2
• Mx=IC.D

57. ARRHYTHMIA

63. LGL syndrome ecg

66. Atrial Fibrillation
• Ectopic foci fires @300-600>>SAN (60-100)
• Absent P wave
• Since ectopics fires at variable freq, A-V nodal
blocks keeps on changing
• Fluctuating V. rate (R-R intreval)
• Reduced R-R intreval
• Narrow/normal qrs complex

68. Treatment
Rate control
Anticoagulant -dabigatran,Rivoroxabin
Chemicalcardioversion-Ibutilide/amiodarone
Electricalcardioversion-200J
Decision for anticoagulant depends on CHAD S2 VASc
Score

69. ATRIAL FLUTTER
• Single ectopic foci in cavotricuspid isthmus
• Saw tooth pattern of waves
• Changes seen in lead 2,3& avF(rtsided)

71. MAT
• 3 different morphologies of P waves
• Isoelectric baseline btw P waves
• Variable P-P & P-R intreval
• NOTE-baseline is never acheived in A.flutter

74. PSVT
• A/k/a AVNRT
• Narrow qrs
• ST segment depression
• Reduced R-R intreval
• R-R intreval is regular
• Holter device monitoring may be indicated

78. Monomorphic VT
• A-V dissociation due to intermyocyte conduction
• Josephson sign-notch during downstroke of S wave
• Captured beats-normal sinus waveform in between
abnormal rythm.

81. Polymorphic VT
• Broad qrs complexes of multiple morphologies

83. Torsades de pointes
• Polymorphic ventricular tachycardia
• Prolonged QTc
• QTc=QT/√R-R intreval
• DOC-MgSO4

86. Thank you🌝