Ecg basics conduction tissue
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This document discusses Dr. Md.Toufiqur Rahman's credentials as an Associate Professor of Cardiology and then provides examples of different types of conduction tissue pathology in electrocardiograms (ECGs), including sinoatrial block, first degree block, second degree block (Mobitz type 2 and Wenckebach), second degree block (2:1), and complete (third degree) block. Diagrams of ECG tracings are shown to illustrate each type of block.
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This case report describes a 37-year-old male with recurrent ventricular tachycardia due to long QT syndrome. The patient experienced multiple episodes of sudden unconsciousness triggered by physical exertion. Electrocardiograms showed a prolonged QT interval over 500 milliseconds. The patient was treated with intravenous and oral amiodarone to revert episodes of ventricular tachycardia, as well as prescribed propranolol. He was advised to receive an implantable cardiac defibrillator but did not follow up. The long QT syndrome is a primary electrical disease characterized by an abnormally prolonged QT interval that can cause dangerous arrhythmias and sudden cardiac death if left untreated.
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The PR interval is the time from the onset of the P wave to the start of the QRS complex.
It reflects conduction through the AV node.
The normal PR interval is between 120 – 200 ms (0.12-0.20s) in duration (three to five small squares).
If the PR interval is > 200 ms, first degree heart block is said to be present.
PR interval < 120 ms suggests pre-excitation (the presence of an accessory pathway between the atria and ventricles) or AV nodal (junctional) rhythm.
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Case-1:
A 23 years old medical student presented with occasional palpitation, shortness of breath and chest discomfort. He had the following ECG.
A 53 years old gentleman presented with palpitations for last 5 hours. He is smoker, diabetic, dyslipidemic and hypertensive. He had exertional chest discomfort for last 5 years and did coronary angiogram 3 years back and CAG revealed TVD and advised for revascularization. But he refused and was irregular in medication and reluctant for life style modification. He came to emergency department with this ECG.
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This case report describes a 37-year-old male with recurrent ventricular tachycardia due to long QT syndrome. The patient experienced multiple episodes of sudden unconsciousness triggered by physical exertion. Electrocardiograms showed a prolonged QT interval over 500 milliseconds. The patient was treated with intravenous and oral amiodarone to revert episodes of ventricular tachycardia, as well as prescribed propranolol. He was advised to receive an implantable cardiac defibrillator but did not follow up. The long QT syndrome is a primary electrical disease characterized by an abnormally prolonged QT interval that can cause dangerous arrhythmias and sudden cardiac death if left untreated.
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This ECG shows a woman with alternating right bundle branch block (RBBB) and left bundle branch block (LBBB) during episodes of atrial ectopy. The mechanism is alternating phase 3 block in the bundle branches due to the relative refractory periods of the left and right bundle branches. Premature atrial contractions conduct down one bundle branch, making it relatively refractory due to the long-short sequence, which then causes the next premature contraction to conduct down the other bundle branch, resulting in the alternating pattern seen. This phenomenon indicates a relative functional delay rather than a diseased conduction system.
Long term post Ventricular tachycardia ablation guided by non contact mapping...
This study assessed radiofrequency catheter ablation guided by non-contact mapping for treatment of monomorphic ventricular tachycardia after myocardial infarction. Fifteen patients underwent either targeted ablation of exit sites and areas of slow conduction (Group I, 7 patients) or substrate modification with linear ablation lesions (Group II, 8 patients). Acute success rates were high for both groups. Long term success was also good, with no recurrence of ablated ventricular tachycardias during follow up for most patients. Substrate modification using linear ablation guided by non-contact mapping showed promise for preventing reinduction of arrhythmias.
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This document discusses defibrillation, cardioversion, and pacing. It provides:
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2) An overview of cardioversion for treating unstable tachyarrhythmias with signs of low cardiac output, excessive heart rates, or chest pain. Synchronized cardioversion times shock delivery to the QRS complex.
3) Information on pacing for unstable bradyarrhythmias and symptomatic bradycardia, including complete heart block and Mobitz type II second-degree heart block.
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This document provides a guide to ECGs. It begins by outlining the objectives which are to cover electrical conduction in the heart, lead placement, ECG settings, components, waves, complexes, and abnormalities. It then discusses the cardiac conduction system, ECG waves and components, 12-lead ECG placement, components of the ECG including rate, rhythm, axis, P wave, PR interval, QRS complex, QT interval, ST segment, T wave, and other waves. It provides examples of normal ECG characteristics and discusses how to systematically analyze an ECG by examining rate, rhythm, axis, P wave, PR interval, QRS complex, QT interval and QTc, ST segment, and T wave
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Presentation of each wave
Some basic findings
And how to interpret them.
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This document provides an overview of electrocardiogram (EKG or ECG) interpretation. It discusses how to determine the rate, rhythm, axis, intervals and segments of an EKG tracing. Specifically, it describes how to measure the heart rate, identify normal sinus rhythm versus conduction blocks, assess the P wave, PR interval, QRS duration, QT interval, and ST segment changes indicative of myocardial infarction. The document also reviews criteria for identifying left ventricular hypertrophy, right ventricular hypertrophy, left and right bundle branch blocks. The goal is to teach healthcare providers how to systematically evaluate EKG tracings.
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Ecg basics conduction tissue
- 1. Dr. Md.Toufiqur Rahman MBBS, FCPS, MD, FACC, FESC, FRCP, FSCAI, FAPSIC, FAPSC Associate Professor of Cardiology National Institute of Cardiovascular Diseases Sher-e-Bangla Nagar, Dhaka-1207
- 2. Dr. Md.Toufiqur Rahman MBBS, FCPS, MD,FACC, FESC, FRCP, FSCAI, FAPSIC, FAPSC
- 5. Leads of ECG
- 7. Pathology of conduction tissue
- 8. Sinoatrial block • Sinus rhythm for three beats, then a 'sinus pause' • P waves arrowed • The expected P wave is not seen, but the SA node must have been depolarized because the next P wave appears at the predicted time
- 9. First degree block • Sinus rhythm • PR interval is constant (360 ms)
- 10. Second degree block (Mobitz type 2) • Sinus rhythm with a normal PR interval • One P wave (arrowed) is not followed by a QRS complex
- 11. Second degree block (Wenckebach) • Three beats with progressively longer PR intervals are followed by a non-conducted P wave (arrowed) • The next PR interval is short, but this is followed by a longer PR interval and then another non-conducted beat
- 12. Second degree block (2:1) • The conducted beats have a normal PR interval • Alternate P waves are not followed by a QRS complex ;
- 13. Complete (third degree) block • No relationship between P waves (arrowed) and QRS complexes • The QRS complexes are normal, indicating that the origin of ventricular depolarization is within the His bundle • The ventricular rate is 30/min
- 14. Complete (third Degree) block • No relationship between P waves (arrowed) and QRS complexes • Wide QRS complexes • Ventricular rate of 22/min
- 15. Thank You All