This document summarizes an ECG interpretation course covering Brugada syndrome, WPW syndrome, electrolyte imbalances, and the effects of digoxin. The course objectives are to understand Brugada syndrome and its associated polymorphic VT, WPW pattern on ECG and WPW syndrome, how electrolyte imbalances like hypomagnesemia can alter the ECG, and how digoxin affects the ECG. It also includes example ECGs and cases to test the interpretation of arrhythmias and electrolyte abnormalities.

1. ECG interpretation course
Dr Syed Raza
MD, MRCP, FRCP, CCT, FACC, FESC, FESCVI
Consultant Cardiologist
Awali Hospital, Bahrain

2. Objectives
• 1. Brugada syndrome
• 2. WPW syndrome
• 3. Electrolyte imbalance
• 4. Digoxin effect

3. Brugada Syndrome

9. Polymorphic VT
Polymorphic VT in Brugada Torsade Pointes

10. Factors that will accentuate or provocate
Brugada ECG changes
• Accentuate : Fever, surgery, beta-blocker, TCA , cocaine, alcohol
• Provocative tests - Ajmaline , Flecainide

11. WPW pattern ECG / WPW syndrome
WPW syndrome = WPW Pattern ECG + symptom

14. WPW pattern types
Type A Type B

16. SVT in WPW - AVRT
Orthodromic -AVRT Ante-dromic - AVRT

19. AF with Pre-excitation

20. Electrolyte Imbalance - ECG changes

27. Hypomagnesaemia / Hypermagnesemia

32. Digoxin effect on ECG

34. 68 m, DM, CKD presents to A & E with
vomiting and weakness.

35. What electrolyte abnormality is likely to
cause the ECG changes ?
• 1. Hypercalcemia
• 2. Hypercalcemia
• 3. Hypomagnesemia
• 4. Hyperkalemia
• 5. Hypokalemia

36. 44 M presents with syncope

37. The ECG is suggestive of …
• 1. Long QT syndrome
• 2. Arrhythmogenic right ventricular arrhythmia
• 3. Short QT interval
• 4. Brugada syndrome
• 5. HOCM