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1 Nonconducted and aberrantly conducted PAC'sIn A the slow sinus rhythm is actually caused by nonconducted PACs hidden in the ST segment. This is confirmed in B where some of the PACs are aberrantly conducted with LBBB, and some PACs are nonconducted.Knowledge Weavers ECG
2 Folate Pool - The Role of B Vitamins in One-Carbon MetabolismThis figure depicts the pathway for folate utilization and the role of vitamins B6 and B12 in the metabolism of methyl-tetrahydrofolate and homocysteine.Folate; FolicinHEAL Open Review Collection
3 ECG components diagram - marquetteECG components diagram - marquetteKnowledge Weavers ECG
4 PAC's with RBBB aberrant conductionPAC's are identified by the arrows. Note that the PP interval surrounding the PAC is less than 2x the basic sinus cycle indicating that the sinus node has been reset by the ectopic P wave. The pause after the PAC, therefore, is incomplete.Knowledge Weavers ECG
5 1st degree AV blockThe normal PR interval is 0.12 - 0.20 sec, or 120 -to- 200 ms. 1st degree AV block is defined by PR intervals greater than 200 ms. This may be caused by drugs, such as digoxin; excessive vagal tone; ischemia; or intrinsic disease in the AV junction or bundle branch system.Knowledge Weavers ECG
6 Neural Network Controlling Wakefulness (Labeled)Brainstem reticular activating system.Royal College of Surgeons in Ireland Illustrations
7 LVH - best seen in the frontal plane leads!LVH - best seen in the frontal plane leads!Knowledge Weavers ECG
8 Propionyl CoA production from odd-chain fatty acidsBeta-oxidation of fatty acids with an odd number of carbons inthe chain yields the three-carbon propionyl CoA as the final fragment.BiosynthesisKnowledge Weavers Fatty Acids
9 Isochronic ventricular rhythmAn isochronic ventricular rhythm is also called an accelerated ventricular rhythm because it represents an active ventricular focus. This arrhythmia is a common reperfusion arrhythmia in acute MI patients. It often begins and ends with fusion beats and there is AV dissociation. Treatment is usuall...Knowledge Weavers ECG
10 LVH: limb lead criteriaIn this example of LVH, the precordial leads don't meet the usual voltage criteria or exhibit significant ST segment abnormalities. The frontal plane leads, however, show voltage criteria for LVH and significant ST segment depression in leads with tall R waves. The voltage criteria include 1) R in...Knowledge Weavers ECG
11 ST segment depressionST segment depression is a nonspecific abnormality that must be evaluated in the clinical context in which it occurs. In a patient with angina pectoris ST depression usually means subendocardial ischemia and, unlike ST elevation, is not localizing to a particular coronary artery lesion.Knowledge Weavers ECG
12 Rate-dependent LBBBIn this rhythm strip of sinus arrhythmia, the faster rates have a LBBB morphology. In some patients with a diseased left bundle branch, the onset of LBBB usually occurs initially as a rate-dependent block; i.e., the left bundle fails to conduct at the faster rate because of prolonged refractoriness...Knowledge Weavers ECG
13 Transfer of a malonyl group to the acyl carrier peptideDuring fatty acid synthesis the incoming two carbon fragment is introduced as the three-carbon malonyl group. It is added to the -SH group of the acyl carier peptide domain of fatty acid synthase. In a subsequent reaction the carbon shown in green will be lost as bicarbonate ion.Knowledge Weavers Fatty Acids
14 RV vs LV PVC's - marquetteRV vs LV PVC's - marquetteKnowledge Weavers ECG
15 RBBB: Precordial leadsRBBB: Precordial leadsKnowledge Weavers ECG
16 Inferior MI and RBBBInferior MI and RBBBKnowledge Weavers ECG
17 Transport of fatty acyl CoA into mitochondria by the carnitine shuttleFatty acyl CoA cannot cross the inner mitochondrial membrane, so it is carried in the form of fatty acyl carnitine.Knowledge Weavers Fatty Acids
18 Atrial parasystoleParasystolic rhythms involve an independent ectopic pacemaker resulting in nonfixed coupled premature beats. Parasystole may occur in the atria, as seen in this example, in the AV junction, and in the ventricles. Note the common inter-ectopic interval separating the parasystolic PAC's.Knowledge Weavers ECG
19 Digitalis intoxication: junctional tachycardia with and without exit blockIn A the rhythm is junctional tachycardia with RBBB. In B there is 2nd degree exit block with a 3:2 conduction ratio; i.e., every 3rd junctional impulse fails to reach the ventricles... at least for the first two groupings on 1.4sec.Knowledge Weavers ECG
20 LVH and many PVCsThe combination of voltage criteria (SV2 + RV6>35mm) and ST-T abnormalities in V5-6 are definitive for LVH. There may also be LAE as evidenced by the prominent negative P terminal force in lead V1. Isolated PVCs and a PVC couplet are also present.Knowledge Weavers ECG
21 Frontal plane QRS axis = +150 degrees (RAD)This is an unusual right axis deviation (RAD). Lead I is negative, which usually means RAD. Lead II is the isoelectric lead, which almost always means -30 degrees; but in this example the axis is 180 degrees away from -30, or +150 degrees.Knowledge Weavers ECG
22 Pacemaker failure to capture - marquettePacemaker failure to capture - marquetteKnowledge Weavers ECG
23 WPW type preexcitation - marquetteWPW type preexcitation - marquetteKnowledge Weavers ECG
24 Sinus pause or arrest - marquetteSinus pause or arrest - marquetteKnowledge Weavers ECG
25 SA exit block - marquetteSA exit block - marquetteKnowledge Weavers ECG
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