Health Education Assets Library (HEAL)
 
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TitleDescriptionSubjectCollection
51 Atypical LBBB with Q waves in leads I and aVLIn typical LBBB, there are no initial Q waves in leads I, aVL, and V6. If Q waves are present in 2 or more of these leads, myocardial infarction is present.Knowledge Weavers ECG
52 AV dissociation by defaultIf the sinus node slows too much a junctional escape pacemaker may take over as indicated by arrows. AV dissociation is incomplete, since the sinus node speeds up and recaptures the entricles.Knowledge Weavers ECG
53 AV dissociation by defaultThe nonconducted PAC's set up a long pause which is terminated by ventricular escapes; note the wider QRS morphology of the escape beats indicating their ventricular origin. Incomplete AV dissociation occurs during the escape beats, since the atria are still under the control of the sinus node.Knowledge Weavers ECG
54 AV dissociation by usurpationNormal sinus rhythm is interrupted by an accelerated ventricular rhythm whose rate is slightly faster than the sinus rhythm. Fusion QRS complexes occur whenever the sinus impulse enters the ventricles at the same time the ectopic ventricular focus initiates its depolarization.Knowledge Weavers ECG
55 AV sequential pacemaker - marquette(Summary)Knowledge Weavers ECG
56 Bifascicular block: RBBB + LAFBBifascicular block: RBBB + LAFBKnowledge Weavers ECG
57 Bifascicular block: RBBB + LAFBThis is the most common of the bifascicular blocks. RBBB is most easily recognized in the precordial leads by the rSR' in V1 and the wide S wave in V6 (i.e., terminal QRS forces oriented rightwards and anterior). LAFB is best seen in the frontal plane leads as evidenced by left axis deviation (-50...Knowledge Weavers ECG
58 Bradycardia-dependent LBBB with carotid sinus massageWhen carotid sinus massage slows the heart rate in this example, the QRS widens into a LBBB. This form of rate-dependent bundle branch block is thought to be due to latent pacemakers in the bundle undergoing phase 4 depolarization; when the sinus impulse enters the partially depolarized bundle, slow...Knowledge Weavers ECG
59 Calibration signal - marquetteCalibration signal - marquetteKnowledge Weavers ECG
60 Cardiac conduction system diagram - marquetteCardiac conduction system diagram - marquetteKnowledge Weavers ECG
61 Compensatory vs. non-compensatory pauses - marquetteCompensatory vs. non-compensatory pauses - marquetteKnowledge Weavers ECG
62 Complete AV block (3rd degree) with junctional rhythmComplete AV block (3rd degree) with junctional rhythmKnowledge Weavers ECG
63 Complete AV block, junctional escape rhythm, and ventriculophasic sinus arrhythmiaComplete AV block is seen as evidenced by the AV dissociation. A junctional escape rhythm sets the ventricular rate at 45 bpm. The PP intervals vary because of ventriculophasic sinus arrhythmia; this is defined when the PP interval that includes a QRS is shorter than a PP interval that excludes a ...Knowledge Weavers ECG
64 Conceptual framework: aArrhythmias and conduction abnormalitiesConceptual framework: aArrhythmias and conduction abnormalitiesKnowledge Weavers ECG
65 Diagram: frontal plane leadsDiagram: frontal plane leadsKnowledge Weavers ECG
66 Diagram: stages of acute Q-wave MIDiagram: stages of acute Q-wave MIKnowledge Weavers ECG
67 Diagram: type I vs. type II 2nd degree AV blockIn type I 2nd degree AV block the PR progressively lengthens until a nonconducted P wave occurs. The PR gets longer by smaller and smaller increments; this results in gradual shortening of the RR intervals. The RR interval of the pause is usually less than the two preceding RR intervals. The RR i...Knowledge Weavers ECG
68 Diagram: AV nodal reentrant tachycardiaThe AV node often has dual pathways; in this diagram the alpha pathway is fast, but has a long refractory period; the beta pathway is conducts more slowly, but recovers faster.In sinus rhythm the faster alpha pathway is used and accounts for the normal PR interval. When a PAC occurs, however, the i...Knowledge Weavers ECG
69 Diagram: digitalis effect on rhythm and conductionDiagram: digitalis effect on rhythm and conductionKnowledge Weavers ECG
70 Diffuse anterolateral T wave abnormalitiesDiffuse anterolateral T wave abnormalitiesT Wave AbnormalitiesKnowledge Weavers ECG
71 Digitalis intoxication: Junctional tachycardia with and without AV blockIn a patient with longstanding atrial fibrillation being treated with digoxin, a regular tachycardia, as seen in A, with a RBBB suggests a junctional or supraventricular tachycardia. Group beating, in B, is likely due to a 2nd degree, Type 1, exit block below the ectopic junctional focus. This is h...Knowledge Weavers ECG
72 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
73 ECG components diagram - marquetteECG components diagram - marquetteKnowledge Weavers ECG
74 ECG intervals and wavesThe P wave represents atrial activation; the PR interval is the time from onset of atrial activation to onset of ventricular activation. The QRS complex represents ventricular activation; the QRS duration is the duration of ventricular activation. The ST-T wave represents ventricular repolarizatio...Knowledge Weavers ECG
75 ECG of the century - part II: dual AV pathwaysAn astute cardiology fellow, yours truly, went to the patient's bedside on Day 2 and massaged the right carotid sinus as indicated by the arrow. Four beats later at a slightly slower heart rate the PR interval suddenly normalized suggesting an abrupt change from a slow AV nodal pathway to a fast AV...Knowledge Weavers ECG
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