1
, Introduction
This book provides basic information on electrocardiography
(ECG). It is written and designed in an easy form and style to suit all
levels. It aims at simplifying ECG reading by utilizing graphic and text
description methods to explain individual electrocardiographic
problems. Although the book is written for students at under-graduate
and graduate levels of medical, dental, pharmacy, anaesthesiology and
nursing schools, all doctors as well as CCU and ICU nurses will find it
helpful in interpreting ECGs and Rhythm Strips during their daily
hospital work.
Being able to read an electrocardiogram is an essential skill for
any clinician. Having a healthy heart means having a healthy heartbeat,
and the best way to evaluate that is by looking at an ECG. We’ve
designed this book to be a quick primer on the essentials of
electrocardiography. By the time you’ve finished this book, you’ll be
familiar with the fundamentals of ECG, and will be able to easily
recognize and interpret common normal and abnormal rhythms, so
that you can spot life- threatening conditions like ventricular fibrillation
and myocardial ischemia.
2
,CONTENTS
Introduction ............................................................ 2
CONTENTS ............................................................... 3
Electrocardiogram (ECG) ......................................... 6
ECG waveforms ........................................................ 7
ECG leads location ................................................... 8
Cardiac Axis............................................................. 8
Sinus Dysrhythmias ................................................. 9
Normal Sinus Rhythm: ..................................................... 10
Sinus Tachycardia: .......................................................... 11
Sinus Bradycardia: .......................................................... 12
Sinus Arrhythmia: ........................................................... 13
Sinus Block: .................................................................. 14
Sinus Arrest (Sinus Pause): ................................................ 15
Sick Sinus Syndrome (SSS): ................................................ 16
Atrial Dysrhythmias .............................................. 17
Wandering atrial pacemaker .............................................. 18
(Multiatrial focus) ........................................................... 18
Multifocal atrial tachycardia ............................................... 19
Premature atrial complexes ............................................... 20
Atrial tachycardia ........................................................... 21
Supraventricular Tachycardia ............................................. 22
Paroxysmal Supraventricular Tachycardia (PSVT) ..................... 23
Atrial flutter .................................................................. 24
Atrial fibrillation ............................................................. 25
Wolff-Parkinson-White (WPW) syndrome ............................... 26
3
, Junctional Dysrhythmias ....................................... 27
Premature Junctional contraction (PJC): ................................. 28
Junctional escape rhythm: ................................................. 29
Accelerated Junctional rhythm: ........................................... 30
Junctional tachycardia: ..................................................... 31
ventricular dysrhythmias ...................................... 32
Premature ventricular complexes (PVCs)................................ 33
Type of Premature ventricular complexes .............................. 34
Idioventricular rhythm ..................................................... 37
Accelerated idioventricular rhythm ...................................... 38
Ventricular tachycardia ..................................................... 39
Ventricular Fibrillation: (VF) .............................................. 40
AV heart block....................................................... 41
1st-degree AV heart block ................................................. 42
2nd-degree AV heart block, Type I ....................................... 43
(Wenckebach) ................................................................ 43
2nd-degree AV heart block, Type II ...................................... 44
3rd-degree AV heart block ................................................. 45
bundle branch block ............................................. 46
Right bundle branch block ................................................. 47
Left bundle branch block .................................................. 47
sgarbossa criteria with LBBB .............................................. 49
Acute Coronary syndrome ..................................... 50
(ACS) ..................................................................... 50
Acute coronary syndrome (ACS) .......................................... 51
Myocardial Infraction (MI) ................................................. 52
Examples of ECG with different types of MI ............................ 53
Conclusion ............................................................. 58
4
, Introduction
This book provides basic information on electrocardiography
(ECG). It is written and designed in an easy form and style to suit all
levels. It aims at simplifying ECG reading by utilizing graphic and text
description methods to explain individual electrocardiographic
problems. Although the book is written for students at under-graduate
and graduate levels of medical, dental, pharmacy, anaesthesiology and
nursing schools, all doctors as well as CCU and ICU nurses will find it
helpful in interpreting ECGs and Rhythm Strips during their daily
hospital work.
Being able to read an electrocardiogram is an essential skill for
any clinician. Having a healthy heart means having a healthy heartbeat,
and the best way to evaluate that is by looking at an ECG. We’ve
designed this book to be a quick primer on the essentials of
electrocardiography. By the time you’ve finished this book, you’ll be
familiar with the fundamentals of ECG, and will be able to easily
recognize and interpret common normal and abnormal rhythms, so
that you can spot life- threatening conditions like ventricular fibrillation
and myocardial ischemia.
2
,CONTENTS
Introduction ............................................................ 2
CONTENTS ............................................................... 3
Electrocardiogram (ECG) ......................................... 6
ECG waveforms ........................................................ 7
ECG leads location ................................................... 8
Cardiac Axis............................................................. 8
Sinus Dysrhythmias ................................................. 9
Normal Sinus Rhythm: ..................................................... 10
Sinus Tachycardia: .......................................................... 11
Sinus Bradycardia: .......................................................... 12
Sinus Arrhythmia: ........................................................... 13
Sinus Block: .................................................................. 14
Sinus Arrest (Sinus Pause): ................................................ 15
Sick Sinus Syndrome (SSS): ................................................ 16
Atrial Dysrhythmias .............................................. 17
Wandering atrial pacemaker .............................................. 18
(Multiatrial focus) ........................................................... 18
Multifocal atrial tachycardia ............................................... 19
Premature atrial complexes ............................................... 20
Atrial tachycardia ........................................................... 21
Supraventricular Tachycardia ............................................. 22
Paroxysmal Supraventricular Tachycardia (PSVT) ..................... 23
Atrial flutter .................................................................. 24
Atrial fibrillation ............................................................. 25
Wolff-Parkinson-White (WPW) syndrome ............................... 26
3
, Junctional Dysrhythmias ....................................... 27
Premature Junctional contraction (PJC): ................................. 28
Junctional escape rhythm: ................................................. 29
Accelerated Junctional rhythm: ........................................... 30
Junctional tachycardia: ..................................................... 31
ventricular dysrhythmias ...................................... 32
Premature ventricular complexes (PVCs)................................ 33
Type of Premature ventricular complexes .............................. 34
Idioventricular rhythm ..................................................... 37
Accelerated idioventricular rhythm ...................................... 38
Ventricular tachycardia ..................................................... 39
Ventricular Fibrillation: (VF) .............................................. 40
AV heart block....................................................... 41
1st-degree AV heart block ................................................. 42
2nd-degree AV heart block, Type I ....................................... 43
(Wenckebach) ................................................................ 43
2nd-degree AV heart block, Type II ...................................... 44
3rd-degree AV heart block ................................................. 45
bundle branch block ............................................. 46
Right bundle branch block ................................................. 47
Left bundle branch block .................................................. 47
sgarbossa criteria with LBBB .............................................. 49
Acute Coronary syndrome ..................................... 50
(ACS) ..................................................................... 50
Acute coronary syndrome (ACS) .......................................... 51
Myocardial Infraction (MI) ................................................. 52
Examples of ECG with different types of MI ............................ 53
Conclusion ............................................................. 58
4
