ECG lecture（後期研修医向け）

For senior residents

-145BP: 142/86 mmHg, HR: 168 bpm

4

Rate control1A+50mL divRhythm control1) 482) 48AnticoagulationNOAC

Bedside UCG

48OK48TEE

4.6%0.5%98%1060Kinch JW, Davidoff R. Arch Intern Med 1995; 155: 1353-1360.Berger M, Schweitzer P. Am J Cardiol 1998; 82: 1545-1547.K. E. Juhani Airaksinen,J Am Coll Cardiol. 2013;62(13):1187-1192.

Kinch JW, Davidoff R. Arch Intern Med 1995; 155: 1353-1360.Berger M, Schweitzer P. Am J Cardiol 1998; 82: 1545-1547.K. E. Juhani Airaksinen,J Am Coll Cardiol. 2013;62(13):1187-1192.

9

etcetcetc

INa blocker01aAPD1bAPDNa1c

Na-CaCa11

etc

IIINa

IIIAPDOKQTQT

IVIII12

Ia(+)(+++)IcPO

III

IVIVPO+AF tachyAF

NOAC11OK11

-1 45AF

divHR80

-236BP: 134/71 mmHg, HR: 180 bpm

PSVT

PSVT(AVNRT, AVRT)ATPATATP

AVNRTAVRT

Europace. 2012 Nov;14(11):1624-8.

AVNRTPpseudo-r(V1)pseudo-s(II,III,aVF)pseudo-r(aVR)AVRTHRRP100ms ST QRS

19

PSVTATP

-3OMI82ER

Wide QRS tachycardiaACLS

12ATPPSVT+RBBB+

Wide QRS tachycardia1) fusion/capture beat2) positive/negative concordance3) 4) RBBB140/LBBB1605) Dominant R at aVR6) Vi/Vt

24Capture beat: VTAV nodeSA nodeAV nodeAAV nodecapture beatFusion beatVT

NW

Positive/Negative QRS concordance

RBBB(>140ms)/LBBB(>160ms)

aVR(Vereckei algorhthm)aVRRVTaVRRSVTVTSVT with aberrancy

Ventricular activation velocity ratioQRS1(40msec)voltageVT!

Narrow QRSWide QRS

RegularIrregular PSVT ATP or AF

Unstablestable ACLS VT or SVT ECGATP

SSSAVBAF bradycardia

-463BP: 120/51 mmHg, HR: 73 bpm

-545AF

div1A

I

AFL

crista terminalis

CT: 44

sinus venarumCS

crista terminalis

RA

CSSVCIVC(SVC)SVCvein of MarshallECGCS rhythm

sinus venosus45

AFL

8:14:12:11:1

-645

WPWAF

ATPBeta blockerCa blockerDigoxinNa blocker

49

-745IV

-882AFIV

-960

(ARVC/D)