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How to Interprete Arrhythmias
Ting Chih Kuan
UKM Medical Centre
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How to Interprete ECGs
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The Basics Rate Rhythm Axis P wave QRS wave T wave Intervals PR, QT ST segment Voltage Regional representation Calibration and paper speed
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I
IIIII aVF
aVLaVR
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Arrhythmias
Bradyarrhythmias
Tachyarrhythmias Narrow complex arrhythmias
Broad complex arrhythmias
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Bradyarrhythmias
SA node AV node
Junctional Always think of Inferior MI
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Tachyarrhythmias
Narrow complex Broad complex
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Narrow Complex Tachycardias
Sinus tachycardia
Supraventricular tachycardia AVNRT
AVRT (Orthodromic) AT
Atrial flutter/fibrillation
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AVNRT
Typical anterograde conduction via the
slow pathway and the retrogradeconduction via the fast pathway ("slow-fast" AVNRT).
Atypical- anterograde conduction via the
fast pathway and the retrogradeconduction via the slow pathway ("fast-slow" AVNRT).
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AVNRT
Typical AVNRT Atypical AVNRT
s l ow f a
s t s l ow
f a s t
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AVRT
Orthodromic AVRT anterograde
conduction via the AV node
Antidromic AVRT retrograde conductionvia the AV node (broad complex)
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What do you think of these ECGs?
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Broad Complex Tachycardia
Ventricular Tachycardia SVT with abberancy
SVT with pre-excitation Always think of electrolytes/toxins.
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Where is it coming from??
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Time for quiz?
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Young Woman With Exercise-Induced
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Syncope
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48 y.o comatose women