Preface (Second Edition)
Preface (First Edition)
Contents
Part I: Basic Electrophysiology and Electrocardiography
Chapter 1: Cardiac Anatomy and Electrophysiology
Cardiac Electrophysiology
Action Potential
Fast Response Action Potential
Slow Response Action Potential
Cardiac Anatomy
Review Questions
Answers to the Review Questions
Chapter 2: Physics of Electrocardiography
Physics of Electrocardiography
Depolarization
Repolarization
Standard Leads
Limb Leads
Bipolar Leads: Einthoven’s Triangle
Unipolar or Augmented Leads
Chest or Precordial Leads
Derived 12-Lead ECG
Standard ECG Display
Summary
Review Questions
Answers to the Review Questions
Chapter 3: The Normal Electrocardiogram
Atrial Depolarization
Atrioventricular Conduction
Ventricular Depolarization
ECG Nomenclature for Ventricular Activation
ECG in the Frontal Plane
ECG in the Precordial Plane
Ventricular Repolarization
ECG Intervals
Heart Rate
PR Interval
QRS Interval
QT Interval
Summary
Review Questions
Answers
Part II: Abnormal Depolarization
Chapter 4: Chamber Enlargement
Atrial Enlargement
Ventricular Enlargement
Left Ventricle
Voltage Criteria
Repolarization Changes
Other/Composite Criteria
Right Ventricle
Questions
Answers
Chapter 5: Conduction Abnormalities in the His-Purkinje Tissue
Anatomy/Electrophysiology
Right Bundle Branch Block
Left Bundle Branch Block
Left Anterior Fascicular Block
Left Posterior Fascicular Block
Questions
Answers
Part III: Abnormal Repolarization
Chapter 6: Ventricular Repolarization: T Waves and U Waves
T Waves
T Wave Shape
T Wave Location
Genetic Causes for a Long QT (Long QT Syndrome)
Acquired Long QT
U Waves
Questions
Answers
Chapter 7: ST Segment Elevation and Other ECG Findings in Myocardial Infarction
Pathophysiology of Coronary Artery Disease
Cellular Changes Associated with Acute Myocardial Infarction
Evolution of Myocardial Infarction and Ischemia
ECG Changes in Acute Myocardial Infarction
T Wave Peaking
ST Segment Changes
Q Waves
T Wave Inversion and ST Segment Depression
Anterior Infarction
Inferior Myocardial Infarction
Lateral Myocardial Infarction
Right Ventricular Infarction
Left Main
Myocardial Infarction in the Presence of Bundle Branch Block
Review Questions
Answers
Chapter 8: ST Segment Elevation not Associated with Myocardial Infarction
Normal ST Segment Elevation and “Early Repolarization”
Left Ventricular Hypertrophy and Left Bundle Branch Block
Pericarditis
Coronary Artery Spasm
Transthoracic Cardioversion
Left Ventricular Aneurysm/Takotsubo Syndrome
Brugada Syndrome
Pulmonary Embolism
Hyperkalemia
Summary
Review Questions
Answers
Part IV: Arrhythmias
Chapter 9: Premature Beats
Premature Atrial Contractions
Premature Ventricular Contractions
Premature Junctional Complex
Questions
Answers
Chapter 10: Bradycardia
Anatomy/Pathophysiology
Abnormal Automaticity/Sinus Node Dysfunction
Atrioventricular Block
Sinus Node Dysfunction
Atrioventricular Block
Types of AV Block
Questions
Answers
Chapter 11: Supraventricular Tachycardia
Tachycardia Mechanisms
Increased Automaticity
Triggered Activity
Reentry
Anatomic Classification
Atrial Tachycardia
Sinus Tachycardia
Focal Atrial Tachycardia
Multifocal Atrial Tachycardia
Atrial Fibrillation
Atrial Flutter
AV Junctional Tachycardia
AV Node Reentry
Automatic Junctional Tachycardia
Accessory Pathway-Mediated Tachycardia
Electrocardiographic Diagnosis
Regular vs. Irregular
P Wave Location and Morphology
AV Node Dependent vs. AV Node Independent
Review Questions
Answers
Chapter 12: Wide Complex Tachycardia
Pathophysiology
ECG Analysis
Clinical Clues
Atrioventricular Relationship
Initiation and Termination
Rate, Axis, and QRS Width
Precordial QRS Morphology
Precordial Concordance
Irregular Wide Complex Tachycardia
Review Questions
Answers
Chapter 13: Pacemakers
Single-Chamber Pacemaker
Dual-Chamber Pacemakers
Biventricular Pacing/His Bundle Pacing
Questions
Answers
Part V: Putting It All Together
Chapter 14: Analyzing ECGs: Methods, Techniques, and Identifying Abnormalities
Systematic Analysis
Assess Quality
Assess Rate and Rhythm
Identify P Waves/Atrial Activity/Shape
Assess Ventricular Depolarization
Wide or Narrow?
QRS Axis?
QRS Voltage?
Q Waves?
Assess Ventricular Repolarization
ECG Reading “Zen”
“Urgent”
“Less Urgent”
Rhythm
QRS and T Wave Morphology
Summary
Chapter 15: Analyzing ECGs: Putting It Together with Case Studies
Case 1
Introduction
Discussion
Conclusion
Case #2
Introduction
Discussion
Conclusion
Case #3
Introduction
Discussion
Conclusion
Case #4
Introduction
Discussion
Conclusion
Case #5
Introduction
Discussion
Conclusion
Case #6
Introduction
Discussion
Conclusion
Case #7
Introduction
Discussion
Conclusion
References
Chapter 16: Electrolyte Disorders
Potassium
Hypokalemia
Hyperkalemia
Calcium
Hypocalcemia
Hypercalcemia
Other Electrolyte Disorders
Review Questions
Answers
Chapter 17: Orphans
Pulmonary Embolus
Infiltrative Diseases: Amyloidosis
Lightning
Hypothermia
Muscular Dystrophy
Arrhythmogenic Right Ventricular Cardiomyopathy
Electrode Misplacement
Artifact
Parasystole
Digoxin Toxicity
Ashman’s Phenomenon
Chapter 18: Case-Based ECG Analysis
ECG in Clinical Practice
Chest Pain
Case #1
“Urgent”
“Less Urgent”
Case #2
“Urgent”
“Less Urgent”
Case #3
“Urgent”
“Less Urgent”
Case #4
“Urgent”
“Less Urgent”
Case #5
“Urgent”
“Less Urgent”
Case #6
“Urgent”
“Less Urgent”
Case #7
“Urgent”
“Less Urgent”
Case #8
“Urgent”
“Less Urgent”
Case #8
“Urgent”
“Less Urgent”
Active Arrhythmia
Case #9
“Urgent”
“Less Urgent”
Case #10
“Urgent”
“Less Urgent”
Case #11
“Urgent”
“Less Urgent”
Case #12
“Urgent”
“Less Urgent”
Case #13
“Urgent”
“Less Urgent”
Case #14
“Urgent”
“Less Urgent”
Case #15
“Urgent”
“Less Urgent”
Case #16
“Urgent”
“Less Urgent”
Case #17
“Urgent”
“Less Urgent”
Case: #18
“Urgent”
“Less Urgent”
Case #19
“Urgent”
“Less Urgent”
Case #20
“Urgent”
“Less Urgent”
Case #21
“Urgent”
“Less Urgent”
Case: #22
“Urgent”
“Less Urgent”
Case #23
“Urgent”
“Less Urgent”
Case #24
“Urgent”
“Less Urgent”
Case #25
“Urgent”
“Less Urgent”
Case #26
“Urgent”
“Less Urgent”
Case #27
“Urgent”
“Less Urgent”
Case #28
“Urgent”
“Less Urgent”
Case #29
“Urgent”
“Less Urgent”
Case #30
“Urgent”
“Less Urgent”
Case #31
“Urgent”
“Less Urgent”
Identifying Structural Heart Disease and Other Abnormalities
Case #32
“Urgent”
“Less Urgent”
Case #33
“Urgent”
“Less Urgent”
Case: #34
“Urgent”
“Less Urgent”
Case #35
“Urgent”
“Less Urgent”
Case: #36
“Urgent”
“Less Urgent”
Case #37
“Urgent”
“Less Urgent”
Case #38
“Urgent”
“Less Urgent”
Appendix
Extra Practice
“So You’re a Glutton for Punishment”
Unknowns
Answers
Index