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(BMJ Books) Quick-reference textual content permits readers to familiarize yourself with the big variety of electrocardiogram styles noticeable in medical perform. For these regularly perform or in hospitals handling sufferers with middle issues. Softcover.
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Additional info for ABC of Clinical Electrocardiography
Atrioventricular dissociation in monomorphic ventricular tachycardia (note P waves, arrowed) Although evidence of atrioventricular dissociation is diagnostic for ventricular tachycardia, a lack of direct evidence of independent P wave activity does not exclude the diagnosis. The situation may be complicated by artefacts that simulate P wave activity. However, beat to beat differences, especially of the ST segment, suggest the possibility of independent P wave activity, even though it may be impossible to pinpoint the independent P wave accurately.
One of the first and most subtle changes in the ST segment is flattening of the segment, resulting in a more obvious angle between the ST segment and T wave. A C Subtle ST segment change in patient with ischaemic chest pain: when no pain is present (top) and when in pain (bottom) 38 B D ST changes with ischaemia showing normal wave form (A); flattening of ST segment (B), making T wave more obvious; horizontal (planar) ST segment depression (C); and downsloping ST segment depression (D) Substantial ST segment depression in patient with ischaemic chest pain Myocardial ischaemia More obvious changes comprise ST segment depression that is usually planar (horizontal) or downsloping.
The resulting tachycardia has broad, bizarre QRS complexes. Atrial fibrillation In patients without an accessory pathway the atrioventricular node protects the ventricles from the rapid atrial activity that occurs during atrial fibrillation. In the Wolff-Parkinson-White syndrome the atrial impulses are conducted down the accessory pathway, which may allow rapid conduction and consequently very fast ventricular rates. The impulses conducted via the accessory pathway produce broad QRS complexes. Occasionally an impulse will be conducted via the atrioventricular node and produce a normal QRS complex or a fusion beat.