Arrhythmias for Interpretation

One hundred and thirty ECGs are presented. Their interpretations, or in the case of questions asked, the answers, can be found at the end of the chapter. As is often the case in practice, there may be more than one observation to make about each example.

Questions

Figure 26.1 What is the arrhythmia?

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Figure 26.2 What is the arrhythmia?

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Figure 26.3 Adenosine or verapamil: which is indicated for tachycardia termination?

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Figure 26.4 What is the pacing mode?

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Figure 26.5 (a) Right bundle branch block? (b) Pre-excitation? (c) Right ventricular hypertrophy? (d) True posterior myocardial infarction?

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Figure 26.6 What is the arrhythmia?

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Figure 26.7 What is the arrhythmia?

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Figure 26.8 Two simultaneously recorded leads. What is the arrhythmia?

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Figure 26.9 Recorded during ambulatory electrocardiography.

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Figure 26.10 What is the arrhythmia?

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Figure 26.11 Lead V1. What is the arrhythmia?

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Figure 26.12 (a) and (b) What is the rhythm in each case? Both ECGs from same patient.

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Figure 26.13 Which drug(s) might have been appropriately used? (a) Digoxin? (b) Flecainide? (c) Verapamil? (d) Sotalol? (e) Disopyramide

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Figure 26.14 Why might have this patient complained of rapid heart beating preceding his ‘dizzy attacks’?

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Figure 26.15 What is the arrhythmia?

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Figure 26.16 What is the arrhythmia?

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Figure 26.17 What type of pacemaker does this patient have?

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Figure 26.18 Why is the PR interval short?

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Figure 26.19 What is the arrhythmia?

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Figure 26.20 What is the arrhythmia? There are three observations to make about this ECG.

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Figure 26.21 Why is the third PR interval prolonged?

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Figure 26.22 What type of pacemaker?

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Figure 26.23 Which drug might the patient have been taking? (a) Flecainide? (b) Tetracycline? (c) Bisoprolol? (d) Clarithromycin? (e) Digoxin?

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Figure 26.24 What is the arrhythmia?

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Figure 26.25 What is the arrhythmia? If catheter ablation were to be carried out, where should radiofrequency energy be delivered?

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Figure 26.26 Leads V1 and V5. What is the arrhythmia? (Why is there changing morphology in lead V1?)

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Figure 26.27 What is the arrhythmia?

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Figure 26.28 Syncope during ambulatory electrocardiography.

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Figure 26.29 What is the arrhythmia?

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Figure 26.30 What is the abnormality?

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Figure 26.31 What type of pacemaker should this asymptomatic patient receive?

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Figure 26.32 Why is the heart rate slow?

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Figure 26.33 What is the arrhythmia?

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Figure 26.34 Should this outpatient be admitted to hospital?

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Figure 26.35 What is the pacing mode?

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Figure 26.36 Ambulatory electrocardiography.

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Figure 26.37 What antiarrhythmic drug in an excessive dose typically does this?

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Figure 26.38 What is the arrhythmia?

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Figure 26.39 What is the arrhythmia?

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Figure 26.40 What are the rhythms?

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Figure 26.41 Ambulatory electrocardiography during karate when the patient felt faint, and at rest.

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Figure 26.42 What is the arrhythmia? Any other observation?

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Figure 26.43 What is the arrhythmia?

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Figure 26.44 What is the arrhythmia?

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Figure 26.45 What does the ECG show?

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Figure 26.46 This arrhythmia could be terminated by (a) adenosine? (b) verapamil? (c) digoxin?

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Figure 26.47 Ambulatory electrocardiography.

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Figure 26.48 This patient had a very poorly functioning sinus node. How could an appropriate increase in heart rate during exercise be achieved?

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Figure 26.49 Are two arrhythmias present?

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Figure 26.50 What is the arrhythmia?

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Figure 26.51 What is the arrhythmia?

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Figure 26.52 Why did this patient complain of blackouts?

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Figure 26.53 What is the arrhythmia?

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Figure 26.54 What is the arrhythmia?

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Figure 26.55 Recorded during ambulatory electrocardiography

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Figure 26.56 What is the pacing mode?

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Figure 26.57 Is this pacemaker performing correctly?

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Figure 26.58 Where is the abnormal pathway?

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Figure 26.59 What is the arrhythmia?

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Figure 26.60 This patient experienced syncope but had a normal pulmonary artery pressure. What was the cause?

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Figure 26.61 What observations can be made?

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Figure 26.62 What are these minor events during ambulatory electrocardiography?

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Figure 26.63 What is the arrhythmia?

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Figure 26.64 Two possible reasons why this patient had syncope?

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Figure 26.65 CHADS2 score = 3. Aspirin, dabigatran or warfarin?

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Figure 26.66 Is the arrhythmia due to impaired ventricular function (left or right)?

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Figure 26.67 What is the arrhythmia?

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Figure 26.68 Interpretation?

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Figure 26.69 In spite of digoxin 0.125 mg daily with normal renal function and body weight. What should be done?

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Figure 26.70 What is the arrhythmia?

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Figure 26.71 What is the arrhythmia?

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Figure 26.72 What is the arrhythmia?

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Figure 26.73 What is the arrhythmia?

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Figure 26.74 There are four findings in this ECG.

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Figure 26.75 What is the arrhythmia?

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Figure 26.76 A or B?

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Figure 26.77 What is the arrhythmia?

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Figure 26.78 This patient had paroxysmal atrial fibrillation and good ventricular function and was prescribed flecainide.

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Figure 26.79 What type of pacemaker? Look carefully.

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Figure 26.80 Why did this patient continue to have blackouts?

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Figure 26.81 This patient complained of syncope. What action should be undertaken?

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Figure 26.82 Referred for cardioversion. Proceed?

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Figure 26.83 What is the arrhythmia?

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Figure 26.84 Inverted P wave in lead I. Why?

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Figure 26.85 What is the arrhythmia?

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Figure 26.86 Lead aVF. Is action required to deal with the arrhythmia?

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Figure 26.87 Digoxin should work?

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Figure 26.88 Interpretation?

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Figure 26.89 What is the arrhythmia?

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Figure 26.90 What are the rhythm disturbances?

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Figure 26.91 What is the abnormality?

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Figure 26.92 What is the arrhythmia?

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Figure 26.93 Implanted pacemaker. What mode?

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Figure 26.94 What is the likely cause of this patient’s syncope?

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Figure 26.95 What type of pacemaker?

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Figure 26.96 Does this hereditary condition ring alarm bells?

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Figure 26.97 What is the arrhythmia?

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Figure 26.98 Ambulatory electrocardiography.

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Figure 26.99 Look carefully at the PR interval.

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Figure 26.100 What is the arrhythmia?

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Figure 26.101 What is the arrhythmia?

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Jun 4, 2016 | Posted by in CARDIAC SURGERY | Comments Off on Arrhythmias for Interpretation

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