12 LEAD EKG & CXR INTERPRETATION.
|
|
|
- Merryl Griffith
- 5 years ago
- Views:
Transcription
1 12 LEAD EKG & CXR INTERPRETATION
2 Audio Product Recording discount for participants $60 Nonparticipants = $190 o Get CEs and manual
3 12 Lead EKG 101 Learn the Normal so you can detect the abnormal
4 12 Lead EKG Taking pictures of the heart from 12 different angles Pictures (EKG complexes) are created by picking up the electrical energy from the electrodes
5 The Electrical Conduction System Creates an electrical impulse and transmits it in an organized manner to the rest of the myocardium SA node AV node BPM BPM Purkinje cells BPM
6 Basic Components of the Complex Deflections & Segments P Wave o Rounded, < 2-3 mm, in hypertrophy QRS Segment o o o <.12 sec. & > 5 mm, transition occurs V3 or V4 presence of Q normal in children/elderly Q wave sig. > 0.5 mm T Wave o < 5-10 mm, peaked in K+ U Wave o Follows T wave, present in K+ ST Segment o o o Isoelectric, sig. If > +1.0 above or below baseline Depression = ischemia Elevation = injury
7 Vector A diagrammatic way of showing the strength and direction of an electrical impulse
8 Vectors Atrial Septal Ventricular
9 Atrial Vectors & Depolarization Two atrial vectors Initial wave spreads anteriorly through the RA towards the AV node Next wave travels posteriorly toward the LA The mean P wave vector represents the average direction and magnitude of depolarization through both atria Normal P wave configuration.
10 Three Stages of Ventricular Septal Depolarization Phase I: Septum from left to right
11 Right Ventricular Depolarization Phase II: Right ventricle and apex
12 Left Ventricular Depolarization Phase III: lateral wall of left ventricle
13 The Electrical Axis of the Heart Sum of all the vectors found in the heart
14 Vectors and Leads Depolarization Parade A vector moving toward an electrode is represented as a positive wave. o In a parade things moving towards the camera see the front or positive A vector moving away from an electrode is represented as a negative wave. o In a parade things moving away from the camera are the back or negative Source: Garcia. 12 Lead ECG 12:9
15 12 Lead EKG 101 Learn the Normal so you can detect the abnormal
16 The 12 Leads Bipolar Leads Each lead has two poles: One positive & one negative I, II, III Unipolar Leads Only one lead is physically positive Negative lead is not a specific site on the body AVR, AVL, AVF, V1-V6
17 Bipolar Leads I, II, III Also referred to as extremity leads due to placement on the body Record electrical forces two points equidistant from the heart. Each lead has two poles: one positive & one negative Two leads to give the picture Current travels Negative to Positive to create the electrical complex 12 Lead EKG reads or takes the picture from the positive electrode to the heart
18 Negative poles & Positive poles You must memorize The heart depolarizes right to left and then down Direction of the current indicates if the heart is depolarizing normally Current travels from negative to positive Arrow () goes from negative pole to positive pole. This is how the poles talk to each other. It will help with axis. Positive electrode on the body is the camera and looking at the heart
19 Lead I Right arm (--) Left arm (+) EKG complex = everything positive = Normal Axis of Heart
20 Lead II Right arm (--) Left leg (+) EKG complex = everything positive = Normal Axis of Heart
21 Lead III Left arm (--) Left leg (+) EKG complex = mostly positive, can be biphasic = Normal Axis of Heart
22 Einthoven s Triangle By connecting the electrodes of the limb leads, the Einthoven s Triangle is formed.
23 Augmented Limb Leads AVR, AVL, AVF Records electrical activity between the center of the heart and an extremity Since these leads are low voltage they are artificially augmented Unipolar leads: Negative pole is the heart
24 AVR: Augmented Voltage Right Heart (--) Right Arm (+) EKG complex = negative AVR + -- = Normal Axis of Heart
25 AVL: Augmented Voltage Left Heart (--) Left Arm (+) EKG complex = May be positive or negative or biphasic because it is perpendicular to axis AVL+ = Normal Axis of Heart
26 AVF: Augmented Voltage Foot Heart (--) Left Leg (+) EKG complex = positive -- = Normal Axis of Heart AVF
27 Depolarization of limb & augmented leads Sweetwood, H. Clinical Electrocardiography for Nurses. 1983
28 To learn you need to hear something. o 6 times o 6 different ways SIX 6 six VI seis IIII I
29 + and - poles? RA RA Lead I Lead II Lead III RA - +LL + LL + RA RA Lead AVR Lead AVL + RA Lead AVF +
30 The Precordial System (Chest Leads V1 V6) Records electrical activity of the heart by placing electrodes on the anterior chest wall Heart is the negative pole Positive pole is where the electrode is placed Unipolar leads
31 Precordial Leads Placement V1 4th intercostal space (ICS) right sternal border (septum) V2 4th ICS, left sternal border (septum) V3 Midway between V2 and V4 (anterior) V4 5th ICS, left midclavicular line (anterior) V5 5th ICS, left anterior axillary line (lateral) V6 5th ICS, left midaxillary line (lateral)
32 Precordial Leads
33 Depolarization of Precordial Leads V1 & V2 = moving away from positive electrode so should be negative Sweetwood, H. Clinical Electrocardiography for Nurses. 1983
34 Depolarization of Precordial Leads V3 & V4 = perpendicular so should be biphasic Sweetwood, H. Clinical Electrocardiography for Nurses. 1983
35 Depolarization of Precordial Leads V5 & V6 = towards so positive Sweetwood, H. Clinical Electrocardiography for Nurses. 1983
36 Depolarization of Precordial Leads Sweetwood, H. Clinical Electrocardiography for Nurses. 1983
37 R Wave Transition Indicates if the heart is depolarizing normally R wave: Rises above baseline
38
39 12 Lead EKG 101 Learn the Normal so you can detect the abnormal Is the EKG depolarizing normally
40 Vectors and Leads Depolarization parade A vector moving toward an electrode is represented as a positive wave. o In a parade things moving towards the camera see the front or positive A vector moving away from an electrode is represented as a negative wave. o In a parade things moving away from the camera are the back or negative Source: Garcia. 12 Lead ECG 12:9
41 Normal Depolarization Review If the wave is moving towards the positive electrode or where the camera is, the wave will be positive If the wave is moving away from positive electrode, the wave will be negative If the wave is perpendicular to the positive electrode then can get a little positive or a little negative or biphasic complex Source: Garcia. 12 Lead ECG 12:9
42 Normal Depolarization Review Leads I, II, III Lead I & II --- Everything positive Lead III mostly positive can be biphasic
43 Normal Depolarization Review AVR, AVL, AVF AVR Negative : Positive electrode on right shoulder and depolarize away from there creating a negative wave AVL Camera perpendicular- may be up or down or biphasic AVF -- Positive
44 Depolarization of limb & augmented leads Sweetwood, H. Clinical Electrocardiography for Nurses. 1983
45 Normal Depolarization Review Precordial Leads V1 & V2 = moving away from positive electrode so should be negative V3 & V4 = perpendicular so should be biphasic V5 & V6 = towards so positive
46 Depolarization of Precordial Leads Sweetwood, H. Clinical Electrocardiography for Nurses. 1983
47 Normal EKG Depolarization I AVR V1 V4 Biphasic II AVL V2 V5 or III AVF V3 V6 Biphasic
48 Practice & Application Time
49 Practice Time: 1. Label the positive and negative poles in the limb leads 2. Label the positive poles appropriately for the augmented leads RA LA Lead I Lead II Lead III LL Lead AVR Lead AVL Lead AVF Complete pages 75,76
50 1. List the correct placement of the positive pole in each chest lead. V1 V2 V4 V6 2. Which polarity is the QRS primarily in V1? Positive Negative 3. Which polarity is the QRS primarily in V6? Positive Negative 4. In which leads should the R wave transition occur?
51 Identify the Normal EKG Depolarization in each of the 12 Leads I AVR V1 V4 II AVL V2 V5 III AVF V3 V6
52 Answers
53 + and Poles Summary -----> = Camera looking from positive lead = Direction of current Negative to Positive to get EKG complex Lead I Lead II Lead III Lead AVR Lead AVL + Lead AVF +
54 + and - poles? RA LA RA Lead I Lead II Lead III LA - RA LL LL LA + LL Lead AVR Lead AVL Lead AVF + LL
55 1. List the correct placement of the positive pole in each chest lead. V1 4 th ICS, right sternal border V2 4 th ICS, left sternal border V4 5 th ICS, mid clavicular line V6 5 th ICS, mid axillary line 2. Which polarity is the QRS primarily in V1? Positive Negative 3. Which polarity is the QRS primarily in V6? Positive Negative 4. In which leads should the R wave transition occur? V3 or V4
56 Normal EKG Depolarization I AVR V1 V4 Biphasic II AVL V2 V5 or III AVF V3 V6 Biphasic
57 Ace the Axis - Axis Deviation
58 Axis Tells that the heart is depolarizing normally Average direction of mean vectors of the heart Described on a 360 degree wheel Only way an axis shift can be determined is by an ECG Axis shift represents an underlying problem the axis is asymptomatic, the cause may have S/S
59 Hexaxial Reference System
60 Hexaxial Reference System
61 Axis
62 Four Quadrants of Hexaxial System Extreme Right Axis -90 to +180/270 Left Axis Quadrant -30 to - 90 Lead I AVF Lead I AVF Right Axis Quadrant + 90 to Normal Axis Quadrant -30 to + 90 Lead I AVF Lead I AVF
63 Normal Axis Downward & to the left -30 to + 90
64 Alterations in Axis Axis shifts TOWARDS area of increased muscle mass hypertrophy bundle branch blocks Axis shifts AWAY from area of AMI from hemiblocks
65 Left Axis Upward & to the left - 30 to 90 Left Ventricular Hypertrophy LAH. LBBB Inferior infarct Mechanical shift of the heart to more horizontal PG, ascites, abdominal tumor WPW
66 Right Axis Downward & to the right + 90 to Right ventricular hypertrophy LPH Lateral infarction Dextrocardia RBBB PE Pulmonary Infarct Emphysema Anything that affects the RV
67 Extreme Right Axis Upward & to the right - 90 to + 180/270 Ventricular Tach Multiple infarctions Never good
68 Methods of Axis Determination Can only be determined by EKG Technology electrography machine calculates
69 Axis 54 = Normal Lead I & AVF =
70 Axis - 78 = Left Axis Lead I & AVF =
71 Methods of Axis Determination Leads I, II, III, AVR, AVL & AVF are used Three different methods can be used for confirmation o o o Quadrant Parallel Perpendicular
72 Quadrant Method Identify polarity of Lead I and AVF = normal axis = LAD = RAD = Extreme right or left
73 Isolating the Direction of the Axis Quadrant Method Lead I & AVF o Are they positive or negative? o Place in appropriate quadrant
74 Quadrant Method Step 1 Lead I Is it positive or negative? Place in appropriate quadrant
75 Quadrant Method Step II AVF Is it positive or negative? Place in appropriate quadrant
76 Quadrant Method Step III Combine the quadrants to determine the QRS axis quadrant
77 Four Quadrants of Hexaxial System Extreme Right Axis -90 to +180/270 Left Axis Quadrant -30 to - 90 Lead I AVF Lead I AVF Right Axis Quadrant + 90 to Normal Axis Quadrant -30 to + 90 Lead I AVF Lead I AVF
78 Quadrant Method Identify polarity of Lead I and AVF = normal axis = LAD = RAD = Extreme right or left
79 Thumb Method
80 Normal Axis Lead I Positive Left thumb up AVF Positive Right thumb up
81 Left Axis Lead I Positive Left thumb up AVF Negative Right thumb down
82 Right Axis Lead I Negative Left thumb down AVF Positive Right thumb up
83 Extreme Axis Lead I Negative Left thumb down AVF Negative Right thumb down
84 Practice & ApplicationTime
85 Indicate if Lead I and AVF are or Axis Degrees Normal Left Right Extreme right Lead I AVF Page 77
86 Axis Summary Axis Normal Left Right Extreme - 30 to to to to +180/270 Lead I AVF Left Apart Right Together
87 Alterations in Axis Match Column A with B Column A Axis shifts AWAY Axis shifts TOWARDS Column B area of increased muscle mass hypertrophy from area of AMI from hemiblocks bundle branch blocks
88 Alterations in Axis Axis shifts TOWARDS area of increased muscle mass hypertrophy bundle branch blocks Axis shifts AWAY from area of AMI from hemiblocks
89 Normal Axis Downward & to the left -30 to + 90
90 Admission EKG --Troponin bumped to 2.0 ng/ml Taken emergently to Cath lab Axis = 49
91 Left Axis Upward & to the left - 30 to 90 Left Ventricular Hypertrophy LAH. LBBB Inferior infarct Mechanical shift of the heart to more horizontal PG, ascites, abdominal tumor WPW
92 Left Axis Deviation from Left Ventricular Hypertrophy Source: Thaler, M. The Only EKG Book You ll Ever Need, 5 th ed
93 EF 30% -- Left Ventricular Hypertrophy Axis = -63
94 Axis = - 43 LBBB
95 Left Axis Deviation from Left Anterior Hemiblock Source: Thaler, M. The Only EKG Book You ll Ever Need, 5 th ed
96 Axis = - 52 LAH
97 Axis = -44 Old Inferior AMI
98 Right Axis Downward & to the right + 90 to Right ventricular hypertrophy LPH Lateral infarction Dextrocardia RBBB PE Pulmonary Infarct Emphysema Anything that affects the RV
99 Right Axis Deviation from Right Ventricular Hypertrophy Source: Thaler, M. The Only EKG Book You ll Ever Need, 5 th ed
100 PMH: 3 year history Chronic lung infection. Mycobacterium avium-intracellular 1 year ago, Cavitary lung lesion, right pneumonectomy day before this EKG Axis = 92
101 LPH PMH: HF with EF 15 20%, COPD, NSTEMI Axis = 112
102 Right Axis Deviation from Left Posterior Hemiblock Source: Thaler, M. The Only EKG Book You ll Ever Need, 5 th ed
103 1 week old infant, murmur? Dextrocardia Echo ASD, mild pulmonary regurgitation Axis = 164
104 Axis = 103 RBBB, PE
105 Extreme Right Axis Upward & to the right - 90 to + 180/270 Ventricular Tach Multiple infarctions Never good
106 83 y/o, PMH: pulmonary hypertension and pulmonary fibrosis Axis = 212 Axis = 212
107 Wide Complex Tachycardia Axis = 221
108 Axis changes during AMI 66 y/o preop EKG #1 Axis = 9
109 EKG #2 upon admission to ICU after thorocotomy. Sent to Cath lab. Stent to RCA Axis = 93
110 EKG #3 3 hours later Axis = 86
111 Axis = - 43 EKG # 4 12 hours later
112 Occluded old RCA Stent Post procedure after deploying new stent
113 Axis Summary Axis Normal Left Right Extreme - 30 to to to to +180/270 Lead I AVF
114 Complete RBBB Complete LBBB Left Posterior Hemiblock (LPH) Beat the Bundles Bundle Branch Blocks Left Anterior Hemiblock (LAH) Bifascicular, Trifascicular Blocks
115 Right Bundle Branch Block RBBB Source: Garcia 12 Lead EKG 13:2 & 13:3
116 Right Bundle Branch Block RBBB Causes Chronically increased right ventricular pressure, as in cor pulmonale Right ventricular hypertrophy A sudden increase in right ventricular pressure with stretch, as in pulmonary embolism. Congenital heart disease (atrial septal defect) Myocardial ischemia or infarction Myocarditis Hypertension
117 RBBB
118 RBBB Criteria QRS > 0.12 sec or 120msec Slurred S wave leads I & V6 RSR pattern V1 Easy way: V1 = Positive, QRS > 0.12 sec Rabbit Ears Source: Garcia. 12 Lead ECG
119 RBBB Half a rabbit ear QRS mostly postive Source: Garcia. 12 Lead ECG
120 QRS = 136 ms Slurred S wave Lead I & V6 Positive V1
121 QRS = 134 ms
122
123 Left Bundle Branch Block LBBB Source: Garcia 12 Lead EKG 13:19
124 Left Bundle Branch Block LBBB Higher mortality than RBBB Most often seen in large Anterior MIs Lower EFs Often seen in later stages of Heart Failure Causes Dilated cardiomyopathy CAD Hypertension Infiltrative diseases of the heart Benign or idiopathic causes
125 LBBB
126 LBBB Criteria QRS > 0.12 sec or 120msec Broad, monomorphic R waves in I & V6, with no Q waves Broad, monomorphic S waves in V1; may have a small r wave Easy way QRS > 0.12 sec Negative V1 = Carrot
127 QRS = 140 ms Broad, monomorphic R waves in I & V6, with no Q waves Broad, monomorphic S waves in V1 Negative V1
128 QRS = 144 ms
129 LVH, LBBB, LAD QRS = 134 ms
130
131 BBB = QRS > 0.12sec LBBB = QRS > 0.12 sec, Negative QRS in V1 (carrot) RBBB = QRS > 0.12sec; Positive QRS in V1 (rabbit ears) RBBB LBBB
132 Incomplete Bundle Branch Block QRS in no man s land Incomplete RBBB O sec RBBB pattern Incomplete LBBB O sec LBBB pattern
133 QRS = 108ms
134 QRS = 110 ms
135 QRS = 108 ms
136 QRS = 106 ms
137 Block of one of the two fascicles of the left bundle branch system LAH & LPH 4 X higher mortality rate for pts with AMI Risk factor for developing CHB Can indicate proximal artery occlusion Hemiblocks
138 Left Anterior Hemiblock LAH Positive polarity Lead I Negative polarity Leads II & III Left Axis Deviation Source: Garcia 12 Lead EKG 13:15
139 Axis = -61
140 Left Axis Deviation from Left Anterior Hemiblock Source: Thaler, M. The Only EKG Book You ll Ever Need, 5 th ed
141 Axis = -52
142 Axis = -60
143 Left Posterior Hemiblock LPH Negative polarity Lead I Positive polarity Leads II & III Rare Right Axis Deviation If RBBB, ask if there a LPH Source: Garcia 12 Lead EKG 13:19
144 Axis = 112
145 Right Axis Deviation from Left Posterior Hemiblock Source: Thaler, M. The Only EKG Book You ll Ever Need, 5 th ed
146
147 LAH = (Anterior) Lead I up LPH = (Posterior) Lead I down
148 LAH & LPH Summary LAH LPH Lead I Lead II Lead III Axis Page 78
149 LAH & LPH Summary LAH LPH Lead I Lead II Lead III Axis Left Right
150 Bi & Tri Blocks Bifascicular Block: RBBB with LPH or LAH Trifasicular Block: RBBB with LPH/LAH & any type of AV Block (1º, Wenckebach, Classical or CHB)
151 Tetralogy of Fallot Septal defect repaired at age of 3 (50 years ago) Severe Right Ventricular Hypertrophy
152 Tetralogy of Fallot Patient 2 years later. 100% paced
153
154 Axis Summary Axis Normal Left Right Extreme - 30 to to to to +180/270 Lead I AVF
155 LAH & LPH Summary LAH LPH Lead I Lead II Lead III Axis Left Right
156 + and Poles Summary -----> = Camera looking from positive lead = Direction of current Negative to Positive to get EKG complex Lead I Lead II Lead III Lead AVR Lead AVL + Lead AVF +
157 Rate & Rhythm Pattern to Read EKG Be consistent QRS Interval V1 for RBBB or LBBB QT interval Normal Depolarization If not, why not ST & T waves What lead is abnormal and what other lead goes with it
158 Practice & Application Time For each EKG o o o o Identify if the depolarization is correct Identify any BBB present Identify any hemiblocks Determine the axis
159 EKG 1
160 EKG 2
161 EKG 3
162 EKG 4
163 Answers 1. LAD, incomplete LBBB, LAH 2. RAD, RBBB, LPH 3. Normal axis, LBBB 4. LAD, RBBB, LAH
164 Reference List Field, J. (2008). STEMI provider manual. Dallas: American Heart Association. Garcia, T.B., & Holtz, N.E. (2001). 12 lead ECG: The art of interpretation. Boston: Jones and Bartlett Publishers. Garcia, T.B., & Holtz, N.E. (2015). 12 lead ECG: The art of interpretation., 2 nd Ed. Boston: Jones and Bartlett Publishers. Goldich, G. (2006). Understanding the 12-lead ECG, part I. Nursing2006, 36(11), Goldich, G. (2006). Understanding the 12-lead ECG, part II. Nursing2006, 36(12), Krasover, T. (1982). A conceptual approach to the electrocardiogram. Critical Care Nurse, March/April, pp
12 Lead ECG Skills: Building Confidence for Clinical Practice. Presented By: Cynthia Webner, BSN, RN, CCRN-CMC. Karen Marzlin, BSN, RN,CCRN-CMC
12 Lead ECG Skills: Building Confidence for Clinical Practice NTI 2009 Preconference Session 803 Presented By: Karen Marzlin, BSN, RN,CCRN-CMC 1 12 Lead ECG Fundamentals: The Starting Place for Linking
12 Lead ECG. Presented by Rebecca Sevigny BSN, RN Professional Practice & Development Dept.
12 Lead ECG Presented by Rebecca Sevigny BSN, RN Professional Practice & Development Dept. Two Main Coronary Arteries RCA LCA which branches into Left Anterior Descending Circumflex Artery Two Main Coronary
Relax and Learn At the Farm 2012
Relax and Learn At the Farm 2012 Session 2: 12 Lead ECG Fundamentals 101 Cynthia Webner DNP, RN, CCNS, CCRN-CMC, CHFN Though for Today Mastery is not something that strikes in an instant, like a thunderbolt,
12-Lead ECG Interpretation. Kathy Kuznar, RN, ANP
12-Lead ECG Interpretation Kathy Kuznar, RN, ANP The 12-Lead ECG Objectives Identify the normal morphology and features of the 12- lead ECG. Perform systematic analysis of the 12-lead ECG. Recognize abnormalities
This presentation will deal with the basics of ECG description as well as the physiological basics of
Snímka 1 Electrocardiography basics This presentation will deal with the basics of ECG description as well as the physiological basics of Snímka 2 Lecture overview 1. Cardiac conduction system functional
By the end of this lecture, you will be able to: Understand the 12 lead ECG in relation to the coronary circulation and myocardium Perform an ECG
By the end of this lecture, you will be able to: Understand the 12 lead ECG in relation to the coronary circulation and myocardium Perform an ECG recording Identify the ECG changes that occur in the presence
EKG. Danil Hammoudi.MD
EKG Danil Hammoudi.MD What is an EKG? The electrocardiogram (EKG) is a representation of the electrical events of the cardiac cycle. Each event has a distinctive waveform, the study of which can lead to
12 Lead ECG Interpretation: Color Coding for MI s
12 Lead ECG Interpretation: Color Coding for MI s Anna E. Story, RN, MS Director, Continuing Professional Education Critical Care Nurse Online Instructional Designer 2004 Anna Story 1 Objectives review
DR QAZI IMTIAZ RASOOL OBJECTIVES
PRACTICAL ELECTROCARDIOGRAPHY DR QAZI IMTIAZ RASOOL OBJECTIVES Recording of electrical events in heart Established electrode pattern results in specific tracing pattern Health of heart i. e. Anatomical
- why the T wave is deflected upwards although it's a repolarization wave?
Cardiac Electrograph: - why the T wave is deflected upwards although it's a repolarization wave? After depolarization the ventricle contracts but since the heart is a volume conductor (3D not 2D), when
12 Lead EKG. The Basics
12 Lead EKG The Basics Objectives Demonstrate proper 12 EKG lead placement Determine electrical axis Identify ST and T wave changes as they relate to myocardial ischemia Describe possible complications
Introduction to Electrocardiography
Introduction to Electrocardiography Class Objectives: Introduction to ECG monitoring Discuss principles of interpretation Identify the components and measurements of the ECG ECG analysis ECG Monitoring
ECG. Prepared by: Dr.Fatima Daoud Reference: Guyton and Hall Textbook of Medical Physiology,12 th edition Chapters: 11,12,13
ECG Prepared by: Dr.Fatima Daoud Reference: Guyton and Hall Textbook of Medical Physiology,12 th edition Chapters: 11,12,13 The Concept When the cardiac impulse passes through the heart, electrical current
also aid the clinician in recognizing both the obvious and subtle abnormalities that may help guide therapy.
Karen Lieberman, MS, CRNP f the many diagnostic tools used to screen for and evaluate cardiac abnormalities, the 12-lead electrocardiogram (ECG) is among the most basic. This inexpensive and noninvasive
Electrocardiogram ECG. Hilal Al Saffar FRCP FACC College of medicine,baghdad University
Electrocardiogram ECG Hilal Al Saffar FRCP FACC College of medicine,baghdad University Tuesday 29 October 2013 ECG introduction Wednesday 30 October 2013 Abnormal ECG ( ischemia, chamber hypertrophy, heart
Conduction Problems / Arrhythmias. Conduction
Conduction Problems / Arrhythmias Conduction Wolf-Parkinson White Syndrome (WPW) and Lown-Ganong-Levine (LGL): Atrial impulses bypass the AV node through an accessory pathway or bypass tract (bundle of
SIMPLY ECGs. Dr William Dooley
SIMPLY ECGs Dr William Dooley 1 No anatomy just interpretation 2 Setting up an ECG 3 Setting up an ECG 1 V1-4 th Right intercostal space at sternal border 2 V2-4 th Left intercostal space at sternal border
5- The normal electrocardiogram (ECG)
5- The (ECG) Introduction Electrocardiography is a process of recording electrical activities of heart muscle at skin surface. The electrical current spreads into the tissues surrounding the heart, a small
Pennsylvania Academy of Family Physicians Foundation & UPMC 43rd Refresher Course in Family Medicine CME Conference March 10-13, 2016
Pennsylvania Academy of Family Physicians Foundation & UPMC 43rd Refresher Course in Family Medicine CME Conference March 10-13, 2016 Disclosures: EKG Workshop Louis Mancano, MD Speaker has no disclosures
INTRODUCTION TO ECG. Dr. Tamara Alqudah
INTRODUCTION TO ECG Dr. Tamara Alqudah Excitatory & conductive system of the heart + - The ECG The electrocardiogram, or ECG, is a simple & noninvasive diagnostic test which records the electrical
12 LEAD EKG BASICS. By: Steven Jones, NREMT P CLEMC
12 LEAD EKG BASICS By: Steven Jones, NREMT P CLEMC ECG Review Waves and Intervals P wave: the sequential activation (depolarization) of the right and left atria QRS complex: right and left ventricular
Acute Coronary Syndromes. Disclosures
Acute Coronary Syndromes Disclosures I work for Virginia Garcia Memorial Health Center, Beaverton, OR. Jon Tardiff, BS, PA-C OHSU Clinical Assistant Professor And I am a medical editor for Jones & Bartlett
Electrocardiography Normal 5. Faisal I. Mohammed, MD, PhD
Electrocardiography Normal 5 Faisal I. Mohammed, MD, PhD 1 Objectives 2 1. Describe the different waves in a normal electrocardiogram. 2. Recall the normal P-R and Q-T interval time of the QRS wave. 3.
Electrocardiography for Healthcare Professionals. Chapter 14 Basic 12-Lead ECG Interpretation
Electrocardiography for Healthcare Professionals Chapter 14 Basic 12-Lead ECG Interpretation 2012 The Companies, Inc. All rights reserved. Learning Outcomes 14.1 Discuss the anatomic views seen on a 12-lead
REtrive. REpeat. RElearn Design by. Test-Enhanced Learning based ECG practice E-book
Test-Enhanced Learning Test-Enhanced Learning Test-Enhanced Learning Test-Enhanced Learning based ECG practice E-book REtrive REpeat RElearn Design by S I T T I N U N T H A N G J U I P E E R I Y A W A
Introduction to ECG Gary Martin, M.D.
Brief review of basic concepts Introduction to ECG Gary Martin, M.D. The electrical activity of the heart is caused by a sequence of rapid ionic movements across cell membranes resulting first in depolarization
The Fundamentals of 12 Lead EKG. ECG Recording. J Point. Reviewing the Cardiac Conductive System. Dr. E. Joe Sasin, MD Rusty Powers, NRP
The Fundamentals of 12 Lead EKG Dr. E. Joe Sasin, MD Rusty Powers, NRP SA Node Intranodal Pathways AV Junction AV Fibers Bundle of His Septum Bundle Branches Purkinje System Reviewing the Cardiac Conductive
Axis. B.G. Petty, Basic Electrocardiography, DOI / _2, Springer Science+Business Media New York 2016
Axis 2 The electrical axis of any electrocardiogram (EKG) waveform is the average direction of electrical activity. It is not a vector, because by definition a vector has both direction and amplitude,
ECG Basics Sonia Samtani 7/2017 UCI Resident Lecture Series
ECG Basics Sonia Samtani 7/2017 UCI Resident Lecture Series Agenda I. Introduction II.The Conduction System III.ECG Basics IV.Cardiac Emergencies V.Summary The Conduction System Lead Placement avf Precordial
All About STEMIs. Presented By: Brittney Urvand, RN, BSN, CCCC. Essentia Health Fargo Cardiovascular Program Manager.
All About STEMIs Presented By: Brittney Urvand, RN, BSN, CCCC Essentia Health Fargo Cardiovascular Program Manager Updated 10/2/2018 None Disclosures Objectives Identify signs and symptoms of a heart attack
ECG WORKBOOK. Rohan Jayasinghe
ECG WORKBOOK Rohan Jayasinghe Contents Preface vii Foreword viii Acknowledgements ix The author x Reviewers xi Section 1 Basics of the ECG 1 Section 2 ECG-based diagnosis: pathology by ECG 21 Section 3
Electrocardiography negative zero LA/VL RA/VR LL/VF recording electrode exploring electrode Wilson right arm right arm, left arm left arm
Electrocardiography In the previous lecture, we were talking about the unipolar limb leads. We said that to make the unipolar lead, you have to make the negative electrode as zero electrode, this is done
The Electrocardiogram part II. Dr. Adelina Vlad, MD PhD
The Electrocardiogram part II Dr. Adelina Vlad, MD PhD Basic Interpretation of the ECG 1) Evaluate calibration 2) Calculate rate 3) Determine rhythm 4) Determine QRS axis 5) Measure intervals 6) Analyze
ECG INTERPRETATION MANUAL
Lancashire & South Cumbria Cardiac Network ECG INTERPRETATION MANUAL THE NORMAL ECG Lancashire And South Cumbria Cardiac Physiologist Training Manual THE NORMAL ECG E.C.G CHECKLIST 1) Name, Paper Speed,
SIMPLY ECGs. Dr William Dooley
SIMPLY ECGs Dr William Dooley Content Basic ECG interpretation pattern Some common (examined) abnormalities Presenting ECGs in context Setting up an ECG Setting up an ECG 1 V1-4 th Right intercostal space
Family Medicine for English language students of Medical University of Lodz ECG. Jakub Dorożyński
Family Medicine for English language students of Medical University of Lodz ECG Jakub Dorożyński Parts of an ECG The standard ECG has 12 leads: six of them are considered limb leads because they are placed
ECG Interpretation. Best to have a system to methodically evaluate ECG (from Dubin) * Rate * Rhythm * Axis * Intervals * Hypertrophy * Infarction
ECG to save Babies ECG Interpretation Best to have a system to methodically evaluate ECG (from Dubin) * Rate * Rhythm * Axis * Intervals * Hypertrophy * Infarction Electrical Activity in the heart 5 events
Determining Axis and Axis Deviation on an ECG
Marquette University e-publications@marquette Physician Assistant Studies Faculty Research and Publications Health Sciences, College of 7-15-2010 Determining Axis and Axis Deviation on an ECG Patrick Loftis
Ask Mish. EKG INTERPRETATION part i
EKG INTERPRETATION part i What is EKG? EKG or ECG= electrocardiogram(~graphy) means the recording of the heart electrical activity from Greek kardio= heart, graphein= to write cardiac cell physiology Cardiac
A few new tools for better detection and understanding of STEMIs in the field.
A few new tools for better detection and understanding of STEMIs in the field. Let s talk, prep and placement. Try to shoot for quality, consistency and no artifact! (looking sometimes for 1 or 2 mm changes)
BASIC CONCEPT OF ECG
BASIC CONCEPT OF ECG Electrocardiogram The electrocardiogram (ECG) is a recording of cardiac electrical activity. The electrical activity is readily detected by electrodes attached to the skin. After the
Myocardial Infarction. Reading Assignment (p66-78 in Outline )
Myocardial Infarction Reading Assignment (p66-78 in Outline ) Objectives 1. Why do ST segments go up or down in ischemia? 2. STEMI locations and culprit vessels 3. Why 15-lead ECGs? 4. What s up with avr?
ECG CONVENTIONS AND INTERVALS
1 ECG Waveforms and Intervals ECG waveforms labeled alphabetically P wave== represents atrial depolarization QRS complex=ventricular depolarization ST-T-U complex (ST segment, T wave, and U wave)== V repolarization.
Electrocardiography Abnormalities (Arrhythmias) 7. Faisal I. Mohammed, MD, PhD
Electrocardiography Abnormalities (Arrhythmias) 7 Faisal I. Mohammed, MD, PhD 1 Causes of Cardiac Arrythmias Abnormal rhythmicity of the pacemaker Shift of pacemaker from sinus node Blocks at different
Ekg pra pr c a tice D.HAMMOUDI.MD
Ekg practice D.HAMMOUDI.MD Anatomy Revisited RCA (Right Coronary Artery) Right ventricle Inferior wall of LV Posterior wall of LV (75%) SA Node (60%) AV Node (>80%) LCA (Left Coronary Artery) Septal wall
12 Lead ECG Interpretation: The Basics and Beyond
12 Lead ECG Interpretation: The Basics and Beyond Cindy Weston, DNP, RN, CCRN, CNS-CC, FNP-BC Assistant Professor Texas A&M University College of Nursing cweston@tamhsc.edu Objectives Review the basics
General Introduction to ECG. Reading Assignment (p2-16 in PDF Outline )
General Introduction to ECG Reading Assignment (p2-16 in PDF Outline ) Objectives 1. Practice the 5-step Method 2. Differential Diagnosis: R & L axis deviation 3. Differential Diagnosis: Poor R-wave progression
Understanding basics of EKG
Understanding basics of EKG By Alula A.(R III) www.le.ac.uk Topic for discussion Understanding of cellular electrophysiology Basics Rate Rhythm Axis Intervals P wave QRS ST/T wave Abnormal EKGs Understanding
12 Lead ECG Interpretation
12 Lead ECG Interpretation Julie Zimmerman, MSN, RN, CNS, CCRN Significant increase in mortality for every 15 minutes of delay! N Engl J Med 2007;357:1631-1638 Who should get a 12-lead ECG? Also include
ELECTROCARDIOGRAPH. General. Heart Rate. Starship Children s Health Clinical Guideline
General Heart Rate QRS Axis T Wave Axis PR Interval according to Heart Rate & Age P Wave Duration and Amplitude QRS Duration according to Age QT Interval R & S voltages according to Lead & Age R/S ratio
402 Index. B β-blockers, 4, 5 Bradyarrhythmias, 76 77
Index A Acquired immunodeficiency syndrome (AIDS), 126, 163 Action potentials, 1, 5, 27 Acute coronary syndromes, 123t, 129 Adenosine, intravenous, 277 Alcohol abuse, as T wave inversion cause, 199 Aneurysm,
Left posterior hemiblock (LPH)/
ECG OF THE MONTH Left Postero-inferior Depolarization Delay Keywords Electrocardiography Intraventricular conduction delay, Inferoposterior hemiblock, Left posterior fascicular block, Left posterior hemiblock
ECG Interpretation Cat Williams, DVM DACVIM (Cardiology)
ECG Interpretation Cat Williams, DVM DACVIM (Cardiology) Providing the best quality care and service for the patient, the client, and the referring veterinarian. GOAL: Reduce Anxiety about ECGs Back to
ECG Workshop. Nezar Amir
ECG Workshop Nezar Amir Myocardial Ischemia ECG Infarct ECG in STEMI is dynamic & evolving Common causes of ST shift Infarct Localisation Left main artery occlusion: o diffuse ST-depression with ST elevation
Section V. Objectives
Section V Landscape of an MI Objectives At the conclusion of this presentation the participant will be able to Outline a systematic approach to 12 lead ECG interpretation Demonstrate the process for determining
ECGs: Everything a finalist needs to know. Dr Amy Coulden As part of the Simply Finals series
ECGs: Everything a finalist needs to know Dr Amy Coulden As part of the Simply Finals series Aims and objectives To be able to interpret basic ECG abnormalities To be able to recognise commonly tested
2017 EKG Workshop Advanced. Family Medicine Review Course Lou Mancano, MD, FAAFP Reading Health System Family and Community Medicine Reading, PA
2017 EKG Workshop Advanced Family Medicine Review Course Lou Mancano, MD, FAAFP Reading Health System Family and Community Medicine Reading, PA Part II - Objective Describe a useful approach to interpreting
Lect.6 Electrical axis and cardiac vector Cardiac vector: net result Vector that occurs during depolarization of the ventricles Figure:
Lect.6 Electrical axis and cardiac vector Objectives: 1. State the relationship between the direction of cardiac vector with the direction (-ve, +ve) and amplitude of an ECG waves. 2. Draw diagram indicting
CARDIOVASCULAR PHYSIOLOGY ECG. Dr. Ana-Maria Zagrean
CARDIOVASCULAR PHYSIOLOGY ECG Dr. Ana-Maria Zagrean Electrocardiogram (ECG) ECG is a non-invasive method to record at the body surface the electrical activity of the heart. - the rate and regularity of
10 ECGs No Practitioner Can Afford to Miss. Objectives
10 ECGs No Practitioner Can Afford to Miss Mary L. Dohrmann, MD Professor of Clinical Medicine Division of Cardiovascular Medicine University of Missouri School of Medicine No disclosures Objectives 1.
Lab Activity 24 EKG. Portland Community College BI 232
Lab Activity 24 EKG Reference: Dubin, Dale. Rapid Interpretation of EKG s. 6 th edition. Tampa: Cover Publishing Company, 2000. Portland Community College BI 232 Graph Paper 1 second equals 25 little boxes
ELECTROCARDIOGRAPHY (ECG)
ELECTROCARDIOGRAPHY (ECG) The heart is a muscular organ, which pumps blood through the blood vessels of the circulatory system. Blood provides the body with oxygen and nutrients, as well as assists in
CORONARY ARTERIES HEART
CARDIAC/ECG MODULE THE HEART CORONARY ARTERIES FIBRILLATING HEART CORONARY ARTERIES HEART PRACTICE RHYTHMS PRACTICE RHYTHMS ELECTRICAL CONDUCTION SA Node (60 100) Primary pacemaker AV Node (40 60) ***Creates
3/26/15 HTEC 91. EKG Sign-in Book. The Cardiac Cycle. Parts of the ECG. Waves. Waves. Review of protocol Review of placement of chest leads (V1, V2)
EKG Sign-in Book HTEC 91 Review of protocol Review of placement of chest leads (V1, V2) Medical Office Diagnostic Tests Week 2 http://www.cvphysiology.com/arrhythmias/a013c.htm The Cardiac Cycle Represents
ECG Interpretation Made Easy
ECG Interpretation Made Easy Dr. A Tageldien Abdellah, MSc MD EBSC Lecturer of Cardiology- Hull University Hull York Medical School 2007-2008 ECG Interpretation Made Easy Synopsis Benefits Objectives Process
Blocks & Dissociations. Reading Assignment (p47-52 in Outline )
Blocks & Dissociations Reading Assignment (p47-52 in Outline ) Objectives Who are Wenckebach and Mobitz? Review SA and AV Blocks AV Dissociations: learning who s the boss and why 2 nd degree SA Block:
Preface: Wang s Viewpoints
AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Part IV, Ischemia and Infarction Presented by: WANG, TZONG LUEN, MD, PhD, JM, FACC, FESC, FCAPSC Professor,
ECG ABNORMALITIES D R. T AM A R A AL Q U D AH
ECG ABNORMALITIES D R. T AM A R A AL Q U D AH When we interpret an ECG we compare it instantaneously with the normal ECG and normal variants stored in our memory; these memories are stored visually in
1 st Degree Block Prolonged P-R interval caused by first degree heart block (lead II)
AV Heart Blocks 1 st degree A condition of a rhythm, not a true rhythm Need to always state underlying rhythm 2 nd degree Type I - Wenckebach Type II Classic dangerous to the patient Can be variable (periodic)
Cardiology Flash Cards
Cardiology Flash Cards EKG in a nut shell www.brain101.info Conduction System www.brain101.info 2 Analyzing EKG Step by step Steps in Analyzing ECG'S 1. Rhythm: - Regular _ Sinus, Junctional or Ventricular.
2017 EKG Workshop Basic. Family Medicine Review Course Lou Mancano, MD, FAAFP Reading Health System Family and Community Medicine Reading, PA
2017 EKG Workshop Basic Family Medicine Review Course Lou Mancano, MD, FAAFP Reading Health System Family and Community Medicine Reading, PA Part I - Objectives Discuss a systematic approach to EKG interpretation
A Review of Cardiac Pathophysiology and EKG. Jamie Dyson PT, DPT Kathy Swanick PT, DPT, OCS
A Review of Cardiac Pathophysiology and EKG Jamie Dyson PT, DPT Kathy Swanick PT, DPT, OCS Cardiac Pathophysiology Coronary Artery Disease Congestive Heart Failure Valvular Heart Disease Athletic Heart
Please check your answers with correct statements in answer pages after the ECG cases.
ECG Cases ECG Case 1 Springer International Publishing AG, part of Springer Nature 2018 S. Okutucu, A. Oto, Interpreting ECGs in Clinical Practice, In Clinical Practice, https://doi.org/10.1007/978-3-319-90557-0
Return to Basics. ECG Rate and Rhythm. Management of the Hospitalized Patient September 25, 2009
Management of the Hospitalized Patient September 25, 2009 ECG Refresher and Update 2009 Return to Basics Determine rate and rhythm Determine intervals and axes Define morphology of P-QRS-T-U Compare with
15 16 September Seminar W10O. ECG for General Practice
15 16 September 2012 Seminar W10O ECG for General Practice Speaker: Ms Natasha Eaton ECG for General Practice Speaker: Natasha Eaton Cardiac CNC Executive Representative Electrocardiography The graphic
CRC 431 ECG Basics. Bill Pruitt, MBA, RRT, CPFT, AE-C
CRC 431 ECG Basics Bill Pruitt, MBA, RRT, CPFT, AE-C Resources White s 5 th ed. Ch 6 Electrocardiography Einthoven s Triangle Chest leads and limb leads Egan s 10 th ed. Ch 17 Interpreting the Electrocardiogram
ECG SIGNS OF HYPERTROPHY OF HEART ATRIUMS AND VENTRICLES
Ministry of Health of Ukraine Kharkiv National Medical University ECG SIGNS OF HYPERTROPHY OF HEART ATRIUMS AND VENTRICLES Methodical instructions for students Рекомендовано Ученым советом ХНМУ Протокол
Bundle Branch & Fascicular Blocks. Reading Assignment (p53-58 in Outline )
Bundle Branch & Fascicular Blocks Reading Assignment (p53-58 in Outline ) Objectives 1. QRS analysis of Right and Left BBB 2. Uncomplicated vs complicated BBB 3. Diagnosis of RBBB with LAFB and LPFB 4.
Basic electrocardiography reading. R3 lee wei-chieh
Basic electrocardiography reading R3 lee wei-chieh The Normal Conduction System Lead Placement avf Limb Leads Precordial Leads Interpretation Rate Rhythm Interval Axis Chamber abnormality QRST change What
Office ECG Interpretation
Office ECG Interpretation Jason Evanchan, DO Assistant Professor of Medicine Division of Cardiovascular Medicine The Ohio State University Wexner Medical Center Outline of topics High risk ischemia T wave
Sheet 5 physiology Electrocardiography-
*questions asked by some students Sheet 5 physiology Electrocardiography- -why the ventricles lacking parasympathetic supply? if you cut both sympathetic and parasympathetic supply of the heart the heart
Case 1. Case 2. Case 3
Case 1 The correct answer is D. Occasionally, the Brugada syndrome can present similar morphologies to A and also change depending on the lead position but in the Brugada pattern the r is wider and ST
Ben Taylor, PhD, PA-C
Ben Taylor, PhD, PA-C The patient is a 23-year-old white male with a history of polysubstance abuse who was found unresponsive, last seen the day before. Classic signs of systemic hypothermia with prominent
Diploma in Electrocardiography
The Society for Cardiological Science and Technology Diploma in Electrocardiography The Society makes this award to candidates who can demonstrate the ability to accurately record a resting 12-lead electrocardiogram
Disclosures. STEMI:To Call or Not to Call. Disclosures 9/18/2017. Alternate Title: Hey Doc, If you re not doing anything Saturday Night
STEMI:To Call or Not to Call Disclosures No financial disclosures September, 2017 Frederick James Trip Meine III MD, FACC, FSCAI Cape Fear Heart Associates, Wilmington, NC Disclosures Alternate Title:
Return to Basics. Normal Intervals & Axes. ECG Rate and Rhythm
Return to Basics Management of the Hospitalized Patient October 15, 2010 ECG Refresher and Update 2010 Determine rate and rhythm Determine intervals and axes Define morphology of P-QRS-T-U Compare with
Acute Coronary Syndromes Unstable Angina Non ST segment Elevation MI (NSTEMI) ST segment Elevation MI (STEMI)
Leanna R. Miller, RN, MN, CCRN-CSC, PCCN-CMC, CEN, CNRN, CMSRN, NP Education Specialist LRM Consulting Nashville, TN Objectives Evaluate common abnormalities that mimic myocardial infarction. Identify
UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST CARDIAC INVESTIGATIONS PAEDIATRIC & CONGENITAL ELECTROCARDIOGRAPHY Guideline
UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST CARDIAC INVESTIGATIONS PAEDIATRIC & CONGENITAL ELECTROCARDIOGRAPHY Guideline Authors: Suhair Shebani, Claire Sansome Contact Name: Deborah Ip, Carla Blunt Approved
Appendix D Output Code and Interpretation of Analysis
Appendix D Output Code and Interpretation of Analysis 8 Arrhythmia Code No. Description 8002 Marked rhythm irregularity 8110 Sinus rhythm 8102 Sinus arrhythmia 8108 Marked sinus arrhythmia 8120 Sinus tachycardia
Chapter 4. Basic ECG Concepts and the Normal ECG. Brian Coyne, MEd, RCEP / Shel Levine, MS, CES
Chapter 4 Basic ECG Concepts and the Normal ECG Brian Coyne, MEd, RCEP / Shel Levine, MS, CES Learning Objectives Upon completion of this chapter, the reader will be able to: 1. Identify standardized components
Huseng Vefali MD St. Luke s University Health Network Department of Cardiology
Huseng Vefali MD St. Luke s University Health Network Department of Cardiology Learning Objectives Establish Consistent Approach to Interpreting ECGs Review Essential Cases for Paramedics and first responders
, David Stultz, MD.
http://www.dilbert.com EKG Rounds Handouts available at http://www.drstultz.com January 5, 2004 David Stultz, MD Cardiology Fellow, PGY 4 Overview of Topics How to read an EKG Normal EKG Determination
Paediatric ECG Interpretation
Paediatric ECG Interpretation Dr Sanj Fernando (thanks to http://lifeinthefastlane.com/ecg-library/paediatric-ecginterpretation/) 3 yo boy complaining of abdominal pain and chest pain Child ECG vs Adult
The ABC of Pediatric ECG
The ABC of Pediatric ECG Mohamed Hamdan, MD, FAAP, FACC Assistant Professor of Pediatrics Columbia University College of Physicians and Surgeons, NY, USA Consultant Pediatric Cardiologist & Co-Director
What s New in IV Conduction? (Quadrafascicular, not Trifascicular)
What s New in IV Conduction? (Quadrafascicular, not Trifascicular) Frank Yanowitz, MD Professor, University of Utah School of Medicine Medical Director, IHC ECG Services (Urban Central Region) http://ecg.utah.edu
Educators have placed an emphasis on the development of laboratory materials that
VIRTUAL EXPERIMENT FOR UNDERSTANDING THE ELECTROCARDIOGRAM AND THE MEAN ELECTRICAL AXIS Jamie Anderson and Stephen E. DiCarlo Department of Physiology, Wayne State University, School of Medicine, Detroit,
2/7/ LEAD ECG CASE STUDIES Lisa Riggs MSN, RN, ACNS-BC, CCRN-K CASE #1 WHAT ELSE WOULD YOU ASSESS? WHAT S YOUR DIAGNOSIS?
12 LEAD ECG CASE STUDIES Lisa Riggs MSN, RN, ACNS-BC, CCRN-K CASE #1 31 y/o male is a direct admit from the physician s office with c/o chest pain and SOA WHAT ELSE WOULD YOU ASSESS? WHAT S YOUR DIAGNOSIS?
Part One Objectives. Don t Worry About It. All done for you Paper Speed 25 mm/sec Calibration 1 mv charge over 20 ms = 10 mm tall Lincoln Hat
12-lead and ACS Review North Lyon Refresher Part One Objectives 12 lead ECG Basics Anatomy and Physiology STEMI Diagnosis Types of MI ACS Review STEMI System and Interventional Cardiology Review The Value
Abnormalities Caused by Left Bundle Branch Block
Marquette University e-publications@marquette Physician Assistant Studies Faculty Research and Publications Physician Assistant Studies, Department 12-17-2010 Abnormalities Caused by Left Bundle Branch
Electrocardiography. Hilal Al Saffar College of Medicine,Baghdad University
Electrocardiography Hilal Al Saffar College of Medicine,Baghdad University Which of the following is True 1. PR interval, represent the time taken for the impulse to travel from SA node to AV nose. 2.