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Electrocardiography & Cardiac Arrhythmias

Electrocardiography & Cardiac Arrhythmias. Saeed Oraii MD, Cardiologist Interventional Electrophysiologist Tehran Arrhythmia Clinic. Some slides have accompanied notes. To view them you can right click on the screen, choose ‘Screen’ and then ‘Speaker Notes’. ECG.

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Electrocardiography & Cardiac Arrhythmias

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  1. Electrocardiography&Cardiac Arrhythmias Saeed Oraii MD, Cardiologist Interventional Electrophysiologist Tehran Arrhythmia Clinic

  2. Some slides have accompanied notes. To view them you can right click on the screen, choose ‘Screen’ and then ‘Speaker Notes’. Tehran Arrhythmia Center

  3. ECG A graphic recording of electrical potentials generated by the heart A noninvasive, inexpensive and highly versatile test Tehran Arrhythmia Center

  4. Normal Pathway of Electrical Conduction Tehran Arrhythmia Center

  5. Cardiac Action Potential Tehran Arrhythmia Center

  6. Cardiac action potentials from different locations have different shapes Tehran Arrhythmia Center

  7. Electrophysiology • Electric currents that spread through the heart are produced by three components • Cardiac pacemaker cells • Specialized conduction tissue • The heart muscle • ECG only records the depolarization and repolarization potentials generated by atrial and ventricular myocardium. Tehran Arrhythmia Center

  8. Electrocardiograph 1903 Tehran Arrhythmia Center

  9. Normal Electrocardiogram Tehran Arrhythmia Center

  10. ECG Waveforms Labeled alphabetically beginning with the P wave Tehran Arrhythmia Center

  11. QRS-T Cycle Corresponds to Different Phases of Ventricular Action Potential Tehran Arrhythmia Center

  12. Limb Leads Tehran Arrhythmia Center

  13. Precordial Leads Tehran Arrhythmia Center

  14. Position of Precordial Electrodes Tehran Arrhythmia Center

  15. Precordial Leads Tehran Arrhythmia Center

  16. 3-D Representation of Cardiac Electrical Activity Tehran Arrhythmia Center

  17. Timing Intervals Tehran Arrhythmia Center

  18. Vector Concept • Cardiac depolarization and repolarization waves have direction and magnitude. • They can, therefore, be represented by vectors. • ECG records the complex spatial and temporal summation of electrical potentials from multiple myocardial fibers conducted to the surface of the body. Tehran Arrhythmia Center

  19. Limb Leads Directions Tehran Arrhythmia Center

  20. Vector Concept Tehran Arrhythmia Center

  21. Ventricular Depolarization Tehran Arrhythmia Center

  22. QRS Axis Tehran Arrhythmia Center

  23. Determination of QRS Axis Tehran Arrhythmia Center

  24. Direction of Propagation Tehran Arrhythmia Center

  25. Determination of QRS Axis Tehran Arrhythmia Center

  26. Determination of QRS Axis Tehran Arrhythmia Center

  27. Main Vector Tehran Arrhythmia Center

  28. Normal QRS Axis Tehran Arrhythmia Center

  29. Left Axis Deviation Tehran Arrhythmia Center

  30. Right Axis Deviation Tehran Arrhythmia Center

  31. Major ECG Abnormalities Tehran Arrhythmia Center

  32. Right Atrial Enlargement Tehran Arrhythmia Center

  33. Left Atrial Enlargement Tehran Arrhythmia Center

  34. Left Ventricular Hypertrophy Tehran Arrhythmia Center

  35. Right Ventricular Hypertrophy Tehran Arrhythmia Center

  36. RVH, RA enlargement Tehran Arrhythmia Center

  37. Left Bundle Branch Block Tehran Arrhythmia Center

  38. Left Bundle Branch Block Tehran Arrhythmia Center

  39. Right Bundle Branch Block Tehran Arrhythmia Center

  40. RBBB Tehran Arrhythmia Center

  41. RBBB, RAD (Bifascicular Block) Tehran Arrhythmia Center

  42. RBBB, LAD (Bifascicular Block) Tehran Arrhythmia Center

  43. Myocardial Ischemia • ECG is the cornerstone in the diagnosis of myocardial ischemia • Findings depend on several factors: • Nature of the process, reversible vs. irreversible • Duration, acute vs. chronic • Extent, transmural vs. subendocardial • Localization, anterior vs. inferoposterior • Other underlying abnormalities Tehran Arrhythmia Center

  44. Acute Ischemia Tehran Arrhythmia Center

  45. Myocardial Infarction Tehran Arrhythmia Center

  46. Acute Pericarditis Tehran Arrhythmia Center

  47. Metabolic Abnormalities Tehran Arrhythmia Center

  48. Hyper-kalemia K 6.9 Tehran Arrhythmia Center

  49. Same patientK 3.9 Tehran Arrhythmia Center

  50. Hypothermia, Osborn Wave Tehran Arrhythmia Center

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