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(BMJ Books) Quick-reference textual content permits readers to familiarize yourself with the big variety of electrocardiogram styles visible in scientific perform. For these as a rule perform or in hospitals dealing with sufferers with middle issues. Softcover.
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Extra info for ABC of Clinical Electrocardiography
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. Indirect evidence of independent atrial activity Capture beat Occasionally an atrial impulse may cause ventricular depolarisation via the normal conduction system. The resulting QRS complex occurs earlier than expected and is narrow.
Although temporary transvenous cardiac pacing may be necessary for patients who are haemodynamically compromised, it is not mandatory in stable patients. Acute myocardial infarction with complete heart block Profound bradycardia or atrioventricular block resulting from ischaemia may provoke an escape rhythm. Such rhythms are the result of spontaneous activity from a subsidiary pacemaker located within the atria, atrioventricular junction, or ventricles. An atrioventricular junction escape beat has a normal QRS complex morphology, with a rate of 40-60 beats/min.
It may be a variant of normal or be due to cardiac or non-cardiac disease. A correct diagnosis has obvious advantages for the patient but is also particularly important before the use of thrombolytic treatment so that unnecessary exposure to the risks of thrombolytic drugs can be avoided. The interpretation of ST segment elevation should always be made in the light of the clinical history and examination findings. There are often clues in the electrocardiogram to differentiate the ST segment elevation of acute ischaemia from other causes; for example, reciprocal changes (see last week’s article) may be present, which strongly indicate acute ischaemia.