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Bradyarrhythmia //

Tachyarrhythmia
Michael-Joseph F. Agbayani, MD, FPCP, FPCC
Photo by Okko Pyykk: https://www.flickr.com/photos/data_op/

Image of heart: Public Domain. Image of Conduction system from Wikimedia user Madhero88:
https://commons.wikimedia.org/wiki/File:Electrical_conduction_system_of_the_heart.svg

SA node: 60 to 100
bpm
AV Junction: 40 to 60
bpm

Ventricle: <40 bpm

Image from Ed Burns, Life in the Fast Lane: http://lifeinthefastlane.com/ecg-library/sinus-bradycardia/

Image from ECGpedia,.org: http://en.ecgpedia.org/wiki/File:Ecgfreq.png

Pietro Longhi, 1744

Images from Wikimedia User Fae: https://upload.wikimedia.org/wikipedia/commons/6/6d/A_doctor_taking_the_pulse_of_a_gouty_bachelor_surrounded_by_Wellcome_V0010995.jpg and


https://upload.wikimedia.org/wikipedia/commons/6/69/A_physician_taking_the_pulse_of_a_female_patient_who_is_touc_Wellcome_V0016032.jpg

Public Domain Image: https://commons.wikimedia.org/wiki/File:12_lead_sinus_bradycardia.JPG

Image from Ed Burns, Life in the Fast Lane: http://lifeinthefastlane.com/ecg-library/sinus-bradycardia/

Image from Ed Burn, Life in the Fast Lane: http://lifeinthefastlane.com/ecg-library/sick-sinus/

Image from Ed Burn, Life in the Fast Lane: http://lifeinthefastlane.com/ecg-library/sick-sinus/

Public Domain Image from https://commons.wikimedia.org/wiki/File:Treadmills_at_gym.jpg

x Impulse Conduction

Image of heart: Public Domain. Image of Conduction system from Wikimedia user Madhero88:
https://commons.wikimedia.org/wiki/File:Electrical_conduction_system_of_the_heart.svg

Sinoatrial exit block: http://commons.wikimedia.org/wiki/User:Jer5150

From ECGPedia User DrJ: http://en.ecgpedia.org/wiki/File:Sa_exit_blok2.png

Image of heart: Public Domain. Image of Conduction system from Wikimedia user Madhero88:
https://commons.wikimedia.org/wiki/File:Electrical_conduction_system_of_the_heart.svg

First degree AV block: http://www.flickr.com/photos/popfossa/

Image from Ed Burns: http://cdn.lifeinthefastlane.com/wp-content/uploads/2011/04/ECG_wenckebach.jpg

Second Degree AV block Mobitz Type 1: http://commons.wikimedia.org/wiki/User:Jer5150

Image from Ed Burns: http://cdn.lifeinthefastlane.com/wp-content/uploads/2011/04/Mobitz_II.gif

Image from Ed Burns: http://cdn.lifeinthefastlane.com/wp-content/uploads/2011/04/mobitz_II_rhythm_strip.jpg

Mobitz type 2 and 2:1: http://commons.wikimedia.org/wiki/User:Jer5150

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/basics/fixed-ratio-blocks/

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/basics/high-grade-block/

Image of heart: Public Domain. Image of Conduction system from Wikimedia user Madhero88:
https://commons.wikimedia.org/wiki/File:Electrical_conduction_system_of_the_heart.svg

SA node: 60 to 100
bpm
AV Junction: 40 to
60 bpm

Ventricle: <40 bpm

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/basics/complete-heart-block/

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/basics/complete-heart-block/

SA node: 60 to 100
bpm
AV Junction: 40 to
60 bpm

Ventricle: <40 bpm

Complete heart block: http://commons.wikimedia.org/wiki/User:Jer5150

Complete heart block strip from Wikimedia user MoodyGroove: http://en.wikipedia.org/wiki/User:MoodyGroove

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/basics/complete-heart-block/

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/basics/complete-heart-block/

Images in Cardiovascular Medicine. From Bad to Worse. Circulation


April 18, 2006 vol. 113 no. 15 e707-e708

Image from Flickr User Helge V. Keltel: https://www.flickr.com/photos/17088227@N00/7147926407

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/basics/complete-heart-block/

From https://en.wikipedia.org/wiki/Dialysis#/media/File:Patient_receiving_dialysis_03.jpg

Pills Image from https://www.flickr.com/photos/emagineart

Diagnosis and Management of Cardiac Amyloidoses. Circulation.


2005; 112: 2047-2060

Image from wikimedia User Kalumet:


https://commons.wikimedia.org/wiki/File:Dilated_cardiomyopathy_B-Mode.jpg

Holter image from Wikimedia user Misscurry:


https://en.wikipedia.org/wiki/Holter_monitor#/media/File:Alex_CM4000.jpg

Brignole et al. J Am Coll Cardiol 2011;58:16773

Image from Wikimedia user Intropin:


https://commons.wikimedia.org/wiki/File:Atropine_(1).JPG

From Wikimedia User


PhilippN.
https://commons.wikimedia.
org/wiki/File:Defibrillation_El
ectrode_Position.jpg

Image from From Wikimedia user:


https://commons.wikimedia.org/wiki/User:Stevenfruitsmaak

Public Domain image from https://commons.wikimedia.org/wiki/File:Pacemaker_NIH.jpg

Image from Wikimedia User Lucien Monfils:


https://commons.wikimedia.org/wiki/File:Herzschrittmacher_auf_Roentgenbild.jpg

Image from Wikimedia user Diberi3: https://en.wikipedia.org/wiki/File:Pacemaker_potential_annotated.gif

From Harrisons Principles of


Internal Medicine, 18th
Edition

From ECGPedia.org user Drj: http://en.ecgpedia.org/wiki/File:Re_entry.svg

Image from Googletrans: http://commons.wikimedia.org/wiki/File:De-Avnrt_ecg2_(CardioNetworks_ECGpedia).jpg

Image from Wikimedia user MoodyGroove: http://commons.wikimedia.org/wiki/File:SinusTach.jpg

Atrial Fibrillation

ECG Image by Jheuser http://en.wikipedia.org/wiki/File:Afib_ecg.jpg


Image of AF Mechanisms from HRS/EHRA/ECAS Expert Consensus Statement on
Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Personnel,
Policy, Procedures and Follow-Up | Europace (2007) 9 (6): 335379.doi: 10.1093/europace/eum120 |
http://europace.oxfordjournals.org/content/9/6/335.full
1.Europace (2007) 9 (6): 335-379.doi: 10.1093/europace/eum120

Photo by Libertas Academica |https://www.flickr.com/photos/libertasacademica/

Multifocal atrial tachycardia (MAT)

Image from Jason E. Roediger: http://en.wikipedia.org/wiki/File:Multifocal_atrial_tachycardia_-_MAT.png

Atrial
Flutter

Image by James Heilman, MD | http://en.wikipedia.org/wiki/File:Atrial_flutter34.svg

Image from Dr. Michael Agbayani


http://twitter.com/HeartRhythmMD

Images by Charles Gomersall, http://www.aic.cuhk.edu.hk/web8/atrial_flutter.htm

AVNRT

Schematic of typical atrioventricular nodal reentry.

Fox D J et al. Mayo Clin Proc. 2008;83:1400-1411

2008 Mayo Foundation for Medical Education and Research

Image from http://www.elektrokardiogram.pl/ksiazka_tachyarytmie-50.html

Image from http://www.elektrokardiogram.pl/ksiazka_tachyarytmie-50.html

Cardiac rhythm strips demonstrating (top) sinus rhythm and (bottom) paroxysmal
supraventricular tachycardia.

Fox D J et al. Mayo Clin Proc. 2008;83:1400-1411

2008 Mayo Foundation for Medical Education and Research

Atypical AVNRT

Image from Ed Burns, Life in the Fast Lane:


http://lifeinthefastlane.com/ecg-library/svt/

Accessory Pathways

Images from ECGpedia.org: http://en.ecgpedia.org/wiki/Ventricular_pre-excitation_(Wolff-Parkinson-White_pattern)

Orthodromic AVRT

Image from Ed Burns, Life In The Fast Lane


http://lifeinthefastlane.com/ecg-library/pre-excitation-syndromes/

Antidromic AVNRT

Schematic of orthodromic and antidromic tachycardia, showing the relationship between the
atrioventricular node (AVN) and the accessory pathway (AP) and the associated QRS
morphology.

Fox D J et al. Mayo Clin Proc. 2008;83:1400-1411


2008 Mayo Foundation for Medical Education and Research

From Wikimedia user Intropin:


http://commons.wikimedia.or
g/wiki/File:Adenosine_(1).JPG

Adenosine

ECG from Life in the Fast Lane (Blog) | http://lifeinthefastlane.com/ecg-library/pre-excitation-syndromes/

Richter S , and Brugada P Circulation. 2006;114:e638-e639


Copyright American Heart Association, Inc. All rights reserved.

Image from Dr. Michael Agbayani


http://twitter.com/HeartRhythmMD

Image from Ed Burns, Life in The Fast Lane


http://lifeinthefastlane.com/ecg-library/basics/fusion-beats/

Image from ECGPedia.org

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/aivr/

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/rvo/

Thiene G, Corrado D, Basso C. Arrhythmogenic right ventricular cardiomyopathy/dysplasia. Orphanet J Rare Dis. 2, 45. 2008. doi:10.1186/1750-1172-245. PMID 18001465.
Image from Wikimedia user Ksheka:
http://commons.wikimedia.org/wiki/File:ARVDEpsilon_wave.png

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/basics/qt_interval/

Seung-Yul Lee, Jin-Bae Kim, Eui Im, Woo-In Yang, Boyoung Joung, Moon-Hyoung Lee,corresponding author and Sung-Soon Kim. A Case of Catecholaminergic Polymorphic
Ventricular Tachycardia. Yonsei Med J. Jun 30, 2009; 50(3): 448451.

Public Domain Images from Wikimedia.

Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/ventricular-fibrillation/

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