1. Mechanics of Recording ECG 1
2. Vectorial Concept of the QRS 2
3. Orientation of the ECG Leads 3
4. Systematic Approach to the Interpretation of ECG 4
5. ECG Waves, Intervals and Segments 4
6. Guide for Heart Rate Estimation 5
7. Proper Labeling of the Component Waves of the Ventricular Depolarization 6
8. QRS Axis 7
9. Glossary of Cardiac Rhythms 8
10. A Normal ECG 18
11. P Wave Abnormalities 20
12. Ventricular Hypertrophy, Left, Right and Biventricular 21
13. Intraventricular Conduction Defect
• Bundle Branch Block 30
• Fascicular Block 33
14. AV Block 37
15. Myocardial Infarction 50
16. Simple Electrophysiologic Characteristics of the Conduction Systems 92
17. P-QRS Relationships in Arrhythmias
• Reciprocal Beats 99
• Ventricular Capture Beats 101
• Fusion Beats 101
• AV Dissociation 102
• Ventriculophasic Sinus Arrhythmia 109
• Retrograde Conduction to Atria 111
18. Atrial Premature Beats 112
19. Atrial Tachycardia 116
20. Role of the AV Junction in Supraventricular Arrhythmias 118
21. Effects of Adenosine in Supraventricular Arrhythmias 119
22. Supraventricular Tachycardia (SVT) 120
xii Atlas of Electrocardiography
23. Atrial Fibrillation 123
24. Atrial Flutter 129
25. Multifocal Atrial Tachycardia 146
26. Ventricular Premature Beats 150
27. Usefulness of Ventricular Premature Beats 154
28. Aberrant Conduction 161
29. Ventricular Tachycardia 165
30. Electrolyte Problems 171
31. Sinus Node Dysfunction 186
32. Electronic Pacemaker 190
33. Stress Electrocardiography 196
34. Atrial Repolarization (Ta) Wave 197
35. Ventricular Pre-excitation 200
36. Concealed Conduction 214
37. ST-Segment Elevation in Conditions Other than Myocardial Infarction
• Normal 222
• Early Repolarization Pattern as a Normal Variant 225
• "The Other" Normal Variant 226
• Left Ventricular Hypertrophy 23
• Left Bundle Branch Block 81
• Pericarditis 227
• Prinzmetal's Angina 228
• Brugada Syndrome 229
• Pulmonary Embolism 230
• Stress Cardiomyopathy 231
• Cardioversion 232
• Hyperkalemia 177
• ‘Metabolic’ ST Elevation 233
38. Miscellaneous:
• Accelerated AV Conduction 234
• Acute Cor Pulmonale 235
• Atrial Septal Defect, Primum and Secundum 237
• Bidirectional Tachycardia 239
• Brugada Syndrome 229
• Cardioinhibitory Response 240
• Dextrocardia 241
• Digitalis Effect on the ST-Segment 242
• Duchenne Muscular Dystrophy 243
Contents xiii
• Early Transition 244
• Ebstein's Anomaly 245
• Electrical Alternans 246
• Hypertrophic Cardiomyopathy 250
• Hypothermia 251
• Late Transition 253
• Long QT interval 254
• Low QRS Voltage 255
• Memory T–Wave 256
• Mitral Stenosis 257
• Nonspecific ST-T Changes 258
• Poor R-Wave Progression 259
• Stress Cardiomyopathy 260
• Swan-Ganz Catheterization Causing High Grade AV Block in a Patient with LBBB 261
• T-Wave Alternans 262
• Transplanted Heart 263
• Tricyclic Overdose 264
• U Waves 265
• U Waves Mimicking P Waves 266
39. Artifacts 267
40. Differential Diagnosis of:
• Regular Narrow-QRS Tachycardia 273
• Regular Narrow-QRS Bradycardia 282
• Pauses 284
• Tall R Waves in the Right Precordial Lead 285
• Bigeminal Rhythm (Paired QRS Complexes) 292
• Changing QRS Axis or Morphology 294
• ST-Segment Elevation in V1-3 296
41. Addendum
• How to Make an Interpretation of Arrhythmia Easy, Correct, Convincing and Clinically Relevant? 298
• A Little Rhythm Strip that Told the Whole Story 300
Index 3