ecg_6lead017.html Left Axis Deviation Frank G. Yanowitz, M.D. Copyright 1998 Lead II is more negative than positive, making the QRS axis more negative than -30 degrees. Because aVR is still negative, however, the axis is about -40 degrees. A PAC is also present. http://library.med.utah.edu/kw/ecg/mml/ecg_6lead017.html [5/11/2006 9:40:59 AM] ecg_12lead005.html Normal ECG-KH Frank G. Yanowitz, M.D., copyright 1997 http://library.med.utah.edu/kw/ecg/mml/ecg_12lead005.html [5/11/2006 9:41:00 AM] ecg_446.html Wandering Atrial Pacemaker-KH Frank Yanowitz Copyright 1996 Wandering atrial pacemaker is a benign rhythm change where the pacemaker site shifts from the sinus node into the atrial tissues. P-wave morphology varies with the pacemaker site. http://library.med.utah.edu/kw/ecg/mml/ecg_446.html [5/11/2006 9:41:00 AM] ecg_brady.html Sinus Bradycardia - Marquette-KH Marquette Electronics Copyright 1996 http://library.med.utah.edu/kw/ecg/mml/ecg_brady.html [5/11/2006 9:41:01 AM] ecg_normal.html Normal Sinus Rhythm - Marquette-KH Marquette Electronics Copyright 1996 http://library.med.utah.edu/kw/ecg/mml/ecg_normal.html [5/11/2006 9:41:02 AM] ecg_tachy.html SinusTachycardia - Marquette-KH Marquette Electronics Copyright 1996 http://library.med.utah.edu/kw/ecg/mml/ecg_tachy.html [5/11/2006 9:41:03 AM] ecg_wander.html Wandering Atrial Pacemaker - Marquette Marquette Electronics Copyright 1996 http://library.med.utah.edu/kw/ecg/mml/ecg_wander.html [5/11/2006 9:41:04 AM] ecg_0226_mod.html PAC's with RBBB Aberrant Conduction Frank Yanowitz Copyright 1996 PAC's are identified by the arrows. Note that the PP interval surrounding the PAC is less than 2x the basic sinus cycle indicating that the sinus node has been reset by the ectopic P wave. The pause after the PAC, therefore, is incomplete. http://library.med.utah.edu/kw/ecg/mml/ecg_0226_mod.html [5/11/2006 9:41:04 AM] ecg_0226_mod2.html What are those funny looking beats???? Frank Yanowitz Copyright 1996 The differential diagnosis of funny-looking-beats, or FLB's, primarily considers beats of supraventricular origin with aberrant conduction and ventricular ectopic beats. In this example the two FLB's have an easily seen ectopic P wave before them; therefore these are PAC's with RBBB aberration. http://library.med.utah.edu/kw/ecg/mml/ecg_0226_mod2.html [5/11/2006 9:41:05 AM] ecg_0228_mod.html Long QT Mischief Frank Yanowitz Copyright 1996 The long QT ECG has many causes: electrolyte abnormalities including hypo-K, hypo-Mg, and hypo- Ca; drugs including type I antiarrhythmics; CNS injury; and hereditary syndromes. Ventricular arrhythmias are thought to be caused by afterdepolarizations or triggered automaticity. http://library.med.utah.edu/kw/ecg/mml/ecg_0228_mod.html [5/11/2006 9:41:06 AM] [...]... http://library.med.utah.edu/kw /ecg/ mml /ecg_ bigeminy.html [5/11/20 06 9:41:19 AM] ecg_ cou_pvc.html PVC Couplet - Marquette-KH Marquette Electronics Copyright 19 96 http://library.med.utah.edu/kw /ecg/ mml /ecg_ cou_pvc.html [5/11/20 06 9:41:20 AM] ecg_ inter_pvc.html Interpolated PVCs - Marquette-KH Marquette Electronics Copyright 19 96 http://library.med.utah.edu/kw /ecg/ mml /ecg_ inter_pvc.html [5/11/20 06 9:41:20 AM] ecg_ isolated.html... Conduction Marquette-KH Marquette Electronics Copyright 19 96 http://library.med.utah.edu/kw /ecg/ mml /ecg_ aberrant.html [5/11/20 06 9:41:17 AM] ecg_ bigem_pvs.html Ventricular Bigeminy - Marquette-KH Marquette Electronics Copyright 19 96 http://library.med.utah.edu/kw /ecg/ mml /ecg_ bigem_pvs.html [5/11/20 06 9:41:18 AM] ecg_ bigeminy.html Atrial Bigeminy - Marquette-KH Marquette Electronics Copyright 19 96 http://library.med.utah.edu/kw /ecg/ mml /ecg_ bigeminy.html... the picture of AV block i.e., pseudo-AV block http://library.med.utah.edu/kw /ecg/ mml /ecg_ 485.html [5/11/20 06 9:41: 16 AM] ecg_ 508.html Premature Junctional Complexes With Retrograde P Waves-KH Frank Yanowitz Copyright 19 96 The ladder diagram illustrates the PJC with retrograde atrial capture http://library.med.utah.edu/kw /ecg/ mml /ecg_ 508.html [5/11/20 06 9:41: 16 AM] ecg_ aberrant.html PAC's With and Without... http://library.med.utah.edu/kw /ecg/ mml /ecg_ 441.html [5/11/20 06 9:41:14 AM] ecg_ 450.html Atrial Parasystole-KH Frank Yanowitz Copyright 19 96 The evenly spaced "dots" indicate ectopic atrial activity from a parasystolic atrial pacemaker Non-fixed coupled PAC's are seen having a common inter-ectopic interval One of the PAC's is nonconducted http://library.med.utah.edu/kw /ecg/ mml /ecg_ 450.html [5/11/20 06 9:41:14 AM] ecg_ 457.html... [5/11/20 06 9:41: 06 AM] ecg_ 0 268 _mod.html Atrial Parasystole Frank Yanowitz Copyright 19 96 In atrial parasystole non-fixed coupled PACs, shown by arrows, occur at a common inter-ectopic interval or at multiples of this interval Atrial fusions, not shown here, may also occur when the PAC occurs in close temporal proximity to the sinus impulse http://library.med.utah.edu/kw /ecg/ mml /ecg_ 0 268 _mod.html [5/11/20 06. .. [5/11/20 06 9:41:10 AM] ecg_ 401.html PAC and PVC: Complete vs Incomplete Pause-KH Frank G Yanowitz, M.D copyright 1997 http://library.med.utah.edu/kw /ecg/ mml /ecg_ 401.html [5/11/20 06 9:41:10 AM] ecg_ 402.html Identification of PVC's and PAC's-KH Frank Yanowitz Copyright 19 96 PVC's usually stick out like sore thumbs; PAC's are often difficult to see because they are hidden in the preceding ST-T wave The... http://library.med.utah.edu/kw /ecg/ mml /ecg_ 415.html [5/11/20 06 9:41:12 AM] ecg_ 418.html A Nonconducted PAC Causes An Unexpected Pause-KH Frank Yanowitz Copyright 19 96 Unexpected pauses in rhythm have several causes, the most frequent being a nonconducted PAC In this example the nonconducted PAC is seen in the ST segment of the pause Note the change in the ST-T compared to the other ST-T waves http://library.med.utah.edu/kw /ecg/ mml /ecg_ 418.html... http://library.med.utah.edu/kw /ecg/ mml /ecg_ 410.html [5/11/20 06 9:41:12 AM] ecg_ 415.html The Three Fates Of PAC's-KH Frank Yanowitz Copyright 19 96 As illustrated,PAC's can have three fates: PAC-1 enters the ventricles and encounters no conduction delays, therefore causing a narrow QRS; PAC-2 occurs a little earlier and can't get through the AV junction, therefore being "nonconducted"; PAC-3 seen in lead V1 makes... Conducted PAC's-KH Frank Yanowitz Copyright 19 96 In 'A' the slow sinus rhythm is actually caused by nonconducted PAC's hidden in the ST segment This is confirmed in 'B' where some of the PAC's are aberrantly conducted with LBBB, and some PAC's are nonconducted http://library.med.utah.edu/kw /ecg/ mml /ecg_ 457.html [5/11/20 06 9:41:15 AM] ecg_ 463 .html Sore Thumbs-KH Frank Yanowitz Copyright 19 96 Two funny... is a PVC The notch on the downslope of the QRS complex clearly dentifies this as a PVC and not aberrancy http://library.med.utah.edu/kw /ecg/ mml /ecg_ 463 .html [5/11/20 06 9:41:15 AM] ecg_ 485.html Junctional Parasystole and Pseudo-AV Block-KH Frank Yanowitz Copyright 19 96 This complicated rhythm strip shows normal sinus rhythm and a competing junctional parasystolic focus Solid circles indicate junctional . http://library.med.utah.edu/kw /ecg/ mml /ecg_ normal.html [5/11/20 06 9:41:02 AM] ecg_ tachy.html SinusTachycardia - Marquette-KH Marquette Electronics Copyright 19 96 http://library.med.utah.edu/kw /ecg/ mml /ecg_ tachy.html. incomplete. http://library.med.utah.edu/kw /ecg/ mml /ecg_ 02 26_ mod.html [5/11/20 06 9:41:04 AM] ecg_ 02 26_ mod2.html What are those funny looking beats???? Frank Yanowitz Copyright 19 96 The differential diagnosis of funny-looking-beats,. Copyright 19 96 http://library.med.utah.edu/kw /ecg/ mml /ecg_ brady.html [5/11/20 06 9:41:01 AM] ecg_ normal.html Normal Sinus Rhythm - Marquette-KH Marquette Electronics Copyright 19 96 http://library.med.utah.edu/kw /ecg/ mml /ecg_ normal.html