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cardiology diagnosis ecg ekg electrocardiogram differential clinical management arrhythmia causes classification comparison indications ppm sinus summary variants 3rd 5asa approach
Pacemaker Placement Indications Class I: • Third degree block • Advanced 2nd degree block • Symptomatic Mobitz
Pacemaker Placement ... with syncope • ... RBBB/LBBB with syncope ... arrest, prolonged PR ... BrighamMedRes #Pacemaker
Summary of Heart Blocks 1st Degree Heart Block: • Prolonged PR >200ms (5 small squares). • Narrow
• Prolonged PR ... • Prolonged PR ... PR shorted after ... • Treatment: Pacemaker ... • Treatment: Pacemaker
Syncope - Differential Diagnosis Algorithm Neurocardiogenic: • Vasovagal • Orthostatic Hypotension • Autonomic Neuropathy • Situational (micturition,
Syncope - Differential ... Diagnosis Algorithm ... /3rd degree AV Block ... • Pacemaker ... Tachy-Brady Syndrome #Syncope
Atrioventricular Blocks (AV blocks) - ECG Diagnosis Summary First Degree AV Block • The P wave is
• PR interval ... There is constant PR ... • The PR interval ... by a junctional pacemaker ... an infra-Hisian pacemaker
Approach to ECGs - Syncope Syndromes Electrolytes • ↑K - brady, peak T, wide QRS, no P,
Approach to ECGs - Syncope ... assoc with 1K, AV block ... wave and short PR ... Trifascicular block ... Wong @mchlwng #Syncope
Approach to ECGs - Tachy/Bradyarrhythmias Tachyarrhythmias - HR > 100 Wide (1) VT - DANGER (2)
- w/ variable block ... (3) SA node block ... 1º - long PR intervals ... successively longer PR ... - ventricular pacemaker
WOBBLER for ECG assessment in Syncope W - Wolff Parkinson White O - Obstructed AV
assessment in Syncope ... - Bifascicular block ... missed in the syncope ... look for a short PR ... or 3rd degree block
The 4 Variants of Sinus Arrhythmia Phasic Sinus Arrhythmia: • The rate increases with respiration and decreases
The P wave and PR ... presence of AV block ... Wandering Atrial Pacemaker ... several cycle the pacemaker
Approach to ECGs Check - Age, gender, name - 25mm/s; 10mm/mV - 1mm = 40ms; 0.1 mV Rate
Intervals - PR ... ) - HiPR: AV block ... ectopic atrial pacemaker ... leads rsr'), V-pacemaker
Third Degree AV Block aka Complete Heart Block • In sinus rhythm with complete AV block,
Third Degree AV Block ... • The PR interval ... by a junctional pacemaker ... an infra-Hisian pacemaker ... ThirdDegree #3rd #AVBlock
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