Chapter
2.2.5. The projection of the electrical activity of the heart on a plane surface
2.3.1. Frontal plane leads
2.3.2. Horizontal plane leads
2.4.1. Vector–loop–hemifield correlation
2.5. ECG wave terminology
2.5.1. Normal ECG: waves and intervals
CHAPTER 3: Recording Devices and Techniques
3.2. The ECG recording: a step-by-step approach
3.3.1. Electrodes not located at an appropriate place (see Section 4.10.4 in Chapter 4)
3.3.2. The correct use of filters
3.4. The importance of a barrier factor
CHAPTER 4: ECG Interpretation
4.1. A systematic method of interpretation
4.1.1. Parameters for study
4.1.2. Measuring waves and intervals
4.2. Heart rate and rhythm
4.2.1. Characteristics of sinus rhythm
4.2.2. Measuring heart rate and the QTc interval
4.3. The PR interval and the PR segment
4.7. ST segment and T wave
4.7.1. The normal ST segment and its variations (Figs 4.9 to 4.13)
4.7.2. Measuring ST shifts
4.8. Calculating the electrical axis
4.9. Heart rotation and its repercussions on the ECG
4.9.1. The normal ECG with no rotation
4.9.2. Heart rotation on the anteroposterior axis (Fig. 4.20)
4.9.3. Heart rotation on the longitudinal axis (Fig. 4.21)
4.9.4. Combined rotations (Fig. 4.22)
4.10. Variations of normal ECGs
4.10.1. Normal ECG changes with age
4.10.2. Transitory changes in repolarization
4.10.3. Other ECG patterns in the normal heart
4.10.4. Repeat the ECG recording if an ECG pattern is unusual
PART II: Morphological Abnormalities in the ECG
CHAPTER 5: Atrial Abnormalities
5.1. Initial considerations
5.2.1. Diagnostic criteria for RAE (Fig. 5.1B and 5.2B and C)
5.2.2. Diagnostic criteria for LAE (Figs 5.1C and 5.2D)
5.2.3. Biatrial enlargement
5.3.2. Interatrial block (Fig. 5.5)
5.4. Atrial repolarization abnormalities
CHAPTER 6: Ventricular Enlargements
6.2. Right ventricular enlargement
6.2.1. Mechanisms of the electrocardiographic changes
6.2.2. Repercussions of these changes in the ECG
6.2.3. Diagnosis of RVE in clinical practice
6.2.4. ECG morphologies in different types of RVE
6.2.5. Differential diagnosis
6.3. Left ventricular enlargement
6.3.1. Mechanisms of ECG changes
6.3.2. Repercussions of the changes in the ECG
6.3.3. The diagnosis of LVE in clinical practice
6.3.4. ECG morphologies in specific types of LVE
6.3.5. Differential diagnosis in LVE
6.4. Biventricular enlargement (Fig. 6.17)
CHAPTER 7: Ventricular Blocks
7.2. Right bundle branch block (RBBB)
7.2.1. Advanced RBBB (third-degree)
7.2.2. Partial RBBB (first-degree)
7.2.3. RBBB: Comparative morphologies (Fig. 7.8)
7.2.4. Second-degree RBBB (Fig. 7.9)
7.2.5. Differential diagnosis of RBBB morphology
7.3. Left bundle branch block (LBBB)
7.3.1. Advanced LBBB (third-degree)
7.3.2. Partial left bundle branch block (first-degree)
7.3.3. Comparative morphologies
7.3.4. Second-degree LBBB (Fig. 7.19)
7.4. Hemiblocks or fascicular blocks
7.4.1. Superoanterior hemiblock (SAH)
7.4.2. Inferoposterior hemiblock (IPH)
B. RBBB + IPH (Fig. 7.26)
7.6. Trifascicular block (Fig. 7.27)
7.7. Block in the middle fibers of the left branch
CHAPTER 8: Ventricular Preexcitation
8.2. WPW-type preexcitation
8.2.1. Electrocardiographic characteristics (Fig. 8.2)
8.2.2. Types of WPW-type preexcitation
8.2.3. Confirming or ruling out preexcitation
8.2.4. WPW-type preexcitation and arrhythmias
8.2.5. Differential diagnosis in WPW-type preexcitation
8.3. Atypical preexcitation
8.4. Short PR-type preexcitation
CHAPTER 9: Myocardial Ischemia and Necrosis
9.2. ACS with ST elevation (STEACS)
9.2.1. Evolutive ECG abnormalities
9.2.2. Electrophysiological mechanisms of typical ECG patterns during the acute phase of STEACS
9.2.3. Electrocardiographic diagnosis
9.2.4. Differential diagnosis
9.3. Acute coronary syndrome without ST elevation (NSTEACS)
9.3.2. Electrophysiologic mechanisms that explain the patterns of ST depression and flat negative T wave
9.3.3. Electrocardiographic diagnosis
9.3.4 In Table 9.2 the most important global characteristics of both STEACS and NSTEACS are shown.
9.3.5. Differential diagnosis
9.4. More frequent pitfalls in the ECG interpretation of ACS
9.5.1. Q wave of necrosis
9.5.3. Suspected ventricular aneurysm
9.5.4. Infarction without the Q wave (Table 9.5)
9.6. ECG abnormalities due to ischemia or necrosis in patients with confounding factors
(A) Bundle branch block and left ventricular hypertrophy with strain
9.7. Myocardial ischemia not due to atherothrombosis
9.7.1. Coronary spasm (Figs 9.52 and 9.53)
9.7.2. Takotsubo syndrome (Fig. 9.54)
9.7.3. X syndrome (Fig. 9.55)
9.8. ECG in myocardial ischemia due to increased demand
9.9. Arrhythmias in ischemic heart disease (IHD)
9.10. The significance of the flat or negative T wave in ischemic heart disease
PART III: The ECG in Arrhythmias
CHAPTER 10: Concepts, Classification, and Mechanisms of Arrhythmias
10.2. Classification and mechanisms: preliminary aspects
10.3. Previous considerations
10.4. Response to carotid sinus massage (CSM) (Fig. 10.1)
10.6. The mechanism of active arrhythmia (Bayés De Luna, 2011)
10.6.1. Increased automaticity
10.6.2. Triggered activity
10.6.3. Reentry phenomena
10.6.4. The mechanism of atrial fibrillation (Fig. 10.12)
10.6.5. The mechanism of ventricular fibrillation (Figs 10.10 and 10.11)
10.7. Mechanisms of passive arrhythmias
10.7.1. Decreased automaticity
10.7.3. Conduction aberrancy
10.7.4. Concealed conduction
CHAPTER 11: ECG Patterns of Supraventricular Arrhythmias
11.1. Premature complexes (Fig. 11.1)
11.2. Sinus tachycardia (Figs 11.2 and 11.3)
11.3. Monomorphic atrial tachycardia (E-AT) (Fig. 10.4)
11.4. Reentrant tachycardia of the AV junction (see Fig. 11.6)
11.4.1. Junctional reentrant paroxysmal tachycardia with circuit exclusively in the AV junction (JRT-E) (Fig. 11.6 A-1 and B)
11.4.2. Junctional reentrant paroxysmal tachycardia with a circuit involving an accessory pathway (JRT-AP) (Figs 11.6 A.2 and C)
11.4.3. Significance of P′ location in the diagnosis of supraventricular paroxysmal tachycardia (Fig. 11.7)
11.4.4. Antidromic tachycardia. Antegrade conduction through accessory pathway
11.4.5. Repetitive reentrant tachycardia of the AV junction (Fig. 11.8)
11.5. Ectopic tachycardia of the AV junction (JT-EF)
11.6. The differential diagnosis of supraventricular paroxysmal tachyarrhythmias with narrow QRS and regular RR intervals (Fig. 11.11 and Table 11.2)
11.7. Chaotic atrial tachycardia (Fig. 11.12)
11.8. Atrial fibrillation
CHAPTER 12: ECG Patterns of Ventricular Arrhythmias
12.1. Premature ventricular complexes
12.1.1. Ventricular extrasystoles (VE): fixed coupling interval
12.1.2. Lown classification of VE from low to high degrees of severity
12.1.3. Ventricular parasystole: variable coupling interval
12.2. Ventricular tachycardia
12.2.2. Idiopathic monomorphic ventricular tachycardia
12.2.3. Classical monomorphic VT in patients with heart disease
12.3. Polymorphic ventricular tachycardia (Fig. 12.13)
12.4. Accelerated idioventricular rhythm (Fig. 12.15)
12.5. Ventricular flutter (Fig. 12.16)
12.6. Ventricular fibrillation (Figs 12.17 and 12.18)
CHAPTER 13: The ECG Patterns of Passive Arrhythmias
13.1. Complex and escape rhythm (Fig. 13.1)
13.4. Atrioventricular block
13.5. ECG in patients with pacemakers
CHAPTER 14: How to Interpret ECG Tracings with Arrhythmia
PART IV: ECG in Clinical Practice
CHAPTER 15: From Symptoms to the ECG: ECGs in the presence of precordial pain or other symptoms
15.1.1. Ischemic heart disease versus pericarditis or other causes of chest pain
15.4.2. The mechanism of syncope involves the following:
15.4.3. How to choose the best management approach
CHAPTER 16: The ECG in Genetically Induced Heart Diseases and Other ECG Patterns with Poor Prognosis
16.2. Genetically induced ECG patterns
16.2.2. Short QT syndrome
16.2.4. Hypertrophic cardiomyopathy
16.2.5. Arrhythmogenic right ventricular dysplasia (ARVD)
16.2.6. Non-compacted cardiomyopathy
16.3. High risk ECG patterns that are not genetically induced
16.3.1. Severe sinus dysfunction
16.3.2. Third-degree interatrial block
16.3.3. Advanced second-degree AV block (Chapter 13)
16.3.4. ECG pattern of ventricular enlargement of poor prognosis (Chapter 6)
16.3.5. High risk ventricular block (Chapter 7)
16.3.6. High risk WPW syndrome
16.3.7. High risk ECG patterns in acute and chronic ischemic heart disease
16.3.8. Hypothermia and other ECG patterns with J wave
16.3.9. Ionic disturbances
16.3.10. Acquired long QT interval
16.3.11. Patients with pacemakers
CHAPTER 17: ECG Recordings in Other Heart Diseases and Different Situations
17.1. Valvular heart diseases
17.1.2. Mitral regurgitation
17.1.3. Aortic valve disease
17.3.1. Genetically induced cardiomyopathies (see Chapter 16)
17.3.2. Dilated cardiomyopathy (DC)
17.3.3. Restrictive cardiomyopathy
17.3.4. Cardiomyopathy in neuromuscular disease
17.4. Diseases of the pericardium
17.4.1. Acute idiopathic pericarditis
17.4.2. Pericarditis with important effusion
17.6. Congenital heart disease
17.7. Arterial hypertension (AH)
17.10. Other repolarization disturbances
CHAPTER 18: Abnormal ECG Without Apparent Heart Disease and Normal ECG in Serious Heart Disease
18.1. Abnormal ECG in a patient with normal history taking and physical examination
18.2. Normal ECG in patients with advanced cardiovascular disease
ECGs for Beginners
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