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Download e-book for iPad: Clinical Electrophysiology Review by George Klein, Eric Prystowsky

By George Klein, Eric Prystowsky

ISBN-10: 0071781064

ISBN-13: 9780071781060

A clinically correct method of the translation of electrophysiograms

Clinical Electrophysiology Review, moment version is a special method of EP, serving in part as a case consultant and in part as a workbook to demanding reviews in complex electrodiagnostics. It presents physicians with a clinically proper method of the translation of electrophysiograms (used to degree middle rhythm disorders).

Clinical Electrophysiology Review, additionally serves as a superb source for applicants taking the electrophysiology board exam. It comprises liberal use of illustrations to assist the reader realize universal rhythym disturbances and unusual arrhythmias, similar to tachycardia and bradycardia. the hot variation will comprise thoroughly up-to-date instances and tracings, and may mirror advances in know-how because the first variation published.

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Extra resources for Clinical Electrophysiology Review

Sample text

It is obviously not artifact or paced in this case. 42 Preexcitation is unlikely if previously not diagnosed in this 74-yearold individual and the sinus rhythm at the end of the trace is obviously not preexcited, so this possibility can be reasonably discounted at this time. P waves are not apparent during this tachycardia. The QRS morphology here is very helpful. The sinus cycles have a relatively normallooking narrow QRS and one would thus expect aberration (which is essentially functional bundle branch block) to resemble a fairly typical right bundle branch block or LBBB pattern.

The evident loss of anterograde right bundle activation (as assumed by the relatively late activation of the right ventricular apical electrogram) was not critical to maintenance of tachycardia and the right bundle was clearly a bystander. Further observation of the tachycardia (Fig. 1–13) illustrates another transition (arrow). The ventricular–His (VH) interval shortens to a new steady state and again the tachycardia rate remains unchanged, oblivious to activity in the H. It is now obvious that the H and right bundle are passive bystanders and the tachycardia is best explained by myocardial reentry with passive activation of the bundle branches (Fig.

This was, in fact, AV reentry over a posterolateral accessory pathway. CHAPTER 2 Figure 2–10A This tracing was recorded from a 74-year-old woman being investigated for chest pain and undocumented palpitations. ELECTROPHYSIOLOGIC APPROACH TO THE ECG 41 Figure 2–10B Explanation: It is useful in a complex tracing to divide it into units choosing a section where one can make sufficient observations to start the analysis meaningfully. In this example, one can identify three areas corresponding to two tachycardias and a transition zone between the two.

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Clinical Electrophysiology Review by George Klein, Eric Prystowsky


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