Trinity University School of Medicine. Society of Medicine and Surgery St. Vincent & the...

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CLINICAL ELECTROCARDIOGRAPHY

Trinity University School of Medicine. Society of Medicine and Surgery

St. Vincent & the Grenadines.November 28th, 2011

Andrei Q. Núñez, MD.

WORKSHOP Objectives

Review the basic concepts of normal cardiac anatomy and electrophysiology.

Establish the functional correlations of ECG signals and traces with the mechanical cardiac events.

Understand components and proper application of the technology used in ECG.

Learn about the up-to-date AHA guidelines and recommendations for a successful and accurate execution of ECG tracing.

Provide Trinity students with a simple method to evaluate ECG and identify abnormal traces effectively in various clinical settings.

ECGBASICS MATTER.

WORKSHOPTopics

I. Cardiac Electrical System1. Anatomy2. Electrophysiology

II. ECG Principles.1. Signals & Vectors2. Leads.3. Machine4. Waves5. Paper.6. Execution.

III. TRACING EXERCISE # 1

IV. TRACING EXERCISE # 21. AHA Considerations2. Technical Factors

3. Operator Dependent Factors

V. ECG Clinical Utility1. Arrhythmia Identification2. Cardiac Arrest Management3. Acute Coronary Syndromes

VI. Interpretation Keypoints.

1. Rhythm2. Cardiac Axis3. Heart Rate4. Pattern 5. Origin6. Auricular Activity7. AV Conduction8. Ventricular Activity

CARDIACElectrical System

CARDIACElectrical System

CARDIACElectrical System

CARDIACElectrical System

CARDIACElectrical System

CARDIACElectrical System

CARDIACElectrical System

CARDIACElectrical System

CARDIACElectrical System

CARDIACElectrical System

KEY CONCEPTSAnatomy & Electrophysiology

Excitable Tissue. AP:

Depolarization (phase 4) vs. Conduction (phase 0)

Pacemakers. (Intrinsic rates) SA N: 100 - 120 bpm *Vagal tone 60 –

100 bpm AV N: 40 – 60 bpm PS: 30 – 40 bpm

Myocardium Electrical Coupling.

CARDIAC Electrophysiology

ECG & Cardiac CycleWAVES, SEGMENTS & INTERVALS

ECG & Cardiac Cycle

ECG & Cardiac Cycle

ECG & Cardiac Cycle

ECG & Cardiac Cycle

ECG & Cardiac Cycle

ECG & Cardiac Cycle

ECG & Cardiac Cycle

ECG & Cardiac Cycle

ECG & Cardiac Cycle

ECG & Cardiac Cycle

ECG & Cardiac Cycle

ECG & Cardiac Cycle

ECG & Cardiac Cycle

ECG & Cardiac Cycle

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