Clinical Electrocardiography A Textbook 5th Edition by Antoni Bayes de Luna, Miquel Fiol Sala, Antoni Bayes Genis, Adrian Baranchuk 1119536456 9781119536451

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ISBN 10: 1119536456

ISBN 13: 9781119536451

Author: Antoni Bayés de Luna; Miquel Fiol-Sala; Antoni Bayés-Genís; Adrian Baranchuk

Electrocardiography is a transthoracic recording over a period of time. Electrical activity is detected and recorded via electrodes attached to the outer surface of the skin. The recording produced by this noninvasive procedure is termed as electrocardiogram.  ECGs are used to measure the rate and regularity of heartbeats as well as the size and position of the chambers, the presence of any damage to the heart, and the effects of drugs or devices used to regulate the heart. Clinical Electrocardiography is the clearest and most accessible guide available to the application and interpretation of the ECG in clinical practice. The book proceeds from the belief that ECG patterns should not be memorized, but rather must be understood based on how they originate; it is only by achieving this level of understanding that clinicians can make the most informed diagnoses and thus manage patient care with complete confidence. This fully revised 5th edition: Gives clear information about the correct diagnoses of different heart diseases based on ECG alterations Presents an exceedingly clear and linear approach to understanding the application and interpretation of the ECG in clinical practice Explains the electrical activity of the heart and basic electrocardiographic principals Offers guidance on normal ECG patterns and the changes various heart diseases produce in ECG morphology Provides a practical, deductive approach to the diagnosis of arrhythmias – one of the most challenging tasks for many clinicians Summarizes current knowledge of the clinical implication of rhythmic disturbances

Clinical Electrocardiography A Textbook 5th Table of contents:

Part 1: Introductory Aspects

Chapter 1: The Electrical Activity of the Heart

Basic concepts

How can we record the electrical activity of the heart?

What is the surface ECG?

What is vectorcardiography? (See Chapter 25 for more extensive information)

ECG–VCG correlation

Why do we record ECG curves and not VCG loops?

Why do we use ECG–VCG correlations to understand ECG patterns?

References

Chapter 2: The History of Electrocardiography

References

Chapter 3: Utility and Limitations of the Surface ECG

Introduction

Utility

Limitations

The future of electrocardiography

References

Part 2: The Normal ECG

Chapter 4: The Anatomical Basis of the ECG

The anatomical basis

The heart walls: perfusion and innervation (Cerqueira 2002; Fiol‐Sala et al. 2020)

The specific conduction system: perfusion and innervation

Ultrastructural characteristics of cardiac cells

References

Chapter 5: The Electrophysiological Basis of the ECG

Types of cardiac cells: slow and fast response cells (Hoffman and Cranefield 1960)

Transmembrane diastolic potential (DP)

Transmembrane action potential

Properties of cardiac cells

Cardiac activation

From cellular electrogram to the human ECG (Wilson et al. 1935; Cabrera 1958; Sodi‐Pallares et al. 1964; Macfarlane and Veitch Lawrie 1989; Wagner 2001; Bayés de Luna and Baranchuk, 2017)

References

Chapter 6: The ECG Recording: Leads, Devices, and Techniques

Leads

Hemifield concept

Correlation between the vectorcardiographic loop and electrocardiographic morphology

Recording devices

Recording techniques

References

Chapter 7: Characteristics of the Normal Electrocardiogram: Normal ECGWaves and Intervals

A systematic and sequential approach to ECG interpretation

Heart rhythm

Heart rate

PR interval and PR segment (Table 7.2; and Figures 7.1 and 7.8)

QT interval (Figure 7.8) (Malik and Camm 2004; Bayés de Luna 2019; Goldenberg et al. 2008; Anttonen et al. 2009) (see also Chapters 19, 21, and 24)

QRS complex

ST segment and T and U waves

T wave

U wave

Abnormalities of repolarization

Calculation of the electrical axis

ÂQRS at +60° (Figure 7.20)

Rotations of the heart

Electrocardiographic variations with age

Other ECG variants

References

Chapter 8: Diagnostic Criteria

Sensitivity

Specificity

Predictive values

Bayes’ theorem

References

Part 3: Abnormal ECG Patterns

Chapter 9: Atrial Abnormalities

Introduction

New concepts on P wave

Atrial enlargement

Atrial blocks

References

Chapter 10: Ventricular Enlargement

Concept: preliminary considerations

Critical review of the electrocardiographic concepts of systolic and diastolic overload

New concepts

Right ventricular enlargement: hypertrophy and dilation

Left ventricular enlargement: hypertrophy and dilation

Biventricular hypertrophy

References

Chapter 11: Ventricular Blocks

Definition of terms

Anatomic considerations (see also Chapter 4)

Electrophysiological considerations

Right bundle branch block (Table 11.1)

Left bundle branch block (Tables 11.3 and 11.4)

Left divisional blocks

Combined blocks

Delayed diffuse intraventricular QRS activation

References

Chapter 12: Ventricular Pre‐excitation

Concept and types of pre‐excitation

WPW‐type pre‐excitation (type 1)

Arrhythmias and WPW–type pre‐excitation: Wolff–Parkinson–White syndrome (Figure 12.9)

Atypical pre‐excitation

Short PR interval pre‐excitation (Lown et al. 1957) (Figures 12.14–12.16)

References

Chapter 13: Ischemia and Necrosis

Concept

Experimental mechanisms of ischemia

Changes of repolarization: T wave

Changes of repolarization: ST segment

Other changes of repolarization

Changes in QRS

References

Part 4: Arrhythmias

Chapter 14: Mechanisms, Classification, and Clinical Aspects of Arrhythmias

Concept

Classification

Clinical significance and symptoms

ECG diagnosis of arrhythmias: preliminary considerations

Mechanisms responsible for active cardiac arrhythmias

Active arrhythmias with fixed coupling interval

Abnormal generation of stimulus

Reentry

Other mechanisms

Active arrhythmias with variable coupling interval: the parasystole

Mechanism responsible for passive arrhythmias

Heart block

Aberrant conduction

Concealed conduction

References

Chapter 15: Active Supraventricular Arrhythmias

Premature supraventricular complexes

Sinus tachycardia (Tables 15.2 and 15.3)

Junctional reentrant (reciprocating) tachycardia

Atrioventricular junctional tachycardia due to ectopic focus

Chaotic atrial tachycardia

Atrial fibrillation

Atrial flutter

References

Chapter 16: Active Ventricular Arrhythmias

Premature ventricular complexes

Ventricular tachycardias

Ventricular flutter

Ventricular fibrillation

References

Chapter 17: Passive Arrhythmias

Escape complex and escape rhythm

Sinus bradycardia due to sinus automaticity depression (Figures 17.7 and 17.8)

Sinoatrial block

Atrioventricular block

The pacemaker electrocardiography (Garson 1990; Kasumoto and Goldschlager 1996; Hesselson 2003; Jastrzebski et al. 2014, 2019; ECG University V2 2019) (Figures 17.16–17.28)

References

Chapter 18: Diagnosis of Arrhythmias in Clinical Practice: A Step‐by‐Step Approach

Determining the presence of a dominant rhythm

Atrial wave analysis

QRS complex analysis

Atrioventricular relationship analysis

Premature complex analysis

Pause analysis

Delayed complex analysis

Analysis of the P wave, the QRS complexes, and the ST‐T of variable morphology (Figures 18.6–18.9 and Table 18.1)

Repetitive arrhythmia analysis: bigeminal rhythm

Differential diagnosis between several arrhythmias in special situations

References

Part 5: The Clinical Usefulness of Electrocardiography

Chapter 19: The Diagnostic Value of Electrocardiographic Abnormalities

Introduction

Abnormal PR interval

Abnormal QT interval

Abnormal QRS complex

Repolarization abnormalities: from innocent to very serious findings

References

Chapter 20: The ECG in Different Clinical Set of Ischemic Heart Disease

Introduction

ECG changes due to decreased blood flow not related to atherothrombosis (Table 20.1)

ECG changes due to ischemia caused by increased demand (see Table 20.1)

References

Chapter 21: Inherited Heart Diseases

Introduction

Cardiomyopathies

Specific conduction system involvement

References

Chapter 22: The ECG in Other Heart Diseases

Valvular heart diseases

Mitral valve disease: ECG changes

Aortic valve disease: ECG changes

Myocarditis and cardiomyopathies

Rheumatic fever

Cor pulmonale

Congenital heart diseases

Mirror image dextrocardia

Arterial hypertension

References

Chapter 23: The ECG in Other Diseases and Different Situations

Cerebrovascular accidents

Endocrine diseases

Respiratory diseases

Other diseases (see Chapter 22)

Athletes (Figures 23.8–23.11) (Corrado et al. 2010); Uberoi et al. 2011)

Drug administration

Alcoholism (Figures 23.16–23.18)

Ionic disorders

Hypothermia

Pregnancy and puerperium

Anesthesia and surgery

Arrhythmias in children

References

Chapter 24: Other ECG Patterns of Risk

Introduction

Severe sinus bradycardia

Advanced interatrial block with left atrial retrograde conduction (Figures 24.3–24.5)

Intraventricular conduction disturbances

High‐risk combined intraventricular blocks

Classic masquerading bifascicular block (see Chapter 11)

Masquerading RBBB pattern in the presence of advanced LBBB pattern

RBBB with alternating block in the two sub‐divisions of the left bundle

Advanced atrioventricular block

The presence of ventricular arrhythmias in chronic heart disease patients

Acquired long QT (see Chapters 7 and 19)

Electrical alternans (see Table 18.1 and Figure 18.9)

New ECG patterns of risk for sudden death

Risk of serious arrhythmias and sudden death in patients with normal or nearly normal ECG

References

Chapter 25: Limitations of the Conventional ECG

Introduction

Interpretation of the surface ECG in light of the patient’s clinical setting

The abnormal ECG in the absence of heart disease and patients with normal ECG and advance heart disease (Bayés de Luna et al. 2020a)

Additional value of other techniques

Holter ECG monitoring and related techniques

Intracavitary ECG and electrophysiologic studies

Wave amplification and filtering techniques

Other ECG leads

Body surface potential mapping

Analysis of late potentials using signal averaging electrocardiogram (SAEGG)

Tilt table test

Imaging techniques

Genetic techniques

References

Chapter 26: The Electrocardiology of the Twenty‐First Century

Do we need to teach electrocardiology nowadays?

References

Index

Supplemental Images

End User License Agreement

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