《心电图基础》ppt课件.ppt

心电图阅读的基础与方法 心电图的地位与作用 心电图阅读的基本问题 正常心电图 异常心电图 Basic Competency in Electrocardiography (Modified from: ACC/AHA Clinical Competence Statement, JACC 2001;38:2091) NORMAL TRACING Normal ECG TECHNICAL PROBLEM Lead misplaced Artifact SINUS RHYTHMS/ARRHYTHMIAS Sinus rhythm (50-90 bpm) Sinus tachycardia (90 bpm) Sinus bradycardia (50 bpm) Sinus Arrhythmia Sinus arrest or pause Sino-atrial exit block OTHER SV ARRHYTHMIAS PACs (nonconducted) PACs (conducted normally) PACs (conducted with aberration) Ectopic atrial rhythm or tachycardia (unifocal) Multifocal atrial rhythm or tachycardia Atrial fibrillation Atrial flutter Junctional prematures Junctional escapes or rhythms Accelerated Junctional rhythms Junctional tachycardia Paroxysmal supraventricular tachycardia VENTRICULAR ARRHYTHMIAS PVCs Ventricular escapes or rhythm Accelerated ventricular rhythm Ventricular tachycardia (uniform) Ventricular tachycardia (polymorphous or torsades) Ventricular fibrillation AV CONDUCTION 1st degree AV block Type I 2nd degree AV block (Wenckebach) Type II 2nd degree AV block (Mobitz) AV block, advanced (high grade) 3rd degree AV block (junctional escape rhythm) 3rd degree AV block (ventricular escape rhythm) AV dissociation (default) AV dissociation (usurpation) AV dissociation (AV block) INTRAVENTRICULAR CONDUCTION Complete LBBB, fixed or intermittent Incomplete LBBB Complete RBBB, fixed or intermittent Incomplete RBBB Left anterior fascicular block (LAFB) Left posterior fascicular block (LPFB) Nonspecific IVCD WPW preexcitation pattern QRS AXIS AND VOLTAGE Right axis deviation (+90 to +180) Left axis deviation (-30 to -90) Bizarre axis (-90 to -180) Indeterminate axis Low voltage frontal plane (0.5 mV) Low voltage precordial (1.0 mV) HYPERTROPHY/ENLARGEMENTS Left atrial enlargement Right atrial enlargement Left ventricular hypertrophy Right ventricular hypertrophy ST-T, AND U ABNORMALITIES Early repolarization (normal variant) Nonspecific ST-T abnormalities