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Additional Description
Edited by
Joseph T. Catalano, PhD, RN
Professor of Nursing
East Central University
Ada, Oklahoma
Reviewers
Audrey J. Bopp, MSN, RN
Assistant Professor
St. John Fisher College
Department of Nursing
Rochester, NY
Janet Gysi, MA, ARNP-C
Family Nurse Practitioner-Private Practice
Panama City Beach, FL
Former Faculty of the BSN Program
Iowa Wesleyan College
Department of Nursing
Burlington, IA
Lauren B. Sutton, PhD, RN, CS
Associate Professor
West Liberty State College
Department of Nursing
West Liberty, WV
Contents
CHAPTER 1
Structures and Functions of the Heart 1
General Functions of the Heart 2
Structures of the Heart 4
Properties of the Myocardium 5
Blood Supply to the Heart 8
Conduction System of the Heart 9
Inherent Rates of Conduction for the Various Parts
of the Heart 14 14
Polarization/Depolarization/Repolarization 15
Refractory Periods of the Cardiac Cycle 17
Effects of the Autonomic Nervous System on
Cardiac Function 18
Summary 22
CHAPTER 2
ECG Basics 25
ECG Pattern 25
Components of the ECG Pattern 30
The Interval 32
The Complex 32
The Law of Wave Formation on the ECG 32
Leads Used to Produce the ECG Pattern 33
ECG Waveforms and Measurements 37
T Wave 38
The ECG Pattern and the Refractory Periods 38
Artifact 40
Summary 44
CHAPTER 3
ECG Analysis 45
Analysis Schema for ECG Rhythm Strips 46
Summary 62
Practice ECG Strips 63
CHAPTER 4
Normal Sinus Rhythm and Dysrhythmias Associated With
the Sinus Node 73
Normal Sinus Rhythm 74
Sinus Bradycardia 75
Sinus Tachycardia 78
Sinus Dysrhythmia 81
Sinus Exit Block 83
Sinus Arrest 85
Summary 87
Practice ECG Strips 88
CHAPTER 5
Dysrhythmias Associated With the Atria 101
Wandering Pacemaker 102
Premature Atrial Contractions 105
Atrial Tachycardia 108
Atrial Flutter 111
Atrial Fibrillation 114
Variations on the Atrial Fibrillation Pattern 117
Summary 119
Practice ECG Strips 119
CHAPTER 6
Dysrhythmias Associated With the AV Junction 131
Premature Junctional Contractions 134
f unctional Tachycardia 136
functional Escape Beats 139
functional Escape Rhythm 141
Summary 143
Practice ECG Strips 144
CHAPTER 7
Dysrhythmias Associated With the Ventricles 153
Ventricular Escape Beats 154
Ventricular Escape Rhythm 158
Premature Ventricular Contraction 160
Ventricular Tachycardia 173
Ventricular Flutter 176
Ventricular Fibrillation 178
Agonal Rhythm 180
Asystole 182
Summary 183
Practice ECG Strips 183
CHAPTER 8
Dysrhythmias Associated With Blocks in the AV Node 199
First Degree AV Block 200
Second Degree AV Block 202
Third Degree AV Block 208
Summary 214
Practic ECG Strips 214
CHAPTER 9
Supraventricular Tachycardia Dysrhythmias 227
Supraventricular Tachycardia 227
Tachy-Brady Syndrome 230
Summary 233
Practice ECG Strips 233
CHAPTER 10
Conduction Abnormalities in the Bundle Branches 237
Right Bundle Branch Block 240
Left Bundle Branch Block 243
Hemiblocks and Multifascicular Blocks 246
Alternating and Intermittent Bundle Branch Blocks
246
Summary 248
Practice ECG Strips 249
CHAPTER 11
Dysrhythmias Associated With Bypass Mechanisms 259
Rapid 1 :1 Conduction 260
Reentry Tachycardia 260
Wolff-Parkinson-White Syndrome 262
Lown-Ganong-Levine Syndrome 267
Summary 270
CHAPTER 12
ECG Patterns Produced by Pacemakers 271
Indications for Permanent (Implanted) Pacemaker
Use 272 272
Indications for Temporary (External) Pacemaker Use
274
Classifications of Pacemakers 275
Key Definitions in Pacemaker Language 277
Three Letter ICHD Code 279
Common Types of Pacemakers and Their ICHD
Designation 281
Pacemaker Failure 286
Abnormal Pacemaker Patterns (Pacemaker
Dysrhythmias) 287 287
Summary 291
Practice ECG Strips 291
APPENDIX I General Practice Strips 299
APPENDIX II Interpretations for Chapter Practice
Strips 395
Index 443
ECG Review Sheets
