Preface, vii
Notes, viii
1 Sinus Rhythm, 1
ECG characteristics, 1
Sinus bradycardia, 4
Sinus tachycardia, 4
Sinus arrhythmia, 5
2 Ectopic Beats, 6
Prematurity, 6
Atrial ectopic beats, 8
Atrioventricular junctional ectopic beats, 9
Ventricular ectopic beats, 10
3 Escape Beats, 15
Timing, 15
Origins, 16
4 Bundle Branch and Fascicular Blocks, 17
Right bundle branch block, 17
Left bundle branch block, 18
Left anterior and posterior fascicular blocks, 19
5 The Supraventricular Tachycardias, 24
Main types, 24
Atrial origin versus atrioventricular re-entry, 25
Effects of supraventricular tachycardias, 26
6 Atrial Fibrillation, 29
ECG characteristics, 29
Causes, 33
Prevalence, 34
Prognosis, 34
Classification, 34
Management, 35
Systemic embolism, 35
Rhythm management, 38
7 Atrial Flutter, 44
Common atrial flutter, 44
Causes, 49
Prevalence, 49
Treatment, 49
Systemic embolism, 51
8 Atrial Tachycardia, 52
ECG characteristics, 52
Causes, 54
Treatment, 55
Multifocal atrial tachycardia, 55
9 Atrioventricular Junctional Re-entrant Tachycardias,
56
Mechanism, 56
ECG characteristics, 57
Clinical features, 62
Treatment, 63
10 Wolff?Parkinson?White Syndrome, 67
Pre-excitation, 67
ECG characteristics, 68
Arrhythmias, 69
Treatment, 72
11 Ventricular Tachyarrhythmias, 77
Ventricular tachycardia, 77
Ventricular fibrillation, 78
Supraventricular versus ventricular tachycardia, 78
12 Monomorphic Ventricular Tachycardia, 79
ECG characteristics, 79
Causes, 81
Mechanisms of ventricular tachycardias, 81
Investigations, 83
Treatment, 85
Coronary heart disease, 88
Hypertrophic cardiomyopathy, 88
Arrhythmogenic right ventricular
cardiomyopathy, 89
Dilated cardiomyopathy, 92
Ventricular tachycardias not due to structural heart disease,
92
Non-sustained ventricular tachycardia, 97
Accelerated idioventricular rhythm, 97
13 Polymorphic Ventricular Tachycardia and Ventricular
Fibrillation, 98
Polymorphic ventricular tachycardia, 98
Torsade de pointes tachycardia, 99
Hereditary long QT syndromes, 102
Ventricular fibrillation, 106
14 Tachycardias with Broad Ventricular Complexes, 115
Causes of a broad complex tachycardia, 115
Useless guidelines, 116
Useful guidelines, 116
15 Atrioventricular Block, 123
Classification, 123
Causes of atrioventricular block, 127
Atrioventricular dissociation, 128
Bilateral bundle branch disease, 128
Clinical aspects of atrioventricular block, 130
Treatment, 131
16 Sick Sinus Syndrome, 132
Causes, 132
ECG characteristics, 133
Clinical features, 135
Diagnosis, 135
Treatment, 136
17 Neurally Mediated Syncope, 137
Malignant vasovagal syndrome, 137
Carotid sinus syndrome, 141
Postural orthostatic tachycardia syndrome, 141
Causes of syncope, 142
18 Arrhythmias due to Myocardial Infarction, 143
Ventricular fibrillation, 144
Ventricular tachycardia, 146
Reperfusion arrhythmias, 146
Arrhythmias subsequent to recent myocardial infarction, 146
Long-term significance of ventricular arrhythmias, 147
Accelerated idioventricular rhythm, 147
Supraventricular tachycardias, 148
Sinus and junctional bradycardias, 148
Atrioventricular block, 149
19 Antiarrhythmic Drugs, 152
Limitations, 152
Choice of treatment, 153
Modes of action, 153
Notes on individual drugs, 154
Antiarrhythmic drugs during pregnancy, 166
20 Sudden Cardiac Death, 167
Definition, 167
Causes of arrhythmic sudden death, 168
Aborted sudden cardiac death, 169
Athletic activities, 169
21 Cardioversion, 171
Transthoracic cardioversion, 171
Transvenous cardioversion, 174
22 Ambulatory ECG Monitoring, 176
Continuous ECG recording, 176
Intermittent ECG recording, 183
23 Cardiac Pacing, 187
Long-term cardiac pacing, 187
Common indications for long-term pacing, 187
Pacing modes, 190
Pacemaker hardware, 200
Pacemaker implantation, 202
Pacemaker clinic, 215
Electromagnetic interference, 215
Other precautions, 217
Temporary cardiac pacing, 218
24 Implantable Cardioverter Defibrillators, 221
Defibrillator implantation, 223
Indications for ICD implanation, 224
Defibrillator function, 226
Precautions, 233
25 Catheter Ablation, 234
Procedure, 234
Wolff?Parkinson?White syndrome, 237
Typical atrioventricular nodal re-entrant tachycardia, 241
Atrial tachycardia, 243
Atrial flutter, 244
Atrial fibrillation, 244
Atrioventricular nodal ablation, 245
Right ventricular outflow tract tachycardia, 247
Fascicular ventricular tachycardia, 248
Ventricular tachycardia due to structural heart disease, 249
Catheter ablation: what should the patient expect? 250
26 Arrhythmias for Interpretation, 252
Questions, 252
Interpretations and answers, 307
Index, 317
