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
