Vavouranakis ECG Monitoring

8/8/2019 Vavouranakis ECG Monitoring

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,

, ,


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,

:

, , , (Holter) 24

, ,


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) -


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.


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P

R

Q

S

0,200,20 secsec

0,50,5

mVmV

T

P < 0.12

PR 0.12 0.20

QRS < 0.12

QT < 0.45


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P

QRS

II aVR


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3

+ -

R L

F

3

6 I II III aVR aVLaVF V1 V2 V3 V4 V5 V6

+ -

R L

F

+ -

R L

F

+ -

R L

F

+ -

R L

F

+ -

R L

F

+ -

R L

F

12


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B. : ST .

C. : ST

.

D. : 10-12 q . ST

.E-F. : q qs 3-6 . ST >3 .


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V1-V4. rS V1 Q V2-V4


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ST V1-V3 V4.

QS V1-V4


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ST V5-V6 I, aVL


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ST II,III, aVF

I, aVL,


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. ST -

ST.

ST

.

ST

.

!!! ST .


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.

1. .

2.

3.

4.

1.

2. 1 2

3. 3

4. His

1.

2.


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1.

2. 3.


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4 .

16%

4%

6%

34%

7%


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1.

80 % .

.


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QRS : (>0.12sec) P

1.


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2.

60-100 /

20% 2

: Purkinje

.


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3.)

QRS>120ms, 100 /

>30 sec.


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3.)

3

> 100/


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12 12

.

.

QRS .

QRS


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4.

.

!


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1.


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2.1

PQ> 0,20 sec

P QRS

2. 2


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2. 2

. Mobitz I (Wenckebach)

.

PR . RR.

(pattern) .. 4 : 3 , 6 : 5.


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. Mobitz I

2

.

PR . .

) 1 P ( )) 2 P ( )


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( .. , ,

) ( .. , Reiter,

)

Lyme

.


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5.

QRS >120msec

R

(V6, I, aVL)-

Qs r S

(V1)


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4.

QRS >120msec

R (rSR)(V1-V2)

- S (V6, I ,aVL)

V1, V2

12

3

1

2

3


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4.

1

2

3


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6.

(-45 -90)rS II, III, aVFqR I, aVLQRS


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7.

(>120)rS I, aVLqR QRS


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8.

RBBB+LAH

RBBB+LP


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9.

RBBBLAH (LPH)

PQ >0,20 sec


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5.

.

.

10 % .

.


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! !


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.

.

:

,

,

.


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. 12

II. (SAECG)

I. (T wave alternans)

( wave variability).

IV.

(Heart rate variability)

V. Holter 24.

.


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. 12

- 24h

- QRS- - QT- QT


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QRS >120msec

(His Purkinje) .

-


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1638 patients with documented coronaryartery disease, nonsustained ventriculartachycardia, depressed (ejection fraction40%) left ventricular function

Were randomized to electrophysiology-

guided antiarrhythmic therapy or tono specific antiarrhythmic therapy(standard medical therapy,including-adrenergic blocking agents andACE inhibitors .


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MUSTT

LBBB

49%

44%

QRS120msec


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Incidence, predictors, and outcomes of high-degreeatrioventricular block complicating acute myocardialinfarction treated with thrombolytic therapy

Atrioventricular block (AVB) is a commoncomplication of acute myocardial infarction(MI).

In the prethrombolytic era, second or thirddegree heart block was seen in

approximately 5% to 7% of patientspresenting with acute

In the setting of inferior MI, the incidenceof second or third degree heart block can

be as high as 28%.


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Thrombolytic therapy has

substantially decreased the mortalityassociated with acute MI,

the incidence of AVB, particularly inthe setting of inferior MI, remains

high AVB also occurs, though less

commonly, in acute anterior MI.

Incidence, predictors, and outcomes of high-degreeatrioventricular block complicating acute myocardialinfarction treated with thrombolytic therapy

n

c ence, pre c ors, an ou comes o g - egree


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In the GUSTO-I trial, AVB occurred inabout 4% of patients with anterior MIs, arate similar to that seen in previous

studies. The development of AVB, particularly in

anterior MI, has been shown to conferhigher in-hospital and long-term mortality.

Atrioventricular block in the setting ofinferior MI is also associated with higherin-hospital mortality; its effect on long-termmortality is uncertain

, p , g gatrioventricular block complicating acute myocardialinfarction treated with thrombolytic therapy


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QT

:370-460msec 400-470msec

QTc=QT/RR Bazett.

QT

: QTc > 440msec .


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QT


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QT

.

QT (max-min) 12 .

70msec .


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QTd>120msec .


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40msec

QRS.

, ,

.

: .

II.

(Signal Average ECG)


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QRS 114msec,

LAS>38msec,

RMS


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. : .

.

: : , .

III. (T wave alternans)

( wave variability)


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( wave variability)

III (T lt )


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( wave variability)

MADIT II

.


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1987 : Kleiger 808

31 ...

34%

12%

IV.



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R Kleiger et al Am J Cardiol


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R Kleiger et al Am J Cardiol

IV


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.

CABG, .

10 min 24 h Holter 24.

IV.



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(PVC )


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(PVCs)

VPCs >10/h .

(NSVT)

.

NSVT , , : .

QT (QT dynamics)

QT : QT/RR QT .


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12 -

, .

10

.


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Vavouranakis ECG Monitoring

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