Vấn đề của bạn là một sinh viên của điện tâm đồ là bạn có thể không nhận đủ thực hành để trở thành tốt ở đó. Cách tốt nhất để có được kinh nghiệm là để đọc ECG từ tích lũy hàng ngày của bệnh viện, cam kết giải thích của bạn lên giấy | 22 150 Practice ECGs Interpretation and Review CLINICAL INSIGHT PSVT is a benign rhythm and rarely necessitates DC cardioversion. However it is not benign when it causes severe hypotension or angina pectoris. Hemodynamic compromise or unstable persistent angina is an indication for immediate cardioversion of any tachyarrhythmia be it atrial or ventricular. It is a medical emergency. There is no time to wait for the cardiology consultant. If you delay the patient may well need CPR before long. Set the defibrillator to synchronize and start with 50 joules as low-voltage cardioversion may work for atrial arrhythmias. FIGURE Nodal or junctional rhythm. The retrograde P wave distorting the T wave is prominent in this example. Usually it is more subtle and it may be absent. Even without retrograde P waves the diagnosis of junctional rhythm may be made when the rate is regular is less than 100 beats min and there are no P waves. The QRS is usually narrow. Nodal or Junctional Rhythm Nodal or junctional rhythm is recognized by the absence of P waves before the QRS and the rhythm is regular. Although tachycardia rate 100 is possible the heart rate usually is within the normal range. As stimulation of the ventricle comes from the AV node the QRS is narrow. There may be retrograde activation of the atria and inverted retrograde P waves may be seen distorting the T waves Fig . Atrial Fibrillation It is a rare day that I read ECGs and do not see a few cases of atrial fibrillation AF . A grossly irregular rhythm without P waves indicates the diagnosis Fig . The rate is usually less than 120 as most patients with chronic AF have already had the ventricular rate or response controlled with drugs that slow AV nodal conduction . digoxin b-adrenergic blockers or the calcium blockers verapamil and diltiazem . Students often are fooled by more rapid rates in which the irregular irregularities may be subtle see Fig . AF is not an example of AV dissociation. The .
