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Understanding the Electrocardiogram

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  2. Understanding the Electrocardiogram In Health & Disease
  3. 3.0.0 Inter and intra-ventricular Conduction Disturbances
  4. 3.3.0 Fascicular blocks (frame 29)

3.3.25 (frame 74)

The mechanism underlying bradycardia dependent aberrancy is not totally understood. The most widely accepted theory postulates that at slow rates, some of the fibers in the conducting system develop slow spontaneous diastolic depolarization such that when stimulated, their membrane will have spontaneously depolarized to a less negative value (from -85 mV to –75 mV in the example shown here). This results in partial inactivation of the sodium inward current because of its dependence on the membrane voltage at the onset of depolarization. This will cause a decreased rate of rise of the action potential upstroke (dV/dt max) which, in turn, will result in slowed conduction in that portion of the conducting system. The voltage dependence of the sodium inward current will be discussed further below (see page 3.4.6)

Book traversal links for 3.3.25 (frame 74)

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  • 3.4.0 Aberrant Ventricular Conduction (52)

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  • Introduction to First Edition
  • 1.0.0 Generation of the ECG
  • 2.0.0 The Normal Electrocardiogram
  • 3.0.0 Inter and intra-ventricular Conduction Disturbances
    • 3.0.1 Introduction Continued
    • 3.1.0 Right Bundle Branch Block (RBBB)
    • 3.2.0 Left Bundle Branch Block (LBBB)
    • 3.3.0 Fascicular blocks (frame 29)
      • 3.3.1(30)
      • 3.3.2 (31)
      • 3.3.3 (32)
      • 3.3.4 (33)
      • 3.3.5 (34)
      • 3.3.6
      • 3.3.7 (35)
      • 3.3.8 (36)
      • 3.3.9 (37)
      • 3.3.10 (38)
      • 3.3.11(39)
      • 3.3.12 (40)
      • 3.3.13 (41)
      • 3.3.14 (42)
      • 3.3.15 (new frame)
      • 3.3.16 (43)
      • 3.3.17 (this is now frame 45)
      • 3.3.18 (46)
      • 3.3.19 (47)
      • 3.3.20(48)
      • 3.3.21 (49)
      • 3.3.22(50)
      • 3.3.23 (51)
      • 3.3.24 (frame73)
      • 3.3.25 (frame 74)
    • 3.4.0 Aberrant Ventricular Conduction (52)
    • 3.5.0 Ventricular Pre-excitation (77)
  • 4.0.0 Ventricular Hypertrophy
  • 5.0.0 ELECTROLYTE ABNORMALITIES, DRUG EFFECTS AND THE LONG QT SYNDROMES
  • 6.0.0 Ischemia and Infarction - Introduction (frame i and ii)
  • 7.0.0 Tachycardias- Introduction
  • 8.0.0 The Bradycardias frame i-introduction
  • 9.0.0 The ECG of Heart Murmurs-introduction
  • 10.0.0 The Electrocardiogram in the Emergency Department-Introduction
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