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Understanding the Electrocardiogram

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  2. Understanding the Electrocardiogram In Health & Disease
  3. 7.0.0 Tachycardias- Introduction

7.4.0 Wide Complex Beats and Rhythms (frame 122)

The QRS complexes in atrial fibrillation, and in the other supraventricular arrhythmias, are usually of normal shape and duration because the impulses arise in the atria and travel normally through the AV junction and the ventricular conducting system to activate the ventricles. For this reason, they are referred to as “narrow (QRS) complex beats and rhythms”. However, when there is an intraventricular conduction disturbance, as exemplified by preexisting bundle branch or fascicular blocks, aberrant ventricular conduction or ventricular pre-excitation, or when the impulses arise in the ventricles, the QRS complexes will be prolonged and of abnormal morphology. These are referred to as “wide (QRS) complex beats and rhythms".

The ECG shown here is from a 70 year old female with atrial fibrillation and wide QRS complexes due to left bundle branch block. The diagnosis is reasonably straightforward because of the irregularly irregular rhythm, the easily recognized fibrillatory waves and the characteristic left bundle branch block morphology of the QRS complexes.

  • 7.4.1 (123)
  • 7.4.2 (124)
  • 7.4.3 (125)
  • 7.4.4 (126)
  • 7.4.5 (127)
  • 7.4.6 (128)
  • 7.4.7 (129)
  • 7.4.8 (130)
  • 7.4.9 (131)
  • 7.4.10 (frame 132)
  • 7.4.20 (frame 142)
  • 7.4.30 (frame 154)
  • 7.4.40 (frame 163)

Book traversal links for 7.4.0 Wide Complex Beats and Rhythms (frame 122)

  • 7.3.28 (121)
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  • 7.4.1 (123)

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Book navigation

  • 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
  • 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
    • 7.1.0 Mechanisms of arrhythmias-frame 1
    • 7.2.0 Narrow Complex Rhythms (frame 38)
    • 7.3.0 Atrial Flutter and Fibrillation (frame 93)
    • 7.4.0 Wide Complex Beats and Rhythms (frame 122)
      • 7.4.1 (123)
      • 7.4.2 (124)
      • 7.4.3 (125)
      • 7.4.4 (126)
      • 7.4.5 (127)
      • 7.4.6 (128)
      • 7.4.7 (129)
      • 7.4.8 (130)
      • 7.4.9 (131)
      • 7.4.10 (frame 132)
      • 7.4.20 (frame 142)
      • 7.4.30 (frame 154)
      • 7.4.40 (frame 163)
  • 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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