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A 53 year old woman has had mitral and tricuspid valve repair. An ECG is recorded. No P waves are seen before QRS complexes. She has temporary atrial pacemaker leads and a recording is made from these leads (recorded as V1 in the second ECG). Now it is evident that a junctional rhythm is present with retrograde P waves. A very long PQ interval is a differential diagnosis, but less likely.
 
A 53 year old woman has had mitral and tricuspid valve repair. An ECG is recorded. No P waves are seen before QRS complexes. She has temporary atrial pacemaker leads and a recording is made from these leads (recorded as V1 in the second ECG). Now it is evident that a junctional rhythm is present with retrograde P waves. A very long PQ interval is a differential diagnosis, but less likely.
 
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Revision as of 08:52, 6 November 2015

Welcome to ECGpedia,
a free electrocardiography (ECG) tutorial and textbook to which anyone can contribute ,
designed for medical professionals such as cardiac care nurses and physicians.
ECGpedia has received more than 1.700.000 visits from 224 countries.
Also visit our new Textbook of Cardiology.
Jonas de Jong.png

Jonas de Jong, cardiologist at the OLVG, The Netherlands & founder of ECGpedia

The ECG Course

Course.jpg
The ECG Made Easy Tutorial

The systematic approach to ECG interpretation

Primer:

The 7+2 step plan:

  1. Rhythm
  2. Rate
  3. Conduction (PQ,QRS,QT)
  4. Heart Axis
  5. P Wave Morphology
  6. QRS Morphology
  7. ST Morphology

Interpretation:

  1. Compare with previous ECG
  2. Conclusion

Reference Card

YouTube videos

Teaching Files

The ECG Textbook

Book.jpg

Cases and Examples

Cases.jpg
Cases:

Case of the Month

Schermafbeelding 2015-11-06 om 07.49.42.png
Schermafbeelding 2015-11-06 om 07.49.50.png A 53 year old woman has had mitral and tricuspid valve repair. An ECG is recorded. No P waves are seen before QRS complexes. She has temporary atrial pacemaker leads and a recording is made from these leads (recorded as V1 in the second ECG). Now it is evident that a junctional rhythm is present with retrograde P waves. A very long PQ interval is a differential diagnosis, but less likely.

Contributors

Main Authors

  • J.S.S.G. de Jong, MD, PhD, cardiologist electrophysiologist, OLVG, the Netherlands
  • P.G. Postema, MD, PhD, cardiology fellow, AMC, the Netherlands, author
  • Rob Kreuger, illustrator, AMC, the Netherlands

ECGs

  • A.A.M. Wilde, MD PhD, FACC, FESC, FAHA,AMC, The Netherlands
  • W.A. de Voogt, MD PhD, SLAZ, The Netherlands
  • Dr. Alberto Giniger, chief of the Electrophysiology and Arrhythmias Department of the Instituto Cardiovascular de Buenos Aires (ICBA), Argentina.
  • M. Rosengarten, BEng, MD, McGill University, Canada

R.B.A. van den Brink, MD PhD, AMC, The Netherlands; Vincent de Rover, RN, AMC, The Netherlands; R.W. Koster, MD PhD, AMC, The Netherlands; K.J. Rooyaards, MD, OLVG, the Netherlands; L.R.C. Dekker, MD PhD, M. Meuwissen, MD, PhD; I.A. Khan, MD; M.L.J.M. van de Wetering, MD; D. Kuys; K. Arkenbout, MD, PhD

Corrections, additions and other contributions

I.A.C. van der Bilt, MD; T.T. Keller, MD, PhD, Bart Duineveld, Abdelghani Bouhiouf, Sabriena Henderson, Amon Heijne, A.O. Verkerk; A.C.G. van Ginneken, K.H.W.J. Ten Tusscher, K. Goldin, MD, S. Rijkenberg, J. van der Hoek, Sebastiaan H. Hols.

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