ЭКГ при нарушениях ритма и проводимости

КубГМУ МЗ России

to 140
in 1 min while maintaining the correct sinus rhythm.
The

main ECG signs:
1. The P wave in all cycles precedes the QRS complex,
its form is constant in each assignment.
2. The duration of the P-Q (R) interval is the same during all complexes.
3. Interval R-R (respectively intervals R-R)
shortened due to shortening of diastole (interval T-
R).
4. Displacement of the R (S) -T segment downward from isoelectric line (with a pronounced tachycardia).

60 in 1 min.
(50-40) while maintaining sinus rhythm.
The main ECG

signs:
1. The P wave in all cycles precedes the QRS complex
its form is constant in each assignment.
2. The duration of the P-Q (R) interval is the same during all complexes.
3. R-R intervals (correspondingly R-R intervals)
lengthened due to the diastolic interval T-P.
4. Slight rise of the R (S) -T segment over
isoelectric line (with a pronounced bradycardia).

rate with
periods of its slowdown. Distinguish between respiratory and non

associated with breathing. With respiratory sinus
arrhythmias there is an increase in cardiac activity on
inhalation and slowing down on exhalation (physiological phenomenon).
The main ECG signs:
1. The P wave in all cardiac cycles precedes complex QRS, its form is constant in each lead.
2. The duration of the interval P-Q (R) is the same in all complexes.
3. Different intervals R-R (P-P), and this the difference is greater than 10% of the average R-R distance (R-R), usually about 12-0.15 C and more.

extrasystole to the beginning of the next one
the atrioventricular complex

is called compensatory pause.
If the pre- and post-extrasystolic intervals in the amount
are equal to the durations of two normal periods R—
R, the compensatory pause is considered complete if less
incomplete.

the atria of the AV node.
The main ECG signs:
1. Premature

contraction
2. The presence of a P wave in front of a QRS complex other than sinus.
A) P positive - extra-atrial extrasystole.
B) P negative - lower atrial extrasystole.
B) P negative immediately precedes QRS,
not defined, follows it - extrasystole from AB connections.
3. The QRS complex of the supraventricular extrasystole is usually not changed, differs little from that of sinus
reduction.
4. Incomplete compensatory pause.

parts of the conducting system ventricles.
The main ECG signs:
Premature contraction
1.

Absence of the P wave in the extrasystolic complex.
2. Significant expansion (more about, 1 s) and deformation
ventricular complex (splitting, bifurcation teeth, serration, large amplitude compared to normal complexes).
3. Discordant displacement of the R (S) -T segment and the T wave (asymmetrical two-phase or negative) on in relation to the main tooth of the QRS complex.
4. Usually full compensatory pausе.

beats: from the left ventricle, from
right ventricle, from the base

of the ventricles and apex
heart, and most accurately on the chest leads.
With left ventricular extrasystole in V1, V2, as well as III
aVF derivations QRS complex of extrasystoles is presented
the main R wave, and in leads V5, V6, I and aVL - a wave
S.
With right ventricular extrasystole, on the contrary: in
leads V1, V2, III, a VF QRS complex is directed downward, and
in V5, V6, I, aVL - up.
With basal (from the base of the ventricles) extrasystole
high and wide R wave is recorded in the leads
V1-V6.

increased heart rate contractions from 140-160 to 250-260 in 1

min while maintaining correct rhythm. Distinguish between atrial, atrioventricular (from the AV junction) and ventricular form.
The main ECG signs of supraventricular paroxysmal tachycardia:
1. Altered (reduced, deformed, biphasic or negative) P wave in front of complex QRS or its absence.
2. Usually, normal, unchanged QRS complexes.
2. Possible lengthening of the interval P-Q (R) or loss
individual QRS complexes (development atrioventricular block I or I degree).

are absent.
3. QRS-complexes are wide and irregular.

R - R
3. Наличие на протяжении всего сердечного цикла беспорядочных,

различных по величине, форме и продолжительности предсердных волн (f-волн), которые лучше регистрируются в III, и часто II, aVF, V1 V2 отведениях.
4. Разная амплитудазубцов R.

P-waves per min, QRS-frequency of 150-180 bpm, f-waves



2. Atrial

flutter atrial frequency is about 300 bpm, sawtooth-like P-waves

2. The heart does not pump blood.
3. It leads

to unconsciousness within 5 seconds.
4. The trigger is anoxia.

from the atria to the AV-node. Three degrees of AV

block are known.
2. 1st degree AV block: PQ - above 0.2 s

are not followed by QRS-complexes
2. Mobitz type I -

PQ-interval is increased progressively until a P-wave is not followed by a QRS-complex. (Wenchebach block).
3. Mobitz type II block - the ventricles drop some beats

total block of the conduction between the SN and the

ventricles.
2. Atriums are regulated by SA node, ventricles by AV node

P

P

P

P

P

P

P

P

p

трепетанием предсердий.
Основные ЭКГ-признаки:
1. Отсутствие зубца Р перед комплексами QRS и

наличие между ними волн фибрилляции (f) или трепетания (F) предсердий.
2. Уширенные, деформированные комплексы QRS.
3. Одинаковой продолжительности интервалы R-R.

branch block:
1. Cleavage of the QRS complex in lead V1

like rSr or rSR '.
2. Broadened (up to o, 11-o, 12s) or normal duration of the QRS complex
3.Increase in the activation time of the right ventricle in lead V1 more than o, o3 from.
4. Absence of typical widening and deepening of the S wave in V6 and I standard leads.
Main ECG signs of complete right bundle branch block:
1. A split, M-shaped QRS complex of the rSR ', rsR', RSR 'or RsR '(and R'> R) in V1 V2 sometimes II and aVF leads.
2. Broadened (up to about, 12 s and more) QRS complex, as well as an increase in time internal deviation (activation of the right ventricle) in V1 V2 leads more about, about7 - 0.08 s.
3- Discordant downward displacement of the R (S) -T segment and the T wave (asymmetric biphasic or negative) in relation to the main tooth of the complex QRS in V1 sometimes V2 III and aVF leads.
4. Wide (more about, 04 s), deep and often serrated S wave in V6, V5, I, aVL
and sometimes II leads.

блокады обеих ветвей левой ножки пучка Гиса:
1. Широкий (более

0,12 с), разнообразной формы, часто расщепленный комплекс QRS, обычно представленный одним зубцом R в Vs, V6, I, aVL отведениях.
2. Увеличение времени внутреннего отклонения (активации левого желудочка) более 0,08 с в V5, V6 отведениях.
3. Дискордантное смещение вниз сегмента R(S)-T и зубца Т (асимметричного двухфазного или отрицательного) по отношению к основному зубцу комплекса QRS в V5, V6, I и aVL отведениях.
4. Уширенный зубец S (или QS) в V1, V2 отведениях.

Выраженное отклонение ЭОС влево (угол альфа превышает -30°). В I

и aVL отведениях комплекс QRS типа qR, а во II, III и aVF отведениях — типа rS.
2. Увеличение амплитуды зубца S в V5, V6 отведениях.
3. Нормальный или несколько уширенный (до 0,10-0,11 с) комплекс QRS.

Выраженное отклонение ЭОС вправо (угол альфа превышает +120°). В I

и aVL отведениях комплекс QRS типа rs, а в III, aVF, иногда II отведениях — типа qR.
Нормальный или несколько уширенный (до 0,10-0,11 с) комплекс QRS.

carrying out of excitatory
pulse along the main conductive system and

additional conductive paths bypassing the AV node. With Wolff-Parkinson-White syndrome (WPW) the impulse is conducted to the ventricles by additional abnormal beams Kent, with shortened P-Q (R) interval syndrome atypical WPW syndrome, Clerk-Levi-Cristesco syndrome, or Launa-
Ganong-Levin). - on a beam of James
Main ECG signs of shortened P-Q (R) interval syndrome:
1. Shortening (less than about 12 s) of the P-Q (R) interval.
2. Normal (no delta waves and undeformed) QRS complexes.

Наличие дельта-волны на восходящем или нисходящем колене комплекса QRS.
3. Уширение

(более 0,11 с) и небольшая деформация комплекса QRS.
4. Дискордантное смещение сегмента R(S)-T и зубца Т (асимметричного двухфазного или отрицательного) по отношению к основному зубцу комплекса QRS (непостоянные признаки).