Strategies For Ecg Arrhythmia Diagnosis

The ECG remains the cornerstone of arrhythmia diagnosis, even after an explosion of technology and rapid expansion of our understanding of arrhythmia mechanisms. While many traditional textbooks emphasize cataloguing arrhythmias and pattern recognition, this book by internationally recognized professor George J. Klein, MD, presents a universally applicable systematic approach to ECG arrhythmia diagnosis based on careful measurement and identification of key events and exploring their expected electrophysiological underpinnings. There is fundamentally no difference in the principles and strategies behind understanding the ECG and intracardiac tracings—both are absolutely complementary. Over 90 case studies with tracings in full landscape format are used to highlight important principles, with each case providing an important diagnostic “tip” or teaching point.A multiple-choice question is provided with each tracing not only to “frame the problem” for the reader but to provide some practice and strategies for answering cardiology board examination-type questions.An important book that paves the way to understanding ECGs when preparing for board or certification exams. The book is meant for serious students of arrhythmias, be they cardiology or electrophysiology trainees or established physicians.

From master teacher George J. Klein, MD, this stepwise book is for those with a working knowledge of electrophysiology who have looked at a complicated ECG or intracardiac tracing and drawn a blank, not recognizing a pattern from their personal experience, and without a good idea of how to proceed or venturing a guess with variable confidence. Dr. Klein presents strategies that he has found useful, not just by providing an “answer,” but also exploring how he solved the problem with a systematic approach using “tools” of analysis that applies to both ECGs and EGM tracings.

One of the most time-consuming tasks in clinical medicine is seeking the opinions of specialist colleagues. There is a pressure not only to make referrals appropriate but also to summarize the case in the language of the specialist. This book explains basic physiologic and pathophysiologic mechanisms of cardiovascular disease in a straightforward manner, gives guidelines as to when referral is appropriate, and, uniquely, explains what the specialist is likely to do. It is ideal for any hospital doctor, generalist, or even senior medical student who may need a cardiology opinion, or for that ma.

Because arrhythmias can present in so many different forms, the only way to be certain of an interpretation is to understand the underlying ECG mechanism of arrhythmia. This is especially important in choosing a management strategy, as similar arrhythmias of differing origin may have vastly different therapies/treatments. Unfortunately, standard teaching methods can seem to divorce the theoretical knowledge required for diagnosis from the hands-on reading of ECGs. To achieve a balance of practicality and competency, the two parts of this book are equally divided between concrete example and didactic theory. Section I provides multiple ECG readings of the most commonly encountered simple and complex arrhythmias, and includes differential diagnosis where appropriate. These readings are presented with a minimum of theory, and are repetitively presented in multiple permutations, as they would be encountered in ECG reading room or on the wards. Section II provides a more in-depth discussion of ECG mechanisms and arrhythmogenesis. Attention is focused on the relevant underlying electrophysiology and the deductive processes used to reach the diagnoses of complex arrhythmias. This book can serve as a quick and handy reference for systematic, rule-based arrhythmic diagnoses, as well as an authoritative teaching text for learning the underlying theory and mechanics. It will be of great interest to students and clinicians at all levels, including cardiologists, electrophysiologists, and others who care for patients with cardiovascular disease, ICU and ER staff, emergency physicians, anesthesiologists, and surgeons.

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